Validation of the Patient-Reported Outcomes Measurement Information System (PROMIS)-57 and -29 item short forms among kidney transplant recipients

Tang, Evan; Ekundayo, Oladapo; Peipert, John Devin; Edwards, Nathaniel; Bansal, Aditya; Richardson, Clifford; Bartlett, Susan J.; Howell, Doris; Li, Madeline; Cella, David; Novák, Márta; Mucsi, István

doi:10.1007/s11136-018-2058-2

Cited by 68 publications

(71 citation statements)

References 84 publications

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“…In that model, ESASr is used for initial symptom screening with a low threshold to trigger subsequent screening for depression or anxiety using more specific but still brief questionnaires. Potentially, combining ESASr with computer adaptive testing administration of the Patient Reported Outcomes Measurement Information System (PROMIS) item banks for depression, anxiety, fatigue, sleep disturbances may increase specificity of the assessment in clinical practice [46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Could symptom burden predict subsequent healthcare use in patients with end stage kidney disease on hemodialysis care? A prospective, preliminary study

Zhang

El-Majzoub

et al. 2020

Renal Failure

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Context: Patients treated with maintenance hemodialysis experience significant symptom burden resulting in impaired quality of life. However, the association of patient reported symptom burden and the risk of healthcare use for patients with end stage kidney disease on hemodialysis has not been fully explored. Objectives: To investigate if higher symptom burden, assessed by the Edmonton Symptom Assessment System-revised (ESASr), is associated with increased healthcare use in patients with end stage kidney disease on hemodialysis. Methods: Prospective, single-center, study of adult patients on HD. Participants completed the ESASr questionnaire at enrollment. Baseline demographic, clinical information as well as healthcare use events during the 12-month following enrollment were extracted from medical records. The association between symptom burden and healthcare use was examined with a multivariable adjusted negative binomial model. Results: Mean (SD) age of the 80 participants was 71 (13) years, 56% diabetic, and 70% male. The median (IQR) dialysis vintage was 2 (1-4) years. In multivariable adjusted models, higher global [incident rate ratio (IRR) 1.02, 95% confidence interval (CI) 1.00-1.04, p ¼ .025] and physical symptom burden score [IRR 1.03, CI 1.00-1.05, p ¼ .034], but not emotional symptom burden score [IRR 1.05, CI 1.00-1.10, p ¼ .052] predicted higher subsequent healthcare use. Conclusions: Our preliminary evidence suggests that higher symptom burden, assessed by ESASr may predict higher risk of healthcare use amongst patients with end stage kidney disease on hemodialysis. Future studies need to confirm the findings of this preliminary study and to assess the utility of ESASr for systematic symptom screening.

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Section: Discussionmentioning

confidence: 99%

Could symptom burden predict subsequent healthcare use in patients with end stage kidney disease on hemodialysis care? A prospective, preliminary study

Zhang

El-Majzoub

et al. 2020

Renal Failure

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“…In addition, the tools have been recommended for the screening of depression or anxiety by the American Society of Clinical Oncology , the Canadian Association of Psychosocial Oncology , and the BC Renal Agency . As with the KDQOL‐36, the PHQ‐9 and GAD‐7 were used as legacy measures for the validation of PROMIS‐57 and PROMIS‐29 questionnaires among KTR .…”

Section: Methodsmentioning

confidence: 99%

“…Physical and emotional symptoms are frequently unrecognized by healthcare professionals and remain unmanaged, potentially impacting clinical outcomes . Patient‐reported outcome measures (PROMs) capture patients’ perception of symptom burden and severity . Their use may improve communication between patients and providers and may lead to better symptom management, patient satisfaction, HRQOL, and survival .…”

Section: Introductionmentioning

confidence: 99%

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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Summary We assessed the validity of the Edmonton Symptom Assessment System (ESAS‐r) in kidney transplant recipients (KTR). A cross‐sectional sample of 252 KTR was recruited. Individual ESAS‐r symptom scores and symptom domain scores were evaluated. Internal consistency, convergent validity, and construct validity were assessed with Cronbach’s α, Spearman’s rank correlations, and a priori‐defined risk group comparisons. Mean (SD) age was 51 (16), 58% were male, and 58% Caucasian. ESAS‐r Physical, Emotional, and Global Symptom Scores demonstrated good internal consistency (α > 0.8 for all). ESAS‐r Physical and Global Symptom Scores strongly correlated with PHQ‐9 scores (0.72, 95% CI: 0.64–0.78 and 0.74, 95% CI: 0.67–0.80). For a priori‐defined risk groups, individual ESAS‐r symptom score differed between groups with lower versus higher eGFR [pain: 1 (0–3) vs. 0 (0–2), delta = 0.18; tiredness: 3 (1–5) vs. 1.5 (0–4), delta = 0.21] and lower versus higher hemoglobin [tiredness: 3 (1–6) vs. 2 (0–4), delta = 0.27]. ESAS‐r Global and Physical Symptom Scores differed between groups with lower versus higher hemoglobin [13 (6–29) vs. 6.5 (0–18.5), delta = 0.3, and 9 (2–19) vs. 4 (0–13), delta = 0.24] and lower versus higher eGFR [11 (4–20) vs. 6.5 (2–13), delta = 0.21, and 7 (2–16) vs. 3 (0–9), delta = 0.26]. These data support reliability and construct validity of ESAS‐r in KTR. Future studies should explore its clinical utility for symptom assessment among KTR.

