Skip to main content

Advertisement

Log in

Item-level informant discrepancies between children and their parents on the PROMIS® pediatric scales

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Objective

The study objective was to describe the individual item-level discrepancies between children ages 8–17 years and their parents for the PROMIS® pediatric scales. Contextual effects on item-level informant discrepancies for the pediatric pain interference items were further analyzed conditional on whether the child, the parent, or anyone else in the household experienced chronic pain.

Methods

Parallel pediatric self-report and parent proxy-report items were completed by approximately 300 parent–child dyads depending on form assignment and individual nonresponse. Agreement between parent and child responses to individual items was measured using the polychoric correlation coefficient and weighted κ. The Chi-square test of symmetry was utilized for a comparison of the pattern of parent–child item discrepancies on the response scales, and the differences between the child and parent responses on the 1–5 item response scale are summarized .

Results

A continuum of higher item-level parent–child discrepancies was demonstrated starting with peer relationships, anger, anxiety, and depressive symptoms, followed by progressively lower parent–child discrepancies for energy, fatigue, asthma impact, pain interference, upper extremity, and mobility items. Parent–child discrepancies for pain interference items were lower in the context of chronic pain either in the child or in the parent.

Conclusions

Parent–child item-level discrepancies were lower for more objective or visible items than for items measuring internal states or less observable items measuring latent variables such as peer relationships and fatigue. Future research should focus on the child and parent characteristics that influence domain-specific item-level discrepancies, and under what conditions item-level parent–child discrepancies predict child health outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

PROMIS:

Patient-Reported Outcomes Measurement Information System

HRQOL:

Health-related quality of life

PROs:

Patient-reported outcomes

NIH:

National Institutes of Health

IRT:

Item response theory

CAT:

Computerized adaptive testing

References

  1. Ader, D. N. (2007). Developing the Patient-Reported Outcomes Measurement Information System (PROMIS). Medical Care, 45(Suppl 1), S1–S2.

    Article  Google Scholar 

  2. Reeve, B. B., Hays, R. D., Bjorner, J. B., Cook, K. F., Crane, P. K., Teresi, J. A., et al. (2007). Psychometric evaluation and calibration of health-related quality of life item banks: Plans for the patient-report outcomes measurement information system (PROMIS). Medical Care, 45(Suppl 1), S22–S31.

    Article  PubMed  Google Scholar 

  3. Irwin, D. E., Stucky, B. D., Thissen, D., DeWitt, E. M., Lai, J. S., Yeatts, K., et al. (2010). Sampling plan and patient characteristics of the PROMIS pediatrics large-scale survey. Quality of Life Research, 19, 585–594.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Irwin, D. E., Stucky, B. D., Langer, M. M., Thissen, D., DeWitt, E. M., Lai, J. S., et al. (2010). An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales. Quality of Life Research, 19, 595–607.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Varni, J. W., Stucky, B. D., Thissen, D., DeWitt, E. M., Irwin, D. E., Lai, J. S., et al. (2010). PROMIS Pediatric Pain Interference Scale: An item response theory analysis of the pediatric pain item bank. Journal of Pain, 11, 1109–1119.

    Article  PubMed Central  PubMed  Google Scholar 

  6. DeWitt, E. M., Stucky, B. D., Thissen, D., Irwin, D. E., Langer, M., Varni, J. W., et al. (2011). Construction of the eight-item patient-reported outcomes measurement information system pediatric physical function scales: Built using item response theory. Journal of Clinical Epidemiology, 64, 794–804.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Irwin, D. E., Stucky, B. D., Langer, M. M., Thissen, D., DeWitt, E. M., Lai, J. S., et al. (2012). PROMIS Pediatric Anger Scale: An item response theory analysis. Quality of Life Research, 21, 697–706.

    Article  PubMed Central  PubMed  Google Scholar 

  8. DeWalt, D. A., Thissen, D., Stucky, B. D., Langer, M. M., DeWitt, E. M., Irwin, D. E., et al. (2013). PROMIS Pediatric Peer Relationships Scale: Development of a peer relationships item bank as part of social health measurement. Health Psychology, 32, 1093–1103.

    Article  PubMed  Google Scholar 

  9. Lai, J. S., Stucky, B. D., Thissen, D., Varni, J. W., DeWitt, E. M., Irwin, D. E., et al. (2013). Development and psychometric properties of the PROMIS® pediatric fatigue item banks. Quality of Life Research, 22, 2417–2427.

