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Comparability of the Patient-Reported Outcomes Measurement Information System Pediatric short form symptom measures across culture: examination between Chinese and American children with cancer

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Abstract

Purpose

Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric forms measure symptoms and function of pediatric patients experiencing chronic disease by using the same measures. Comparability is one of the most important purposes of the PROMIS initiative. This study aimed to test the factorial structures of four symptom measures (i.e., Anxiety, Depression, Fatigue, and Pain Interference) in the original English and the Chinese versions and examine the measurement invariance of the measures across two cultures.

Methods

Four PROMIS Pediatric measures were used to assess symptoms, respectively, in Chinese (n = 232) and American (n = 200) children and adolescents (8–17 years old) in treatment for cancer or in survivorship. The categorical confirmatory factor analysis (CCFA) model was used to examine factorial structures, and multigroup CCFA was applied to test measurement invariance of these measures between the Chinese and American samples.

Results

The CCFA models of the four PROMIS Pediatric symptom measures fit the data well for both the Chinese and American children and adolescents. Minor partial measurement invariance was identified. Factor means and factor variances of the four PROMIS measures were not significantly different between the two populations.

Conclusions

Our results provide evidence that the four PROMIS Pediatric symptom measures have valid factorial structures and a statistical property of measurement invariance across American and Chinese children and adolescents with cancer. This means that the items of these measures were interpreted in a conceptually similar manner by two groups. They could be readily used for meaningful cross-cultural comparisons involving pediatric oncology patients in these two countries.

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Notes

  1. Anxiety, Depression, and Pain all have eight items; thus, each has 32 item thresholds. Fatigue has 10 items and thus has 40 item thresholds.

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Acknowledgments

The Chinese study was supported by the National Natural Science Foundation of China (Project No. 71473262) and the Oncology Nursing Society (ONS) Foundation and China Scholarship Council (No. 201406580007). The America study (PROMIS®) was funded with cooperative agreements from the National Institutes of Health (NIH) Common Fund Initiative (Northwestern University, PI: David Cella, PhD, U54AR057951, U01AR052177; Northwestern University, PI: Richard C. Gershon, PhD, U54AR057943; American Institutes for Research, PI: Susan (San) D. Keller, PhD, U54AR057926; State University of New York, Stony Brook, PIs: Joan E. Broderick, PhD and Arthur A. Stone, PhD, U01AR057948, U01AR052170; University of Washington, Seattle, PIs: Heidi M. Crane, MD, MPH, Paul K. Crane, MD, MPH, and Donald L. Patrick, PhD, U01AR057954; University of Washington, Seattle, PI: Dagmar Amtmann, PhD, U01AR052171; University of North Carolina, Chapel Hill, PI: Harry A. Guess, MD, PhD (deceased), Darren A. DeWalt, MD, MPH, U01AR052181; Children’s Hospital of Philadelphia, PI: Christopher B. Forrest, MD, PhD, U01AR057956; Stanford University, PI: James F. Fries, MD, U01AR052158; Boston University, PIs: Alan Jette, PT, PhD, Stephen M. Haley, PhD (deceased), and David Scott Tulsky, PhD (University of Michigan, Ann Arbor), U01AR057929; University of California, Los Angeles, PIs: Dinesh Khanna, MD (University of Michigan, Ann Arbor) and Brennan Spiegel, MD, MSHS, U01AR057936; University of Pittsburgh, PI: Paul A. Pilkonis, PhD, U01AR052155; Georgetown University, PIs: Carol. M. Moinpour, PhD (Fred Hutchinson Cancer Research Center, Seattle) and Arnold L. Potosky, PhD, U01AR057971; Children’s Hospital Medical Center, Cincinnati, PI: Esi M. Morgan DeWitt, MD, MSCE, U01AR057940; University of Maryland, Baltimore, PI: Lisa M. Shulman, MD, U01AR057967; and Duke University, PI: Kevin P. Weinfurt, PhD, U01AR052186). NIH Science Officers on this project have included Deborah Ader, PhD, Vanessa Ameen, MD (deceased), Susan Czajkowski, PhD, Basil Eldadah, MD, PhD, Lawrence Fine, MD, DrPH, Lawrence Fox, MD, PhD, Lynne Haverkos, MD, MPH, Thomas Hilton, PhD, Laura Lee Johnson, PhD, Michael Kozak, PhD, Peter Lyster, PhD, Donald Mattison, MD, Claudia Moy, PhD, Louis Quatrano, PhD, Bryce Reeve, PhD, William Riley, PhD, Peter Scheidt, MD, Ashley Wilder Smith, PhD, MPH, Susana Serrate-Sztein, MD, William Phillip Tonkins, DrPH, Ellen Werner, PhD, Tisha Wiley, PhD, and James Witter, MD, PhD. The contents of this article use data developed under PROMIS. These contents do not necessarily represent an endorsement by the US Federal Government or PROMIS. See www.nihpromis.org for additional information on the PROMIS® initiative.

