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Qiao X, Zhan Y, Li L, Cui R. Development and validation of a nomogram to estimate fatigue probability in hemodialysis patients. Ren Fail 2024; 46:2396460. [PMID: 39238156 DOI: 10.1080/0886022x.2024.2396460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/20/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024] Open
Abstract
OBJECTIVE This study aims to investigate the factors that influence fatigue in hemodialysis (HD) patients and to develop and validate a nomogram to estimate the probability of fatigue in this population. METHODS This cross-sectional study collected 453 patients who underwent HD at the tertiary hospital in Hubei, China, from April to December 2023. They were randomly divided into a 70% training group (n = 316) and a 30% validation group (n = 137). In the training set, factors influencing fatigue were screened using multivariate logistic regression analysis, and a nomogram was developed to estimate fatigue probability in HD patients. The discrimination and calibration of the nomogram were validated in both the training and validation sets through the area under the receiver operating characteristic (ROC) curve (AUC) and the Hosmer-Lemeshow (H-L) test. RESULTS In the training group, logistic regression showed that age, dialysis vintage, inter-dialysis weight gain, hemoglobin, depression, insomnia, and social support were variables associated with fatigue in HD patients. Based on these factors, a nomogram for assessing fatigue probability in HD patients was developed. The AUC was 0.955 (95% CI: 0.932-0.977) and 0.979 (95% CI: 0.961-0.997) in the training and validation sets. The results from the H-L test indicated a good fit. CONCLUSION The nomogram can evaluate fatigue probability in HD patients and may serve as a convenient clinical tool.
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Affiliation(s)
- Xinran Qiao
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yan Zhan
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Longti Li
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Rong Cui
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei, China
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2
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Liegl G, Fischer FH, Canaud B, Woodward M, Barth C, Davenport A, Török M, Strippoli GFM, Hegbrant J, Cromm K, Bots ML, Blankestijn PJ, Fischer KI, Rose M. Using a measurement type-independent metric to compare patterns of determinants between patient-reported versus performance-based physical function in hemodialysis patients. Qual Life Res 2024:10.1007/s11136-024-03745-6. [PMID: 39103575 DOI: 10.1007/s11136-024-03745-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE We applied a previously established common T-score metric for patient-reported and performance-based physical function (PF), offering the unique opportunity to directly compare measurement type-specific patterns of associations with potential laboratory-based, psychosocial, sociodemographic, and health-related determinants in hemodialysis patients. METHODS We analyzed baseline data from the CONVINCE trial (N = 1,360), a multinational randomized controlled trial comparing high-flux hemodialysis with high-dose hemodiafiltration. To explore the associations of potential determinants with performance-based versus patient-reported PF, we conducted multiple linear regression (backward elimination with cross-validation and Lasso regression). We used standardized T-scores as estimated from the PROMIS PF short-form 4a (patient-reported PF) and the Physical Performance Test (performance-based PF) as dependent variables. RESULTS Performance-based and patient-reported PF were both significantly associated with a laboratory marker-based indicator of muscle mass (simplified creatinine index), although the effects were relatively small (partial f2 = 0.04). Age was negatively associated with PF; the effect size was larger for performance-based (partial f2 = 0.12) than for patient-reported PF (partial f2 = 0.08). Compared to performance-based PF, patient-reported PF showed a stronger association with self-reported health domains, particularly pain interference and fatigue. When using the individual difference between patient-reported and performance-based T-scores as outcome, we found that younger age and more fatigue were associated with lower patient-reported PF compared to performance-based PF (small effect size). CONCLUSION Patient-reported and performance-based assessments were similarly associated with an objective marker of physical impairment in hemodialysis patients. Age and fatigue may result in discrepancies when comparing performance-based and patient-reported scores on the common PF scale. Trial Registration CONVINCE is registered in the Dutch Trial Register (Register ID: NL64750.041.18). The registration can be accessed at: https://onderzoekmetmensen.nl/en/trial/52958 .
