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

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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.

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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

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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

  1. Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX, USA

    James W. Varni

  2. Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX, 77843-3137, USA

    James W. Varni

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

    David Thissen, Yang Liu, Brooke Magnus & Jason He

  4. RAND Corporation, Santa Monica, CA, USA

    Brian D. Stucky

  5. Department of Pediatrics, Division of Rheumatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Esi Morgan DeWitt

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

    Debra E. Irwin

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

    Jin-Shei Lai

  8. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

    Dagmar Amtmann

  9. 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. James W. Varni
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  2. David Thissen
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  7. Esi Morgan DeWitt
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  9. Jin-Shei Lai
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  11. Darren A. DeWalt
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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
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Table 10 Agreement statistics for the PROMIS® pediatric anxiety items
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Table 11 Agreement statistics for the PROMIS® pediatric depressive symptoms items
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Table 12 Agreement statistics for the PROMIS® pediatric pain interference items
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Table 13 Agreement statistics for the PROMIS® pediatric peer relationships items
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Table 14 Agreement statistics for the PROMIS® pediatric lack of energy items
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Table 15 Agreement statistics for the PROMIS® pediatric fatigue items
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Table 16 Agreement statistics for the PROMIS® pediatric upper extremity items
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Table 17 Agreement statistics for the PROMIS® pediatric mobility items
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Table 18 Agreement statistics for the PROMIS® pediatric asthma impact items
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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

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