Development and Psychometric Evaluation of a German Version of the PROMIS® Item Banks for Satisfaction With Participation

Translation and linguistic validation of 24 PROMIS item banks into French

PURPOSE

The Patient-Reported Outcome Measurement Information System (PROMIS®) was developed to provide reliable, valid, and normed item banks to measure health. The item banks provide standardized scores on a common metric allowing for individualized, brief assessment (computerized adaptive tests), short forms (e.g. heart failure specific), or profile assessments (e.g. PROMIS-29). The objective of this study was to translate and linguistically validate 24 PROMIS adult item banks into French and highlight cultural nuances arising during the translation process.

METHODS

We used the FACIT translation methodology. Forward translation into French by two native French-speaking translators was followed by reconciliation by a third native French-speaking translator. A native English-speaking translator fluent in French then completed a back translation of the reconciled version from French into English. Three independent reviews by bilingual translators were completed to assess the clarity and consistency of terminology and equivalency across the English source and French translations. Reconciled versions were evaluated in cognitive interviews for conceptual and linguistic equivalence.

RESULTS

Twenty-four adult item banks were translated: 12 mental health, 10 physical health, and two social health. Interview data revealed that 577 items of the 590 items translated required no revisions. Conceptual and linguistic differences were evident for 11 items that required iterations to improve conceptual equivalence and two items were revised to accurately reflect the English source.

CONCLUSION

French translations of 24 item banks were created for routine clinical use and research. Initial translation supported conceptual equivalence and comprehensibility. Next steps will include validation of the item banks.

Validação brasileira dos bancos de itens Distúrbio do Sono e Distúrbio da Vigília do Patient-Reported Outcomes Measurement Information System (PROMIS)

O objetivo deste estudo foi validar a versão brasileira dos bancos de itens Distúrbio do Sono e Distúrbio da Vigília do Patient-Reported Outcomes Measurement Information System (PROMIS). A validação desses bancos de itens foi feita por meio da Teoria Clássica dos Testes, Teoria de Resposta ao Item, calibração dos itens conforme o modelo de resposta gradual proposto por Samejima e análise do Funcionamento Diferencial do Item (DIF), sendo a amostra constituída por 627 participantes com mais de 18 anos. Em relação à qualidade dos dados, observou-se que não houve dados perdidos, e cinco itens do banco Distúrbio do Sono e quatro itens do banco Distúrbio da Vigília tiveram efeito piso, e nenhum dos bancos apresentou efeito teto. Os dois bancos mostraram excelente confiabilidade com uma escala homogênea e boa estabilidade temporal. Com a Análise Fatorial Confirmatória, através dos índices de qualidade de ajuste absoluto e incremental, verificou-se um bom ajuste para os dois bancos, o que revela que os instrumentos são válidos e suficientemente unidimensionais. A calibração evidenciou que as propriedades psicométricas dos itens foram satisfatórias com boa cobertura do construto sono-vigília. No tocante ao DIF, tanto o banco Distúrbio do Sono quanto o banco Distúrbio da Vigília mostraram ser homogêneos para os diferentes grupos testados. Pode-se concluir que a versão para a língua portuguesa falada no Brasil dos bancos de itens Distúrbio do Sono e Distúrbio da Vigília do PROMIS demonstrou ser uma medida confiável, precisa e válida, com análises psicométricas robustas.

Translation and cross-cultural adaptation of eight pediatric PROMIS® item banks into Spanish and German

PURPOSE

The Patient-Reported Outcome Measurement Information System (PROMIS®) is a National Institutes of Health (NIH)-funded initiative to develop reliable, valid, and normed item banks to measure health. We describe the first large-scale translation and cross-cultural adaptation effort to German and Spanish of eight pediatric PROMIS item banks: Physical activity (PAC), subjective well-being (SWB), experiences of stress (EOS), and family relations (FAM).

METHODS

We utilized methods outlined in the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force recommendations. Ten professional translators performed a translatability assessment and generated forward translations. Forward Translations were compared within a country and cross-culturally to identify problems and to produce a consensus-derived version, which was then back translated, evaluated, and revised where necessary. Reconciled versions were evaluated in cognitive interviews with 126 children before finalization.

RESULTS

Eight resulting pediatric PROMIS® item banks were translated: Two PAC banks (22 total items), three SWB banks (125 total items), two EOS banks (45 total items), and one FAM bank (47 total items). Up to 92% of all items raised no or only minor translation difficulties, 0-5.6% were difficult to translate. Up to 20% item revisions were necessary to ensure conceptual equivalence and comprehensibility. Cognitive interviews indicated that 91-94% of the final items were appropriate for children (8-17 years).

