Using item response theory to enrich and expand the PROMIS® pediatric self report banks.

Hally Quinn,Darren A Dewalt,Heather E Gross,Dagmar Amtmann,Jin-Shei Lai,Brooke Magnus,James W Varni,Yang Liu,David Thissen

doi:10.1186/s12955-014-0160-x

Abstract

BackgroundThe primary objective was to enhance the content coverage of some of the pediatric self-report item banks for ages 8–17 years from the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®), and extend the range of precise measurement to higher levels of physical functioning.MethodsData from 1,419 pediatric patients with cancer, chronic kidney disease, obesity, rehabilitation needs, rheumatic disease, and sickle cell disease were combined with item responses from the original standardization sample of 3,048 children to calibrate new items for the pediatric PROMIS Anger, Anxiety, Depressive Symptoms, Pain Interference, Fatigue, and physical functioning Upper Extremity and Mobility scales. Simultaneous or concurrent calibration using the graded item response theory model placed all of the items on the same scale.ResultsTwenty-two of 28 potential new items were added across the seven scales. A recommended short form was proposed for the Anger scale, and the recommended short forms for the Anxiety and Depressive Symptoms scales were revised. Unfortunately, we were not particularly successful at extending the range of measurement for the physical functioning banks.ConclusionsThe present study expanded PROMIS pediatric item banks to add new content and to increase the range of measurement. Using item response theory, the banks were revised and expanded without changing the underlying scale of measurement. For Anger, Anxiety, and Depressive Symptoms, we successfully added new content that may render those banks more robust and flexible.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-014-0160-x) contains supplementary material, which is available to authorized users.

Highlights

The primary objective was to enhance the content coverage of some of the pediatric self-report item banks for ages 8–17 years from the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®), and extend the range of precise measurement to higher levels of physical functioning
Anxiety The LD X2 statistics computed in the course of concurrent unidimensional calibration of the five new items with the existing 15-item Anxiety item pool suggested local dependence for six pairs of items, three of which involved the new items and three were pairs of items in the existing pool (LD X2 values range 6.1 - 19.9)
Pain interference LD X2 statistics computed in the course of concurrent unidimensional calibration of the seven new items with the existing 13-item Pain Interference item pool suggested local dependence among some of the existing items, with values from 6.7 to 13 and one pair that involved a new item

Summary

Introduction

The primary objective was to enhance the content coverage of some of the pediatric self-report item banks for ages 8–17 years from the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®), and extend the range of precise measurement to higher levels of physical functioning. The PROMIS Pediatric Working Group created self-report item banks for ages 8–17 years across five general health domains (emotional health, pain, fatigue, physical function, and social health), consistent with the larger PROMIS network [2]. While that is appropriate for many uses of the scales in health outcomes research, we wanted to add items that might extend the range of precise measurement to higher levels of physical functioning

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Discussion

Conclusion