    Article  PubMed  Google Scholar 

  10. Varni, J. W., Magnus, B., Stucky, B. D., Liu, Y., Quinn, H., Thissen, D., et al. (2014). Psychometric properties of the PROMIS® pediatric scales: Precision, stability, and comparison of different scoring and administration options. Quality of Life Research, 23, 1233–1243.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Yeatts, K., Stucky, B. D., Thissen, D., Irwin, D. E., Varni, J. W., DeWitt, E. M., et al. (2010). Construction of the Pediatric Asthma Impact Scale (PAIS) for the Patient-Reported Outcomes Measurement Information System (PROMIS). Journal of Asthma, 47, 295–302.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Thissen, D., Varni, J. W., Stucky, B. D., Liu, Y., Irwin, D. E., & DeWalt, D. A. (2011). Using the PedsQL™ 3.0 Asthma Module to obtain scores comparable with those of the PROMIS Pediatric Asthma Impact Scale (PAIS). Quality of Life Research, 20, 1497–1505.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). How young can children reliably and validly self-report their health-related quality of life? An analysis of 8,591 children across age subgroups with the PedsQL™ 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5(1), 1–13.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). Parent proxy-report of their children’s health-related quality of life: An analysis of 13,878 parents’ reliability and validity across age subgroups using the PedsQL™ 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5(2), 1–10.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Irwin, D. E., Gross, H. E., Stucky, B. D., Thissen, D., DeWitt, E. M., Lai, J. S., et al. (2012). Development of six PROMIS pediatrics parent proxy-report item banks. Health and Quality of Life Outcomes, 10(22), 1–13.

    Google Scholar 

  16. Varni, J. W., Thissen, D., Stucky, B. D., Liu, Y., Gorder, H., Irwin, D. E., et al. (2012). PROMIS® parent proxy report scales: An item response theory analysis of the parent proxy report item banks. Quality of Life Research, 21, 1223–1240.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Varni, J. W., Thissen, D., Stucky, B. D., Liu, Y., Magnus, B., Quinn, H., et al. (2014). PROMIS® parent proxy report scales for children ages 5–7 years: An item response theory analysis of differential item functioning across age groups. Quality of Life Research, 23, 349–361.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Sprangers, M. A. G., & Aaronson, N. K. (1992). The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: A review. Journal of Clinical Epidemiology, 45, 743–760.

    Article  CAS  PubMed  Google Scholar 

  19. Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213–232.

    Article  CAS  PubMed  Google Scholar 

  20. Varni, J. W., Katz, E. R., Colegrove, R., & Dolgin, M. (1995). Adjustment of children with newly diagnosed cancer: Cross-informant variance. Journal of Psychosocial Oncology, 13, 23–38.

    Article  Google Scholar 

  21. De Los Reyes, A. (2011). Introduction to the special section: More than measurement error: Discovering meaning behind informant discrepancies in clinical assessments of children and adolescents. Journal of Clinical Child & Adolescent Psychology, 40, 1–9.

    Article  Google Scholar 

  22. Upton, P., Lawford, J., & Eiser, C. (2008). Parent-child agreement across child health-related quality of life instruments: A review of the literature. Quality of Life Research, 17, 895–913.

    Article  PubMed  Google Scholar 

  23. Eiser, C., & Varni, J. W. (2013). Health related quality of life and symptom reporting: Similarities and differences between children and their parents. European Journal of Pediatrics, 172, 1299–1304.

    Article  PubMed  Google Scholar 

  24. Maurizi, L. K., Gershoff, E. T., & Aber, J. L. (2012). Item-level discordance in parent and adolescent reports of parenting behavior and its implications for adolescents’ mental health and relationships with their parents. Journal of Youth and Adolescence, 41, 1035–1052.

    Article  PubMed  Google Scholar 

  25. Drasgow, F. (1986). Polychoric and polyserial correlations. In S. Kotz & N. L. Johnson (Eds.), Encyclopedia of statistical sciences (Vol. 7, pp. 68–74). New York: Wiley.

    Google Scholar 

  26. Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.

    Article  Google Scholar 

  27. Cicchetti, D. V., & Allison, T. (1971). A new procedure for assessing reliability of scoring EEG sleep recordings. American Journal of EEG Technology, 11, 101–109.

