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Using item response theory to enrich and expand the PROMIS® pediatric self report banks
Hally Quinn1, David Thissen2, Yang Liu3
1Department of Psychology, University of North Carolina at Chapel Hill, 358 Davie Hall, CB #3270, Chapel Hill, NC, 27599, USA. hallyq@live.unc.edu.
Insights
New items were added to the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®) pediatric item banks, improving content for Anger, Anxiety, and Depressive Symptoms. Physical functioning measurement range was not significantly extended.
Area of Science:
- Pediatric Health Outcomes Research
- Psychometrics
- Health Measurement
Background:
- Enhancing content coverage of pediatric self-report item banks for ages 8-17 years.
- Expanding precise measurement to higher physical functioning levels.
Purpose of the Study:
- To augment the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®) pediatric item banks.
- To improve content and extend measurement range for specific PROMIS® scales.
Main Methods:
- Combined data from 1,419 pediatric patients with diverse conditions and 3,048 children from the original sample.
- Calibrated new items using graded item response theory for Anger, Anxiety, Depressive Symptoms, Pain Interference, Fatigue, and physical functioning scales.
Main Results:
- Added 22 of 28 potential new items across seven scales.
- Revised recommended short forms for Anxiety and Depressive Symptoms scales; proposed a new one for Anger.
- Limited success in extending the measurement range for physical functioning scales.
Conclusions:
- Expanded PROMIS® pediatric item banks with new content and increased measurement range.
- Revised and expanded banks using item response theory without altering the underlying scale.
- Successfully enhanced content for Anger, Anxiety, and Depressive Symptoms scales, increasing robustness and flexibility.
Background:
The primary objective was to enhance the content coverage of some of the pediatric self-report item banks for ages 8-17 years from the National Institutes of Health (NIH) Patient Reported Outcomes Measurement Information System (PROMIS®), and extend the range of precise measurement to higher levels of physical functioning.
Methods:
Data from 1,419 pediatric patients with cancer, chronic kidney disease, obesity, rehabilitation needs, rheumatic disease, and sickle cell disease were combined with item responses from the original standardization sample of 3,048 children to calibrate new items for the pediatric PROMIS Anger, Anxiety, Depressive Symptoms, Pain Interference, Fatigue, and physical functioning Upper Extremity and Mobility scales. Simultaneous or concurrent calibration using the graded item response theory model placed all of the items on the same scale.
Results:
Twenty-two of 28 potential new items were added across the seven scales. A recommended short form was proposed for the Anger scale, and the recommended short forms for the Anxiety and Depressive Symptoms scales were revised. Unfortunately, we were not particularly successful at extending the range of measurement for the physical functioning banks.
Conclusions:
The present study expanded PROMIS pediatric item banks to add new content and to increase the range of measurement. Using item response theory, the banks were revised and expanded without changing the underlying scale of measurement. For Anger, Anxiety, and Depressive Symptoms, we successfully added new content that may render those banks more robust and flexible.