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Affiliation(s)
- Gregor Liegl
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany.
| | - Felix H Fischer
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
| | - Bernard Canaud
- Global Medical Office, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
- School of Medicine, Montpellier University, Montpellier, France
| | - Mark Woodward
- School of Public Health, The George Institute for Global Health, Imperial College London, London, UK
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Claudia Barth
- Medical Scientific Affairs, B. Braun Avitum AG, Melsungen, Germany
| | - Andrew Davenport
- Department of Renal Medicine, UCL, Royal Free Hospital & University College London, London, UK
| | | | - Giovanni F M Strippoli
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J) University of Bari, Italy & School of Public Health, University of Sydney, Darlington, Australia
| | - Jörgen Hegbrant
- Division of Nephrology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Krister Cromm
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
- Global Medical Office, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Peter J Blankestijn
- Department of Nephrology & Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Kathrin I Fischer
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research (CPCOR), Department of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, 10117, Berlin, Germany
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3
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van der Willik EM, van Breda F, van Jaarsveld BC, van de Putte M, Jetten IW, Dekker FW, Meuleman Y, van Ittersum FJ, Terwee CB. Validity and reliability of Patient-Reported Outcomes Measurement Information System (PROMIS®) using Computerized Adaptive Testing (CAT) in patients with advanced chronic kidney disease. Nephrol Dial Transplant 2022; 38:1158-1169. [PMID: 35913734 PMCID: PMC10157750 DOI: 10.1093/ndt/gfac231] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Patient-Reported Outcomes Measurement Information System (PROMIS®) has been recommended for computerized adaptive testing (CAT) of health-related quality of life (HRQOL). This study compared the content, validity and reliability of seven PROMIS CATs to the 12-item Short-Form Health Survey (SF-12) in patients with advanced chronic kidney disease (CKD). METHODS Adult CKD patients with an eGFR < 30 ml/min.1.73m2 not receiving dialysis treatment completed seven PROMIS CATs (assessing physical function, pain interference, fatigue, sleep disturbance, anxiety, depression, and ability to participate in social roles and activities), the SF-12 and, additionally, the PROMIS Pain Intensity single item and Dialysis Symptom Index (DSI) at inclusion and 2-weeks. A content comparison was performed between PROMIS CATs and SF-12. Construct validity of PROMIS CATs was assessed using Pearson's correlations. Test-retest reliability of all patient-reported outcome measures (PROMs) was assessed by calculating the intra-class correlation coefficient (ICC) and minimal detectable change (MDC). RESULTS In total, 207 patients participated in the study. A median of 45 items (10 minutes) was completed for PROMIS CATs. All PROMIS CATs showed evidence for sufficient construct validity. PROMIS CATs, most SF-12 domains and summary scores, and DSI showed sufficient test-retest reliability (ICC ≥ 0.70). PROMIS CATs had a lower MDC compared to the SF-12 (5.7-7.4 compared to 11.2-21.7 across domains, respectively). CONCLUSION PROMIS CATs showed sufficient construct validity and test-retest reliability in patients with advanced CKD. PROMIS CATs required more items but showed better reliability than the SF-12. Future research is needed to investigate the feasibility of PROMIS CATs for routine nephrology care.