    Google Scholar 

  28. SAS. (2008). SAS/STAT ® 9.2 user’s guide. Cary, NC: SAS Institute Inc.

    Google Scholar 

  29. Bowker, A. H. (1948). Bowker’s test for symmetry. Journal of the American Statistical Association, 43, 572–574.

    Article  CAS  PubMed  Google Scholar 

  30. Rescorla, L. A., Ginzburg, S., Achenbach, T. M., Ivanova, M. Y., Almqvist, F., Begovac, I., et al. (2013). Cross-informant agreement between parent-reported and adolescent self-reported problems in 25 societies. Journal of Clinical Child and Adolescent Psychology, 42, 262–273.

    Article  PubMed  Google Scholar 

  31. De Los Reyes, A., Goodman, K. L., Kliewer, W., & Reid-Quinones, K. (2008). Whose depression relates to discrepancies? Testing relations between informant characteristics and informant discrepancies from both informants’ perspectives. Psychological Assessment, 20, 139–149.

    Article  PubMed  Google Scholar 

  32. Campo, J. V., Comer, D. M., Jansen-McWilliams, L., Gardner, W., & Kelleher, K. J. (2002). Recurrent pain, emotional distress, and health service use in childhood. Journal of Pediatrics, 141, 76–83.

    Article  PubMed  Google Scholar 

  33. Janicke, D. M., Finney, J. W., & Riley, A. W. (2001). Children’s health care use: A prospective investigation of factors related to care-seeking. Medical Care, 39, 990–1001.

    Article  CAS  PubMed  Google Scholar 

  34. Varni, J. W., & Setoguchi, Y. (1992). Screening for behavioral and emotional problems in children and adolescents with congenital or acquired limb deficiencies. American Journal of Diseases of Children, 146, 103–107.

    CAS  PubMed  Google Scholar 

  35. Varni, J. W., Burwinkle, T. M., & Lane, M. M. (2005). Health-related quality of life measurement in pediatric clinical practice: An appraisal and precept for future research and application. Health and Quality of Life Outcomes, 3(34), 1–9.

    Google Scholar 

  36. Varni, J. W., Bendo, C. B., Denham, J., Shulman, R. J., Self, M. M., Neigut, D. A., et al. (2014). PedsQL™ gastrointestinal symptoms module: Feasibility, reliability, and validity. Journal of Pediatric Gastroenterology and Nutrition, 59, 347–355.

    Article  PubMed  Google Scholar 

  37. Yeh, M., & Weisz, J. R. (2001). Why are we here at the clinic? Parent-child (dis)agreement on referral problems at outpatient treatment entry. Journal of Consulting and Clinical Psychology, 69, 1018–1025.

    Article  CAS  PubMed  Google Scholar 

  38. Hawley, K. M., & Weisz, J. R. (2003). Child, parent, and therapist (dis)agreement on target problems in outpatient therapy: The therapist’s dilemma and its implications. Journal of Consulting and Clinical Psychology, 71, 62–70.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was funded by the National Institutes of Health through the NIH Roadmap for Medical Research, Grant U01AR052181. Information on the Patient-Reported Outcomes Measurement Information System (PROMIS®) can be found at http://nihroadmap.nih.gov/ and http://www.nihPROMIS.org.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James W. Varni.

Appendix

Appendix

Tables 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18 display the indices of inter-rater agreement (polychoric correlations, weighted κ, and Bowker’s test of symmetry) for all items, as well as the average and standard deviation (SD) of the difference between the child and parent responses on the 1–5 response scale. Items are sorted by degree of polychoric correlation within domain.

Table 9 Agreement statistics for the PROMIS® pediatric anger items
Table 10 Agreement statistics for the PROMIS® pediatric anxiety items
Table 11 Agreement statistics for the PROMIS® pediatric depressive symptoms items
Table 12 Agreement statistics for the PROMIS® pediatric pain interference items
Table 13 Agreement statistics for the PROMIS® pediatric peer relationships items
Table 14 Agreement statistics for the PROMIS® pediatric lack of energy items
Table 15 Agreement statistics for the PROMIS® pediatric fatigue items
Table 16 Agreement statistics for the PROMIS® pediatric upper extremity items
Table 17 Agreement statistics for the PROMIS® pediatric mobility items
Table 18 Agreement statistics for the PROMIS® pediatric asthma impact items

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Varni, J.W., Thissen, D., Stucky, B.D. et al. Item-level informant discrepancies between children and their parents on the PROMIS® pediatric scales. Qual Life Res 24, 1921–1937 (2015). https://doi.org/10.1007/s11136-014-0914-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-014-0914-2

Keywords

Navigation