J Pediatr Gastroenterol Nutr. 2021 Feb 24. doi: 10.1097/MPG.0000000000003101.Online ahead of print.

Erica J Brenner ¹, Millie D Long, Courtney M Mann, Li Lin, Wenli Chen, Camila Reyes, Kirsten M Bahnson, Bryce B Reeve, Michael D Kappelman

Author information

• ¹University of North Carolina Department of Pediatric Gastroenterology, Chapel Hill, North Carolina University of North Carolina Department of Gastroenterology, Chapel Hill, North Carolina Duke University School of Medicine Department of Population Health Sciences, Durham, North Carolina Duke University School of Medicine Office of Clinical Research, Durham, North Carolina.

Abstract

Objectives: Patient-reported outcome (PRO) measures allow children to directly report on their health and well-being. We assessed the construct validity and responsiveness of the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Pediatric measures in children and adolescents with ulcerative colitis (UC).

Methods: Through the Inflammatory Bowel Disease Partners Kids & Teens' internet-based cohort, children with UC reported symptoms related to disease activity [Pediatric Ulcerative Colitis Activity Index (PUCAI)], IMPACT-III health-related quality of life measure, and five PROMIS Pediatric measures (anxiety, depressive symptoms, pain interference, fatigue, and peer relationships). We included participants aged 9-17 years and conducted cross sectional and longitudinal, mixed-linear regression analyses to examine the extent to which PROMIS Pediatric scores are associated with and respond to changes in PUCAI and IMPACT-III.

Results: We evaluated 91 participants with UC (mean age 13 years, 57% female). Better PROMIS Pediatric scores were associated with lower disease activity, in both cross sectional and longitudinal analyses. For a change from moderate/severe to remission, observed effect estimates were -5.1 points for anxiety, -5.0 for depressive symptoms, -14.7 for pain interference, -13.7 for fatigue, and 5.3 for peer relationships (p < 0.05 for all domains). Better PROMIS Pediatric scores were associated with improved IMPACT-III scores (p values <0.01), and changes in scores were moderately correlated with changes in IMPACT-III over time (adjusted p values <0.01).

Conclusions: This study provides evidence for the construct validity and longitudinal responsiveness of the PROMIS Pediatric measures in pediatric UC patients, thus supporting their use in clinical research and patient care.