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Affiliation(s)
- Esmee M van der Willik
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Fenna van Breda
- Department of Nephrology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Brigit C van Jaarsveld
- Department of Nephrology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Marlon van de Putte
- Department of Nephrology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Isabelle W Jetten
- Department of Nephrology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Yvette Meuleman
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frans J van Ittersum
- Department of Nephrology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Bennett PN, Kohzuki M, Bohm C, Roshanravan B, Bakker SJL, Viana JL, MacRae JM, Wilkinson TJ, Wilund KR, Van Craenenbroeck AH, Sakkas GK, Mustata S, Fowler K, McDonald J, Aleamañy GM, Anding K, Avin KG, Escobar GL, Gabrys I, Goth J, Isnard M, Jhamb M, Kim JC, Li JW, Lightfoot CJ, McAdams-DeMarco M, Manfredini F, Meade A, Molsted S, Parker K, Seguri-Orti E, Smith AC, Verdin N, Zheng J, Zimmerman D, Thompson S. Global Policy Barriers and Enablers to Exercise and Physical Activity in Kidney Care. J Ren Nutr 2022; 32:441-449. [PMID: 34393071 PMCID: PMC10505947 DOI: 10.1053/j.jrn.2021.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/06/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Impairment in physical function and physical performance leads to decreased independence and health-related quality of life in people living with chronic kidney disease and end-stage kidney disease. Physical activity and exercise in kidney care are not priorities in policy development. We aimed to identify global policy-related enablers, barriers, and strategies to increase exercise participation and physical activity behavior for people living with kidney disease. DESIGN AND METHODS Guided by the Behavior Change Wheel theoretical framework, 50 global renal exercise experts developed policy barriers and enablers to exercise program implementation and physical activity promotion in kidney care. The consensus process consisted of developing themes from renal experts from North America, South America, Continental Europe, United Kingdom, Asia, and Oceania. Strategies to address enablers and barriers were identified by the group, and consensus was achieved. RESULTS We found that policies addressing funding, service provision, legislation, regulations, guidelines, the environment, communication, and marketing are required to support people with kidney disease to be physically active, participate in exercise, and improve health-related quality of life. We provide a global perspective and highlight Japanese, Canadian, and other regional examples where policies have been developed to increase renal physical activity and rehabilitation. We present recommendations targeting multiple stakeholders including nephrologists, nurses, allied health clinicians, organizations providing renal care and education, and renal program funders. CONCLUSIONS We strongly recommend the nephrology community and people living with kidney disease take action to change policy now, rather than idly waiting for indisputable clinical trial evidence that increasing physical activity, strength, fitness, and function improves the lives of people living with kidney disease.
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Affiliation(s)
- Paul N Bennett
- Medical and Clinical Affairs, Satellite Healthcare, San Jose, California; Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai City, Japan
| | - Clara Bohm
- University of Manitoba, Winnipeg, Canada
| | | | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center MC Groningen, University of Groningen, Groningen, the Netherlands
| | - João L Viana
- Research Center in Sports Sciences, Health Sciences and Human Development, University Institute of Maia, Maia, Portugal
| | - Jennifer M MacRae
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Kenneth R Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | | | - Giorgos K Sakkas
- Cardiff Metropolitan University, Cardiff, UK and University of Thessaly, Volos, Greece
| | - Stefan Mustata
- Faculty of Medicine, University of Calgary, Calgary, Canada
| | | | - Jamie McDonald
- School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK
| | | | - Kirsten Anding
- Nephrology, KfH Nierenzentrum Bischofswerda, Bischofswerda, Germany
| | - Keith G Avin
- Indiana University Department of Physical Therapy, Indianapolis, Indiana
| | - Gabriela Leal Escobar
- Department of Nephrology Instituto Nacional de Cardiologia Ignacio Chávez, Mexico City, Mexico
| | - Iwona Gabrys
- University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Jill Goth
- Programs & Public Policy, The Kidney Foundation of Canada, Montreal, Quebec, Canada
| | | | | | - Jun Chul Kim
- Division of Nephrology, Department of Internal Medicine, CHA Gumi Medical Center, CHA University, Gumi, Republic of Korea
| | - John Wing Li
- Renal Medicine, Nepean Hospital, Katoomba, New South Wales, Australia
| | | | | | - Fabio Manfredini
- Department of Biomedical Sciences and Surgical specialties, University of Ferrara, Ferrara, Italy
| | | | | | | | - Eva Seguri-Orti
