Development and psychometric properties of the PROMIS(®) pediatric fatigue item banks

Abstract

Purpose: This paper reports on the development and psychometric properties of self-reported pediatric fatigue item banks as part of the Patient-Reported Outcomes Measurement Information System (PROMIS).

Methods: Candidate items were developed by using PROMIS qualitative methodology. The resulting 39 items (25 tiredness related and 14 energy related) were field tested in a sample that included 3,048 participants aged 8-17 years. We used confirmatory factor analysis (CFA) to evaluate dimensionality and differential item functioning (DIF) analysis to evaluate parameter stability between genders and by age; we examined residual correlations to evaluate local dependence (LD) among items and estimated the parameters of item response theory (IRT) models.

Results: Of 3,048 participants, 48 % were males, 60 % were white, and 23 % had at least one chronic condition. CFA results suggest two moderately correlated factors. Two items were removed due to high LD, and three due to gender-based DIF. Two item banks were calibrated separately using IRT: Tired and (Lack of) Energy, which consisted of 23 and 11 items, respectively; 10- and 8-item short-forms were created.

Conclusion: The PROMIS assessment of self-reported fatigue in pediatrics includes two item banks: Tired and (Lack of) Energy. Both demonstrated satisfactory psychometric properties and can be used for research settings.

Figures

Figure 1

Item characteristic curves between males and females for items demonstrating gender DIF. These two items were “I had enough energy to do the things I like to do” and “I had enough energy to play or go out with my friends”.

Figure 2

Test information curves are displayed for the 11 (Lack of) Energy item pool, the 8 item short form, and the most informative 8 items at various score locations.

Figure 3

Test information curves are displayed for the 23 Tired item pool, the 8 item short form, and the most informative 8 items at various score location.