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“…The most commonly used psychiatric screening tools are however time-consuming and difficult for patients to complete [21][22][23][24][25][26][27]. A pragmatic patient-centred symptom assessment tool with visual analogue scale, the Edmonton Symptom Assessment System (ESAS), has been validated in dialysis patients [28] and, recently, in a single kidney-transplant cohort [29][30][31]. ESAS scores varies with the burden and the effects of disease and is correlated with all domains of health-related quality of life in dialysis patients.…”

Section: Introductionmentioning

confidence: 99%

Screening Performance of Edmonton Symptom Assessment System in Kidney Transplant Recipients

Battaglia

Zerbinati

Piazza

et al. 2020

JCM

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An average prevalence of 35% for psychiatric comorbidity has been reported in kidney transplant recipients (KTRs) and an even higher prevalence of other psychosocial syndromes, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), has also been found in this population. Consequently, an easy, simple, rapid psychiatric tool is needed to measure physical and psychological symptoms of distress in KTRs. Recently, the Edmonton Symptom Assessment System (ESAS), a pragmatic patient-centred symptom assessment tool, was validated in a single cohort of KTRs. The aims of this study were: to test the screening performances of ESAS for the International Classification of Diseases-10th Revision (ICD-10) psychiatric diagnoses in KTRs; to investigate the optimal cut-off points for ESAS physical, psychological and global subscales in detecting ICD-10 psychiatric diagnoses; and to compare ESAS scores among KTR with ICD-10 diagnosis and DCPR diagnosis. 134 KTRs were evaluated and administered the MINI International Neuropsychiatric Interview 6.0 and the DCPR Interview. The ESAS and Canadian Problem Checklist (CPC) were given as self-report instruments to be filled in and were used to examine the severity of physical and psychological symptoms and daily-life problems. The physical distress sub-score (ESAS-PHYS), psychological distress sub-score (ESAS-PSY) and global distress score (ESAS-TOT) were obtained by summing up scores of six physical symptoms, four psychological symptoms and all single ESAS symptoms, respectively. Routine biochemistry, immunosuppressive agents, socio-demographic and clinical data were collected. Receiving Operating Characteristic (ROC) analysis was used to examine the ability of the ESAS emotional distress (DT) item, ESAS-TOT, ESAS-PSY and ESAS-PHYS, to detect psychiatric cases defined by using MINI6.0. The area under the ROC curve for ESAS-TOT, ESAS-PHYS, ESAS-PSY and DT item were 0.85, 0.73, 0.89, and 0.77, respectively. The DT item, ESAS-TOT and ESAS-PSY optimal cut-off points were ≥4 (sensitivity 0.74, specificity 0.73), ≥20 (sensitivity 0.85, specificity 0.74) and ≥12 (sensitivity 0.85, specificity 0.80), respectively. No valid ESAS-PHYS cut-off was found (sensitivity <0.7, specificity <0.7). Thirty-nine (84.8%) KTRs with ICD-10 diagnosis did exceed both ESAS-TOT and ESAS-PSY cut-offs. Higher scores on the ESAS symptoms (except shortness of breath and lack of appetite) and on the CPC problems were found for ICD-10 cases and DCRP cases than for ICD-10 no-cases and DCPR no-cases. This study shows that ESAS had an optimal screening performance (84.8%) to identify ICD-10 psychiatric diagnosis, evaluated with MINI; furthermore, ESAS-TOT and ESAS-PSY cut-off points could provide a guide for clinical symptom management in KTRs.

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Validation of the Patient-Reported Outcomes Measurement Information System (PROMIS)-57 and -29 item short forms among kidney transplant recipients

Cited by 68 publications

References 84 publications

Could symptom burden predict subsequent healthcare use in patients with end stage kidney disease on hemodialysis care? A prospective, preliminary study

Could symptom burden predict subsequent healthcare use in patients with end stage kidney disease on hemodialysis care? A prospective, preliminary study

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

Screening Performance of Edmonton Symptom Assessment System in Kidney Transplant Recipients

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