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, Alfara del Patriarca, Valencia, Spain
| | - Alice C Smith
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Jing Zheng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, P.R. China
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Wu YH, Hsu YJ, Tzeng WC. Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073972. [PMID: 35409654 PMCID: PMC8997862 DOI: 10.3390/ijerph19073972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 11/16/2022]
Abstract
Comorbidities cause psychological distress to patients on hemodialysis and cause their physical function to deteriorate. This study aims to examine whether physical patterns are associated with anxiety, depression and fatigue among patients with and without comorbidities who are on hemodialysis. To this end, a cross-sectional survey was administered to 120 patients on hemodialysis. Data were collected using the International Physical Activity Questionnaire—Short Form, Beck Depression Inventory—Second Edition, Beck Anxiety Inventory, and Brief Fatigue Inventory—Taiwan Version. An independent sample t test and generalized linear model analyses were conducted. The results revealed that patients with comorbidities exhibited more severe levels of depression (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.010) than patients without comorbidities. Additionally, patients on hemodialysis with a high physical activity level (≥600 metabolic equivalent of task per min/week) exhibited less depression (B = −4.03; p < 0.001; 95% confidence interval [CI] = −6.04, −2.03) and anxiety (B = −2.64; p = 0.002; 95% CI = −4.27, −1.00) severity than those with a low physical activity level; those who engaged in weekly physical activities exhibited less fatigue severity (B = −1.17; p = 0.001; 95% CI = −1.84, −0.49) and fatigue interference (B = −0.61; p = 0.015; 95% CI = −1.10, −0.12). For patients on hemodialysis, having comorbidities was correlated with more severe levels of depression, anxiety, and fatigue. Weekly moderate-intensity physical activities were revealed to be correlated with less severity levels of depression, anxiety, and fatigue. The study findings aid the development of interventions for promoting physical activity among patients on hemodialysis to prevent the exacerbation of complications caused by comorbidities and psychological distress.
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Affiliation(s)
- Yu-Hui Wu
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Nursing Department, Tri-Service General Hospital, Taipei 11490, Taiwan
| | - Yu-Juei Hsu
- Nephrology Division, Tri-Service General Hospital, Taipei 11490, Taiwan;
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan
| | - Wen-Chii Tzeng
- School of Nursing, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence:
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Hussain J, Chawla G, Rafiqzad H, Huang S, Bartlett SJ, Li M, Howell D, Peipert JD, Novak M, Mucsi I. Validation of the PROMIS sleep disturbance item bank computer adaptive test (CAT) in patients on renal replacement therapy. Sleep Med 2022; 90:36-43. [DOI: 10.1016/j.sleep.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/21/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
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Ozen N, Aydin Sayilan A, Bal Ozkaptan B, Neves Sousa C, Unver V. The reliability and validity of the Turkish version of the postdialysis fatigue scale. Int J Clin Pract 2021; 75:e14871. [PMID: 34525246 DOI: 10.1111/ijcp.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/12/2021] [Indexed: 11/29/2022] Open
Abstract
AIM Haemodialysis (HD) commonly leads to postdialysis fatigue (PDF) and, thus, worsens the quality of life and the clinical outcomes. The aim of this study was to translate, linguistically validate and determine the psychometric properties of the "Postdialysis Fatigue" Scale for Turkish patients with HD. STUDY DESIGN A methodological study. METHODS The standard lingual translation and validation methods for the initial translation of the PDF Scale and then assessed the psychometric properties of reliability and validity of the translated scale. Visual analogue scale (VAS) and Piper Fatigue Scale were used to assess concurrent and construct validity. In addition, postdialysis recovery time was used it as an indirect measurement method for PDF. RESULTS A total of 93 patients participated in the study. The Cronbach's alpha coefficient of PDF was 0.773. There was a statistically significant relationship between the test and retest scores (ICC: 0.973; P < .001). PDF Scale was acceptable with 11 items. There was a positive correlation with a statistically significant relationship was present between the PDF scores and Piper Fatigue Scale (r = .488; P < .001) and VAS score (r = .656; P < .001). There was a statistically significant positive correlation between the PDF Scale and the postdialysis recovery time (r = .270; P = .009), CONCLUSION: The study results have shown that the Turkish form of the PDF Scale is a valid and reliable tool in patients undergoing HD treatment. Postdialysis recovery time may be used as an indirect measurement method to evaluate PDF.