CONCLUSIONS

German and Spanish translations of eight PROMIS Pediatric item banks were created for clinical trials and routine pediatric health care. Initial translatability assessment and rigorous translation methodology helped to ensure conceptual equivalence and comprehensibility. Next steps include cross-cultural validation and adaptation studies.

[Cross-cultural adaptation and validation of the PROMIS Global Health scale in the Portuguese language]

This study aimed to perform the cross-cultural adaptation and validation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health scale in the Portuguese language. The ten Global Health items were cross-culturally adapted by the method proposed in the Functional Assessment of Chronic Illness Therapy (FACIT). The instrument's final version in Portuguese was self-administered by 1,010 participants in Brazil. The scale's precision was verified by floor and ceiling effects analysis, reliability of internal consistency, and test-retest reliability. Exploratory and confirmatory factor analyses were used to assess the construct's validity and instrument's dimensionality. Calibration of the items used the Gradual Response Model proposed by Samejima. Four global items required adjustments after the pretest. Analysis of the psychometric properties showed that the Global Health scale has good reliability, with Cronbach's alpha of 0.83 and intra-class correlation of 0.89. Exploratory and confirmatory factor analyses showed good fit in the previously established two-dimensional model. The Global Physical Health and Global Mental Health scale showed good latent trait coverage according to the Gradual Response Model. The PROMIS Global Health items showed equivalence in Portuguese compared to the original version and satisfactory psychometric properties for application in clinical practice and research in the Brazilian population.

The reciprocal effect of pain catastrophizing and satisfaction with participation in the multidisciplinary treatment of patients with chronic back pain

Background

The aim of the study was to examine the reciprocity between pain catastrophizing, social participation and quality of life outcomes (pain intensity, pain disability, negative affectivity) in patients with low back pain in a multidisciplinary pain treatment.

Methods

Patients undergoing inpatient rehabilitation were surveyed at the beginning and two weeks after the end of rehabilitation. N = 262 low back pain patients participated (mean age: 52.2, 62.1 % female). A two-wave cross-lagged design and structural equation modeling were used to analyze data.

Results

We found evidence of reciprocal relations with regard to several outcomes. For example, pain catastrophizing at the beginning of treatment is associated with negative affectivity after rehabilitation, and the post-treatment value of pain catastrophizing is associated with pain disability and satisfaction with participation at the start of treatment. Pain disability and pain catastrophizing are predictors of lower treatment outcome while pain intensity and negative affectivity are not risk factors. Participation stands in a reciprocal relationship with some of the pain treatment outcomes. The surprising result, namely, that those patients more satisfied with social participation experience less improvement regarding catastrophizing, can be explained by ceiling effects and the Communal Coping Model.

Conclusions

This study provides evidence of the importance of taking reciprocal relations among pain catastrophizing, social participation and other pain outcomes into account. Providers of multidisciplinary pain treatment need to play attention to patients at risk with high disability and catastrophizing thoughts. Pain treatment would benefit from closer integration of psychosocial measures to foster social participation.

Participation and social functioning in patients with fibromyalgia: development and testing of a new questionnaire

Background

While there are numerous instruments for capturing the symptoms of fibromyalgia syndrome (FMS) patients, there is a lack of questionnaires capable of measuring in detail FMS patients’ participation and social functioning. It was our aim to develop and methodologically test a new patient questionnaire specific to FMS measuring these concepts (the “Fibromyalgia Participation Questionnaire” FPQ).

Methods

We first conducted a qualitative prestudy (focus groups, N = 38) to identify which impairments FMS patients experience in daily life because of their illness. To analyze the data we developed a coding system that contained 10 supercategories and a total of 105 subcategories. Items for the FPQ were developed from the subcategories. The psychometric analysis was done on a sample of N = 256 FMS patients undergoing inpatient rehabilitation in Germany.

Results

The final version of the FPQ contained 27 items and three scales (participation in social life FPQ-S, 11 items; participation in daily life FPQ-D, 11 items, participation in work-life FPQ-W 5 items). The FPQ displays good distribution properties, all the scales are unidimensional, and the scales fit to the Rasch model. Cronbach’s Alpha range from 0.85 to 0.94. We noted indications of construct validity in that the FPQ correlates as expected with the Fibromyalgia Impact Questionnaire (physical scale), Pain Disability Index and scales from the PROMIS® item banks for satisfaction with participation. The FPQ scales generally reveal greater responsiveness than other instruments. By linking FPQ items to the categories of the International Classification of Functioning, Disability and Health (ICF) we demonstrate content validity.

Conclusions

The FPQ captures participation and social functioning in FMS patients. As its psychometric properties are good, it can be recommended for use in evaluation studies and clinical trials.