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Kidney Week

Abstract: PO2063

Construct Validity of the Patient-Reported Outcomes Measurement Information System (PROMIS®) Profile Summary Scores in Patients with Kidney Failure

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Mucsi, Istvan, University Health Network, Toronto, Ontario, Canada
  • Chawla, Gaauree, University Health Network, Toronto, Ontario, Canada
  • Chen, Anqi, University Health Network, Toronto, Ontario, Canada
  • Sanchez, Mark JP M., University Health Network, Toronto, Ontario, Canada
  • Edwards, Nathaniel, University Health Network, Toronto, Ontario, Canada
  • Peipert, John D., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Li, Madeline, University Health Network, Toronto, Ontario, Canada
  • Howell, Doris, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
  • Bartlett, Susan J., McGill University, Montreal, Quebec, Canada
  • Hays, Ron D., University of California Los Angeles, Los Angeles, California, United States

Group or Team Name

  • Kidney Health Education and Research Group
Background

The PROMIS® profiles include a single pain intensity item and 7 multi-item scales (e.g., physical function, fatigue, depression, social participation, etc.). These domains can be summarized into physical (PHS) and mental health summary (MHS) scores. We examine correlations of the PHS and MHS with generic and kidney-disease targeted measures in patients treated with kidney replacement therapies and compare the summary scores between patients on dialysis vs kidney transplant.

Methods

Cross-sectional convenience sample of 606 adults. Higher PHS and MHS scores correspond to better health. We estimated correlations of the PHS and MHS with the SF-12 physical (PCS) and mental component score (MCS), the Patient Health Questionnaire (PHQ-9), EQ-5D-5L, KDQOL-36 symptom scores, and serum albumin. The PHS was hypothesized to be strongly associated with other measures of physical health, and the MHS with other measures of mental health.

Results

Correlations with the PROMIS PHS and MHS (Table) with legacy health-related quality of life measures were large. The patterns of correlations of the PHS and MHS were consistent with a-priori hypotheses.
Patients on dialysis were older (mean[SD] age 64(14) vs 50(15) years), and less likely to be White (32% vs 68%); p<0.01 for all. Kidney transplant recipients reported better health than patients on dialysis: PHS (mean[SD] 47[10] vs 37[9], p<0.001) and MHS (50[9] vs 45[9], p<0.001) and this remained significant in multivariable adjusted (age, sex, ethnicity, marital status, comorbidity, serum albumin and hemoglobin) regression models (coefficient[95% CI] of difference between dialysis and transplant for PH:5.9 [3.8-7.9]; for MH: 3.2 [1.0-5.3]; both p<0.01).

Conclusion

These results support the construct validity of PROMIS PHS and MHS scores among patients treated with kidney replacement therapies. PHS and MHS was substantially better among kidney recipients compared to patients on dialysis.

Table
PROMIS ProfilePCSMCSPHQ-9EQ5D5LKDQOL-36 SymptomsSerum albumin
PHS0.810.39-0.48*0.660.580.44
MHS0.650.66-0.74*0.670.690.24

Footnote: * : higher PHS and MHS indicates better health; higher PHQ-9 score indicates more severe depressive symptoms; the correlation is negative