Responsiveness to Change in PROMIS® Measures among Children with Asthma: A Report from the PROMIS® Pediatric Asthma Study

Abstract

Objective This study aimed to compare the responsiveness to change of the Patient-Reported Outcomes Measurement Information System (PROMIS®) asthma impact and generic scales to a legacy scale, the Paediatric Asthma Quality of Life Questionnaire (PAQLQ). Methods 229 child-parent dyads in public insurance programs were enrolled. PROMIS Pediatric Short Forms and the PAQLQ were used to measure health-related quality of life (HRQoL) across 4 time points (T1 to T4) over 2 years; the Asthma Control and Communication Instrument was used to measure change of asthma control; Global Rating of Change (GRC) for breathing problems and overall health were used to measure change of health status. Responsiveness was tested by comparing the changes of HRQoL with change of asthma control and health status over time using t-tests, generalized estimating equation, and relative validity approaches. Results The PROMIS asthma impact scale (p<0.05) and all PAQLQ scales (p’s<0.05) exhibited significant responsiveness when anchored to asthma control and health status. Several PROMIS generic scales (pain, fatigue, and mobility) also indicated adequate responsiveness. Conclusion The PROMIS asthma impact scale indicated similar responsiveness to the PAQLQ. Due to its brevity and responsiveness, the PROMIS asthma impact scale is useful for clinical practice or research.

Impaired Patient-Reported Outcomes Predict Poor School Functioning and Daytime Sleepiness: The PROMIS Pediatric Asthma Study

“…PROMIS PAS is a retrospective cohort study initially designed to evaluate responsiveness of the PROMIS Pediatric measures. 8 Between 2010 and 2011, a sample of 238 children was recruited from public insurance programs, the Florida Medicaid and State Children’s Health Insurance Program (SCHIP). To be eligible, participants were between ages 8 and 17.9; had an asthma diagnosis (ICD-9-CM 493.1, 493.2, or 493.x); had at least two medical events caused by asthma in the last year; and had uninterrupted enrollment in the Florida Medicaid or SCHIP for the previous six months.…”

“…8, 9 The PROMIS PAS collected data from children with asthma via telephone interviews over two 13-week time periods. In each period, asthma control was evaluated weekly and PROs were collected from two time points (denoted T1 and T2 in the first period and T3 and T4 in the second period).…”

Association of consistently suboptimal quality of life with consistently poor asthma control in children with asthma

“…3 The effects of impaired HRQoL domains (e.g., fatigue, pain, mobility, and peer relationships) in addition to anxiety and depressive symptoms on subsequent asthma outcomes in pediatric populations has been inadequately studied. This study aimed to test the usefulness of HRQoL assessed by the Patient-Reported Outcomes Measurement Information System ® (PROMIS ® ) Pediatric measures 4,5 collected at baseline and three subsequent time points, with a meaningful threshold (e.g., good or poor HRQoL), to indicate the asthma control status over time among children with asthma from low-income families.…”

“…4 Enrollment criteria for children/adolescents were ages 8-17.9 years; an asthma diagnosis (ICD-9-CM 493.1, 493.2, or 493.x); ≥ two medical encounters due to asthma in the last 12 months; and continuous enrollment in the Florida Medicaid for the previous six months. Asthma control and HRQoL were evaluated at four time points: baseline in the first year, a follow-up in the first year, baseline in the second year, and a follow-up in the second year.…”

“…If all five items indicated well-controlled asthma, a child/adolescent was classified as having good control; otherwise, he/she was classified as poor control. 6 PROMIS Pediatric Short-Forms 4,5 were administered to assess HRQoL, including asthma impact, pain interference, fatigue, depressive symptoms, anxiety, mobility, and peer relationships domains. Domain scores were calculated and converted to a T-metric (mean=50/SD=10).…”