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An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales

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Abstract

Purpose

The Patient-Reported Outcomes Measurement Information System (PROMIS) aims to develop self-reported item banks for clinical research. The PROMIS pediatrics (aged 8–17) project focuses on the development of item banks across several health domains (physical function, pain, fatigue, emotional distress, social role relationships, and asthma symptoms). The psychometric properties of the anxiety and depressive symptom item banks are described.

Methods

Participants (n = 1,529) were recruited in public school settings, hospital-based outpatient and subspecialty pediatrics clinics. The anxiety (k = 18) and depressive symptoms (k = 21) items were split between two test administration forms. Hierarchical confirmatory factor-analytic models (CFA) were conducted to evaluate scale dimensionality and local dependence. IRT analyses were then used to finalize item banks and short forms.

Results

CFA results confirmed that anxiety and depressive symptoms are separate constructs and indicative of negative affect. Items with local dependence and DIF were removed resulting in 15 anxiety and 14 depressive symptoms items. The psychometric differences between short forms and simulated computer adaptive tests are presented.

Conclusions

PROMIS pediatric item banks were developed to provide efficient assessment of health-related quality of life domains. This sample provides initial calibrations of anxiety and depressive symptoms item banks and creates PROMIS pediatric instruments, version 1.0.

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Abbreviations

PROMIS:

Patient-reported outcomes measurement information system

PedsQL™:

Pediatric quality of life inventory™

HRQOL:

Health-related quality of life

PRO:

Patient-reported outcomes

CFA:

Confirmatory factor analysis

IRT:

Item response theory

LD:

Local dependence

DIF:

Differential item function

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Author information

Authors and Affiliations

  1. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

    Debra E. Irwin & Karin Yeatts

  2. Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Brian Stucky & David Thissen

  3. National Board of Medical Examiners, Philadelphia, PA, USA

    Michelle M. Langer

  4. Department of Pediatrics, Duke University Medical Center, Durham, NC, USA

    Esi Morgan DeWitt

  5. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Jin-Shei Lai

  6. Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA

    James W. Varni

  7. Division of General Medicine and Clinical Epidemiology, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Darren A. DeWalt

Authors
  1. Debra E. Irwin
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Corresponding author

Correspondence to Debra E. Irwin.

Appendix

Appendix

Listed below are the item stems for the recommended eight-item short forms for the PROMIS Pediatric Anxiety and Depressive Symptoms Scales. All items use a 7-day recall period (the preface is “In the past seven days”), and a 5-point response scale with the options never (0), almost never (1), sometimes (2), often (3) and almost always (4).

  • Anxiety:

  • I felt scared.

  • I worried about what could happen to me.

  • I felt worried.

  • I felt like something awful might happen.

  • I worried when I went to bed at night.

  • I thought about scary things.

  • I felt nervous.

  • I was afraid that I would make mistakes.

  • Depressive symptoms:

  • I felt like I couldn’t do anything right.

  • I felt everything in my life went wrong.

  • I felt unhappy.

  • I felt lonely.

  • I felt sad.

  • I felt alone.

  • I thought that my life was bad.

  • I could not stop feeling sad.

Summed score to scale score translation for these short forms is in Table 7.

Table 7 Summed score to scale score translation table for the recommended short forms
Full size table

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Irwin, D.E., Stucky, B., Langer, M.M. et al. An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales. Qual Life Res 19, 595–607 (2010). https://doi.org/10.1007/s11136-010-9619-3

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