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Published on: October 1, 2019
PROMIS fatigue scores are moderately correlated with heart failure severity in pediatrics
Lindsay J May1, Josef Stehlik2, Zhining Ou2
1Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Insights
Patient-Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue scores moderately correlate with heart failure (HF) severity in children. This finding suggests PROMIS Fatigue can aid in monitoring pediatric HF patients and in clinical trials.
Area of Science:
- Pediatric Cardiology
- Clinical Outcomes Research
- Patient-Reported Outcomes
Background:
- Patient-reported outcome measures (PROMs) are valuable in adult heart failure (HF) but understudied in pediatric HF.
- Limited data exist on the validity of PROMs for assessing pediatric HF severity.
Purpose of the Study:
- To evaluate the correlation between Patient-Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue scores and heart failure (HF) severity in children.
- To assess the utility of PROMIS measures as adjunct tools in pediatric HF care.
Main Methods:
- Prospective enrollment of 41 children (aged 8-17) with inpatient HF across 4 hospitals.
- Administration of PROMIS measures (including Fatigue) and the New York University Pediatric Heart Failure Index (NYU PHFI) during inpatient and outpatient care.
- Statistical analysis using paired t-tests and a mixed-effects model to determine correlations.
Main Results:
- PROMIS Pediatric Fatigue scores showed moderate correlation with HF severity (r=0.5), indicating a relationship between fatigue and disease status.
- Significant improvements in PROMIS Fatigue scores (p=0.007) and NYU PHFI scores (p<0.001) were observed over time.
- Clinically meaningful improvements were noted in other PROMIS measures, except for Peer relationships.
Conclusions:
- PROMIS Pediatric Fatigue scores demonstrate moderate correlation with HF severity in children.
- PROMIS Fatigue is a potentially valuable tool for longitudinal monitoring and clinical trials in pediatric HF.
- PROMIS measures may enhance the clinical care and research of pediatric heart failure.
Background:
Patient-reported outcome measures (PROMs) correlate with heart failure (HF) severity among adults and are adjunct tools in clinical care. Limited data exist regarding the validity of PROMs in pediatric HF. Hypothesis: Patient-Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue correlates with HF severity, measured by the New York University Pediatric Heart Failure Index (NYU PHFI).
Methods:
Children ≥8 and <18 years old were enrolled prospectively at 4 hospitals, from September 2019 to February 2023, while receiving inpatient HF care. NYU PHFI and pediatric self-report PROMIS measures were administered to inpatient and outpatient patients. PROMIS measures: Mobility, Anxiety, Depressive symptoms, Peer relationships, and Fatigue (primary outcome). Paired t-tests compared PROMIS and NYU PHFI scores across time. A mixed-effects model generated correlation coefficients.
Results:
In the 41-patient cohort, 20 (48.8%) were discharged without ventricular assist device/transplant, 18 completed inpatient and outpatient assessments. Mean PROMIS Fatigue t-scores improved: 58.1 ± 12.9 to 48.9 ± 16.9; p = 0.007. Clinically meaningful improvements were observed in other PROMIS t-scores, except Peer relationships. NYU PHFI scores improved: 13.3 ± 2.6 to 7.8 ± 3.4; p < 0.001. PROMIS Fatigue and NYU PHFI moderately correlated (r = 0.5; 95% confidence interval 0.3, 0.6).
Conclusions:
PROMIS Fatigue t-scores moderately correlated with HF severity in children suggesting that Fatigue could be useful in longitudinal monitoring and clinical trials.
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