Comparison of Patient‐Reported Outcomes Measurement Information System Computerized Adaptive Testing Versus Fixed Short Forms in Juvenile Myositis

Abstract

Objective Patient‐Reported Outcomes Measurement Information System (PROMIS) measures can be administered via computerized adaptive testing (CAT) or fixed short forms (FSFs), but the empirical benefits of CAT versus FSFs are unknown in juvenile myositis (JM). The present study was undertaken to assess whether PROMIS CAT is feasible, precise, correlated with FSFs, and less prone to respondent burden and floor/ceiling effects than FSFs in JM. Methods Patients 8–17 years of age (self‐report and parent proxy) and parents of patients 5–7 years of age (only parent proxy) completed PROMIS fatigue, pain interference, upper extremity function, mobility, anxiety, and depressive symptoms measures. Pearson correlations, paired t‐tests, and Cohen's d were calculated between PROMIS CAT and FSFs. McNemar's test assessed floor/ceiling effects between CAT and FSFs. Precision and respondent burden were examined across the T score range. Results Data from 67 patient–parent dyads were analyzed. CAT and FSF mean scores did not significantly differ except in parent proxy anxiety and fatigue (effect size 0.23 and 0.19, respectively). CAT had less pronounced floor/ceiling effects at the less symptomatic extreme in all domains except self‐report anxiety. Increased item burden and higher SEs were seen in less symptomatic scorers for CAT. Modified stopping rules limiting CAT item administration did not decrease precision. Conclusion PROMIS CAT appears to be feasible and correlated with FSFs. CAT had less pronounced floor/ceiling effects, allowing detection of individual differences in less symptomatic patients. Modified stopping rules for CAT may decrease respondent burden. CAT can be considered for long‐term follow‐up of JM patients.

Computerized-adaptive testing versus short forms for pediatric inflammatory bowel disease patient-reported outcome assessment

“…The CAT and SF instruments have been previously evaluated in the PROMIS Pediatric measures, but in a different cohort of 67 pediatric patients with juvenile myositis. 29 The present study confirms many of this study's findings and offers additional key insights. As in our study, Patel et al found that the CAT and SF had similar scores and correlated highly, and that the CAT had fewer floor effects than the SF.…”

“…Patel et al recommended a follow-up study such as ours to better optimize stopping rules. 29 We showed that CAT offers improvement in floor effects and precision over the SF even with a stopping rule at six questions, which carries the added benefit of minimizing respondent burden.…”

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“…68,69 The fixed short form had the strongest evidence of the four versions with 'very low' quality internal consistency, 77 'low' quality reliability, 71,74,77,86,87 and 'low' quality construct validity. 71,73,77,86,87…”

Improvement in Disease Activity in Refractory Juvenile Dermatomyositis Following Abatacept Therapy

“…Physician Global Damage VAS and Myositis Damage Index scores were obtained at baseline and week 24 (11). Health-related quality of life was parent-assessed at each visit using the Child Health Questionnaire 50-item parent form (CHQ-PF50), the Dermatology Life Quality Index (DLQI), and the Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue scale (18,19). Safety analysis.…”