Author information

Authors and Affiliations

  1. School of Nursing, Second Military Medical University, 800 Xiang Yin Rd, Shanghai, 200433, China

    Yanyan Liu & Changrong Yuan

  2. Division of Biostatistics and Study Methodology, Center for Translational Science, Children’s National Health System, Washington, DC, USA

    Jichuan Wang

  3. School of Medicine, The George Washington University, Washington, DC, USA

    Jichuan Wang & Pamela S. Hinds

  4. Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA

    Jeanne Geiger Brown

  5. Department of Hematology and Oncology, Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China

    Fen Zhou

  6. Nursing Department, West China Second University Hospital Affiliated to Sichuan University, Sichuan, China

    Xiufang Zhao

  7. Nursing Department, Children’s Hospital of Soochow University, Suzhou, Jiangsu, China

    Min Shen

  8. Department of Nursing Research and Quality Outcomes, Center for Translational Science, Children’s National Health System, Washington, DC, USA

    Pamela S. Hinds

Authors
  1. Yanyan Liu
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  2. Changrong Yuan
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  3. Jichuan Wang
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  4. Jeanne Geiger Brown
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  5. Fen Zhou
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  6. Xiufang Zhao
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  7. Min Shen
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  8. Pamela S. Hinds
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Corresponding author

Correspondence to Changrong Yuan.

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Conflict of interest

The authors have no conflict of interest to disclose.

Ethical approval

All the studies conducted in China and USA have got the ethical approval from the hospitals and institutions. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee.

Informal consent

Informed consent was obtained from all individual participants included in this study.

Appendix

Appendix

It was listed the item stems of the original English version of PROMIS Pediatric (PROMIS Pediatric SF v1.0) Anxiety and Depression, Fatigue, and Pain Interference Symptom Short Forms. All items with 7-day recall period stated as “in the past seven days,” and a 5-point responses with the options never (0), almost never (1), sometimes (2), often (3), and always (4). In the updated PROMIS Pediatric Short Forms (PROMIS Pediatric SF v1.1 versions), the item 3460R1 and 3462R1 in Anxiety and item 3477R1 in Depression were deleted and replaced by new items, and the item 3506R1 in Anger was deleted.

Original English version of PROMIS Pediatric measures

Order

PROMIS item ID

Item stem

Anxiety

 1

2220R2

I felt like something awful might happen

 2

713R1

I felt nervous

 3

227bR1

I felt scared

 4

5044R1

I felt worried

 5

3460R1

I thought about scary things

 6

3462R1

I was afraid that I would make mistakes

 7

231R1

I was worried about what could happen to me

 8

3150bR2

I worried when I went to bed at night

Depression

 1

488R1

I could not stop feeling sad

 2

461R1

I felt alone

 3

5041R1

I felt everything in my life went wrong

 4

5035R1

I felt I could not do anything right

 5

711R1

I felt lonely

 6

228R1

I felt sad

 7

712R1

I felt unhappy

 8

3477R1

I thought that my life was bad

Fatigue

 1

4239aR2

Being tired made it hard for me to keep up with my schoolwork

 2

4212R1

Being tired made it hard for me to play or go out with my friends as much as I’d like

 3

4213R1

I felt weak

 4

2876R1

I got tired easily

 5

4221R1

I had trouble finishing things because I was too tired

 6

4220R1

I had trouble starting things because I was too tired

 7

4210R2

I was so tired it was hard for me to pay attention

 8

4241R2

I was too tired to do sports or exercise

 9

4208bR2

I was too tired to do things outside

 10

4196R1

I was too tired to enjoy the things I like to do

Pain Interference

 1

1698bR1

I felt angry when I had pain

 2

2035R1

I had trouble doing schoolwork when I had pain

 3

3793R1

I had trouble sleeping when I had pain

 4

9004

It was hard for me to pay attention when I had pain

 5

2045R1

It was hard for me to run when I had pain

 6

2049R1

It was hard for me to walk one block when I had pain

 7

1703R1

It was hard to have fun when I had pain

 8

2180R1

It was hard to stay standing when I had pain

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Liu, Y., Yuan, C., Wang, J. et al. Comparability of the Patient-Reported Outcomes Measurement Information System Pediatric short form symptom measures across culture: examination between Chinese and American children with cancer. Qual Life Res 25, 2523–2533 (2016). https://doi.org/10.1007/s11136-016-1312-8

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  • DOI: https://doi.org/10.1007/s11136-016-1312-8

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