PROMIS Pediatrics - Linking Pediatric and Adult Item Banks

Having independent versions of the PROMIS® scales (for Pediatric and Adults) is problematic as scores cannot be evaluated longitudinally as individuals move from childhood into adulthood. The primary aim of this research project is to use item response theory (IRT) to develop a transitional scoring link (or “crosswalk”) between the PROMIS adult and pediatric physical health measures. Sample 1 was collected at 6 rehabilitation hospitals in the U.S., and participants in Sample 2 were recruited from public health insurance programs and an online research panel. PROMIS pediatric and adult physical function, mobility, upper extremity, fatigue, and pain measures were administered to a sample of 874 individuals aged 14–20 years old with special health needs and a sample of 641 individuals aged 14–25 years with a disability. IRT-based scores were linked using a linear approximation to calibrated projection. Estimated latent variable correlations ranged between 0.84 and 0.95 for the PROMIS pediatric and adult scores. Root Expected Mean Square Difference values were below the 0.08 threshold in all cases except when comparing genders on the Mobility (0.097) and Pain (0.10) scales in the special health care needs sample. Sum score conversion tables for the pediatric and adult PROMIS measures are presented. The linking coefficients can be used to calculate scale scores on PROMIS adult measures from pediatric measure scores and vice versa. This may lead to more accurate measurement in cross-sectional studies spanning multiple age groups or longitudinal studies that require comparable measurement across distinct developmental stages.

拥有适用于儿童与成人的独立版PROMIS®量表存在一项局限：当个体从儿童阶段过渡至成年阶段时，无法对其测评得分开展纵向比较分析。本研究项目的核心目标为，运用项目反应理论（Item Response Theory，IRT）搭建PROMIS成人与儿童躯体健康测评工具间的过渡性计分链接（或称"跨量表转换表"）。样本1采集自美国6家康复医院，样本2的参与者则从公共健康保险计划及在线研究招募面板中招募获得。研究向两类样本施测了PROMIS儿童与成人版躯体功能、活动能力、上肢功能、疲劳及疼痛相关躯体健康测评量表：第一类样本包含874名14~20岁存在特殊健康需求的个体，第二类样本包含641名14~25岁存在残疾的个体。基于项目反应理论的得分通过校准投影的线性近似方法完成链接。PROMIS儿童与成人版得分的估计潜变量相关系数区间为0.84~0.95。各类场景下的均方根期望差（Root Expected Mean Square Difference）值均低于0.08的阈值，仅在特殊健康需求样本中，针对活动能力量表与疼痛量表的性别比较场景除外，其对应值分别为0.097与0.10。本研究同时提供了PROMIS儿童与成人版量表的总得分转换表。该链接系数可用于基于儿童版量表得分计算成人版PROMIS量表得分，反之亦然。这一方法可为覆盖多年龄组的横断面研究，或需要在不同发育阶段开展可比测评的纵向研究，提供更为精准的测量支持。