Member's paper - Kidney Health Education and Research Group

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Abstract
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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