Quality of Life Research

, Volume 28, Issue 3, pp 815–827 | Cite as

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

  • Evan Tang
  • Oladapo Ekundayo
  • John Devin Peipert
  • Nathaniel Edwards
  • Aarushi Bansal
  • Candice Richardson
  • Susan J. Bartlett
  • Doris Howell
  • Madeline Li
  • David Cella
  • Marta Novak
  • Istvan MucsiEmail author



The Patient-Reported Outcomes Measurement Information System (PROMIS) aims to address the lack of generalizable and universal measure of patient-reported outcomes to assess health-related quality of life. It has not been validated for patients with chronic kidney disease. We aim to validate the PROMIS-57 and PROMIS-29 questionnaires among kidney transplant recipients.


A cross-sectional sample of stable kidney transplant recipients was recruited. Each participant completed PROMIS-57, a 57-question instrument covering seven domains—physical function, anxiety, depression, fatigue, pain, sleep disturbance, and social functioning—alongside validated legacy questionnaires [Patient Health Questionnaire (PHQ9), General Anxiety Disorder (GAD7), Edmonton Symptom Assessment Scale revised (ESASr), and Kidney Disease Quality of Life (KDQoL-36)]. PROMIS-29, a 29-question instrument, is nested within PROMIS-57 and measures the same domains. Structural validity of PROMIS was assessed with confirmatory factor analysis, reported using the Comparative Fit Index (CFI). Construct validity was assessed with known-groups comparisons. Internal consistency was evaluated with Cronbach’s α and convergent validity was assessed with Spearman’s Rho. Test–retest reliability was assessed through the intraclass correlation coefficient (ICC).


Mean (± SD) age of the 177 participants was 50 (± 17), 57% were male and 55% Caucasian. Internal consistency of each domain was high (Cronbach’s α > 0.88). Confirmatory factor analysis showed good structural validity for most domains (CFI > 0.95, RMSEA < 0.05). Test–retest reliability indicated good agreement (ICC > 0.6). Known-groups comparisons by clinical and socio-demographic differences were found as hypothesized.


Our results provide evidence that PROMIS-57 and PROMIS-29 are highly reliable and valid instruments among kidney transplant recipients. We propose it as a valuable tool to assess important domains of the illness experience.


PROMIS PROMIS-57 PROMIS-29 Kidney transplant Renal transplant Patient-reported outcomes Validation study 


Compliance with ethical standards

Conflict of interest

The author(s) have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

Ethical approval for this study was obtained from the University Health Network (REB# 15-9645). All study procedures were conducted in accordance with the standards of the University Health Network research ethics board and with the 1964 Helsinki declaration and its later amendments.

Informed consent

All participants signed a written informed consent form.


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Authors and Affiliations

  • Evan Tang
    • 1
  • Oladapo Ekundayo
    • 1
  • John Devin Peipert
    • 2
  • Nathaniel Edwards
    • 1
  • Aarushi Bansal
    • 1
  • Candice Richardson
    • 1
  • Susan J. Bartlett
    • 3
  • Doris Howell
    • 4
  • Madeline Li
    • 5
  • David Cella
    • 2
  • Marta Novak
    • 1
    • 6
  • Istvan Mucsi
    • 1
    • 7
    Email author
  1. 1.Division of Nephrology, Multi-Organ Transplant ProgramUniversity Health Network and University of TorontoTorontoCanada
  2. 2.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Center for Health Outcomes ResearchMcGill UniversityMontrealCanada
  4. 4.Princess Margaret Cancer Center, Faculty of NursingUniversity of TorontoTorontoCanada
  5. 5.Psychosocial OncologyPrincess Margaret Cancer CentreTorontoCanada
  6. 6.Centre for Mental HealthUniversity Health NetworkTorontoCanada
  7. 7.Multi-Organ Transplant Unit, Toronto General HospitalUniversity Health NetworkTorontoCanada

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