Session Name: Kidney Psychosocial
Session Date & Time: None. Available on demand.
*Purpose: To assess the validity and reliability of the PROMIS Anxiety item bank administered using Computer Adaptive Test (PROMIS-A CAT) in patients who received solid organ transplant.
*Methods: A cross-sectional convenience sample of adult kidney (KTR), kidney-pancreas (KPTR), and liver (LTR) transplant recipients completed PROMIS-A CAT, General Anxiety Disorder-7 (GAD7), Patient Health Questionnaire (PHQ-9), Kidney/Liver Disease Quality of Life-36 (KDQoL/LDQoL), Edmonton Symptom Assessment System Revised (ESASr) and EuroQoL EQ-5D (EQ5D) questionnaires on an electronic data capture platform. Sociodemographic and clinical variables were collected from medical records. A sub-group of participants was asked to retake PROMIS-A CAT within 14 days; test-retest reliability was assessed using intraclass correlation coefficient (ICC). Construct validity was confirmed using correlation between PROMIS-A CAT scores and scores on questionnaires measuring similar constructs, and also using “known group” comparisons. Discrimination of PROMIS-A CAT was assessed using receiver operating characteristic (ROC) analysis and an established cut-off on GAD7 (≥10) for moderate/severe anxiety.
*Results: A cross-sectional, convenience sample of 431 participants were recruited (mean [SD] age: 53  years, 65% male, 68% Caucasian). 251 (58%) were KTRs, 18 (4%) were KPTRs and 162 (38%) were LTRs. 13% reported moderate/severe anxiety (GAD7 score ≥10). Mean (SD) PROMIS-A CAT score was 52.4 (8.5); participants answered an average of 5 questions. PROMIS-A CAT showed good test-retest reliability (ICC: 0.802). PROMIS-A CAT showed moderate correlation with GAD7 (rho=0.63, p<0.001), PHQ9 (rho=0.60, p<0.001), and KDQoL/LDQoL SF-12 Mental Health Composite Score (rho=-0.56, p<0.001). In “known group” comparisons, mean (SD) PROMIS-A CAT scores were significantly higher for females compared to males (54 , 51 ; p<0.001) and for albumin (g/L) ≤35 compared to ≥40 (56 , 52 ; p=0.024). PROMIS-A CAT scores were also significantly higher for patients who reported ≥30 score on ESASr compared to <30 (59 , 51 ; p<0.001), and for patients who reported moderate/severe compared to no/slight anxiety/depression on EQ5D (56 , 51 ; p<0.001). PROMIS-A-CAT had excellent discrimination with an area under of the ROC curve of 0.87 (95% CI: 0.82, 0.93).
*Conclusions: These results provide support the validity and reliability of PROMIS-A CAT among patients who received a solid organ transplant and support its use in research and clinical care.
To cite this abstract in AMA style:Saqib M, Yang M, Jamal F, Aghamohammadi S, Ahmadzadeh G, Hamid M, Shah V, Jayakumar N, Novak M, Mucsi I. Validation of PROMIS Anxiety Computer Adaptive Test in Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/validation-of-promis-anxiety-computer-adaptive-test-in-solid-organ-transplant-recipients/. Accessed June 18, 2021.
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