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Affiliation(s)
- Nurten Ozen
- Florence Nightingale Hospital School of Nursing, Demiroglu Bilim University, Istanbul, Turkey
| | - Aylin Aydin Sayilan
- Nursing Department, Faculty of Health Sciences, Kirklareli University, Kirklareli, Turkey
| | - Bilge Bal Ozkaptan
- Nursing Department, Sinop University Faculty of Health Sciences, Sinop, Turkey
| | - Clemente Neves Sousa
- Nursing School of Porto, Porto, Portugal
- Faculty of Medicine, CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal
- Vascular Access Center (Grupo Estudos Vasculares), Porto, Portugal
| | - Vesile Unver
- Department of Nursing, Faculty of Health Sciences, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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Zhang J, Dewitt B, Tang E, Breitner D, Saqib M, Li D, Siddiqui R, Edwards N, Peipert JD, Hays RD, Hanmer J, Mucsi I. Evaluation of PROMIS Preference Scoring System (PROPr) in Patients Undergoing Hemodialysis or Kidney Transplant. Clin J Am Soc Nephrol 2021; 16:1328-1336. [PMID: 34272256 PMCID: PMC8729576 DOI: 10.2215/cjn.01880221] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/22/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES A preference-based health utility score (PROPr) can be calculated using Patient-Reported Outcomes Measurement Information System domain scores. We assessed the construct validity of PROPr among patients treated with KRT (hemodialysis or kidney transplant). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We performed a secondary analysis of data collected in multicenter, cross-sectional studies of adults treated with KRT, recruited between April 2016 to March 2020 in Toronto, Canada. All participants provided informed consent. The outcome was the PROPr score. Coadministered outcome variables included the Short-Form Six-Domain (SF-6D) and EuroQol Five-Domain Five-Level (EQ-5D-5L) scores. Socioeconomic and clinical variables included age, sex, diabetes, eGFR, serum albumin, hemoglobin, KRT, and Charlson Comorbidity Index. Construct validity was assessed through correlations between PROPr and SF-6D or EQ-5D-5L, and associations between PROPr and other exposure variables. Health-condition impact estimates (coefficients for health conditions compared with a referent category, e.g., dialysis versus kidney transplant) were calculated using multivariable linear regression. RESULTS The mean (SD) age of the 524 participants was 57 (17) years, 58% were male, and 45% were White. Median (interquartile range) score was 0.39 (0.24-0.58) for PROPr, 0.69 (0.58-0.86) for SF-6D, and 0.85 (0.70-0.91) for EQ-5D-5L. Large correlations were observed between PROPr versus SF-6D (0.79; 95% confidence interval [95% CI], 0.76 to 0.82) and EQ-5D-5L (0.71; 95% CI, 0.66 to 0.75). Both PROPr and the other utility indices demonstrated health-condition impact in the expected direction. For example, the estimate for PROPr was -0.17 (95% CI, -0.13 to -0.21) for dialysis (versus kidney transplant), -0.05 (95% CI, -0.11 to 0.01; P=0.08) for kidney transplant recipients with an eGFR of <45 versus ≥45 ml/min per 1.73 m2, and -0.28 (95% CI, -0.22 to -0.33) for moderate/severe versus no/mild depressive symptoms. CONCLUSIONS Our results support the validity of PROPr among patients treated with KRT.
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Affiliation(s)
- Jing Zhang
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - Barry Dewitt
- Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Evan Tang
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - Daniel Breitner
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - Mohammed Saqib
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - Dan Li
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - Rabail Siddiqui
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - Nathaniel Edwards
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
| | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois.,Northwestern University Transplant Outcome Research Collaborative, Chicago, Illinois
| | - Ron D Hays
- Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Janel Hanmer
- Department of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Istvan Mucsi
- Multi-Organ Transplant Program, University Health Network and University of Toronto, Toronto, Canada
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