Member's paper - Kidney Health Education and Research Group

Abstract

Validation of PROMIS Computer Adaptive Testing Depression Item Bank in Patients with End Stage Kidney Disease

Shah, V., Rezaeishahreza, A., Lui, E., Aser, R., Bartlett, S., Li, M., Howell, D., Peipert, J., Novak, M., Mucsi, I.

2020

European Association of Psychosomatic Medicine

Full Abstract
Objectives: To evaluate the reliability and validity of the Patient Reported Outcomes Measurement Information System Depression computerized adaptive test (PROMIS-D CAT) item bank in adult patients with End Stage Kidney Disease (ESKD). Methods: Adults with ESKD completed the PROMIS-D CAT and Patient Health Questionnaire (PHQ-9) on an electronic data capture platform. Socio–demographic and clinical data was collected from the medical records. Construct validity was assessed using Spearman’s Rho and known groups comparisons; test-retest reliability using intra-class correlation (ICC). Receiver operating characteristics (ROC) analysis was used to assess discrimination of PROMIS-D CAT for moderate/severe depression, defined as PHQ-9 ≥10. Results: Mean(SD) age of the 192 participants was 53(17) years, 67% male, 57% Caucasian, 19% on dialysis. Based on the PHQ-9, 18% reported moderate/severe depression. The PROMIS-D CAT and the PHQ-9 were moderately correlated (r=0.67). Test-retest reliability was good (ICC=0.73). Patients with Charlson Comorbidity Index ≥4, compared to <3 tended to have higher mean (SD) PROMIS-D CAT scores (50(7) vs 48(8); p=0.08). Similarly PROMIS-D CAT scores were higher for patients with an Edmonton Symptom Assessment System score ≥30 compared to <30 (56(7) vs 47(8), p<0.01). Discrimination for PROMIS-D CAT was excellent (area under the curve 0.88 [95%CI: 0.81, 0.95]). The cut-off for moderate/severe depression for PROMIS-D CAT was 54 (Sensitivity:88%, specificity:82%, positive predictive value:0.5, negative predictive value:0.97). Conclusion: These results provide new evidence about the validity and reliability of PROMIS-D CAT in ESKD patients and support its use in research and care.

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