Validation of PROMIS Computer Adaptive Testing (CAT) Sleep Disturbance Item Bank in Kidney Transplant Recipients
1Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada, 2Centre for Health Outcomes Research, McGill University, Montreal, QC, Canada, 3Department of Supportive Care, Princess Margaret Hospital, Toronto, ON, Canada, 4Princess Margaret Cancer Centre, Faculty of Nursing, University of Toronto, Toronto, ON, Canada, 5Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 6Centre for Mental Health, University Health Network, Toronto, ON, Canada
Meeting: 2020 American Transplant Congress
Abstract number: D-064
Keywords: Kidney transplantation, Outcome, Psychosocial, Quality of life
Session Information
Session Name: Poster Session D: Kidney Psychosocial
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: To assess the reliability and validity of the PROMIS Sleep Disturbance Item Bank using the Insomnia Severity Index as the primary legacy instrument in KTRs.
*Methods: A cross-sectional, sample of stable adult KTRs completed the PROMIS CAT Sleep Disturbance (SD) Item Bank, the Insomnia Severity Index (ISI), General Anxiety Disorder (GAD7), and Kidney Disease Quality of Life-36 (KDQoL-36) questionnaires on an electronic data capture platform. Sociodemographic and clinical data were collected from medical records. Construct validity was assessed using Spearman’s rho and known-group comparisons. Cut-off PROMIS CAT SD score to identify potentially clinically significant sleep problems was defined by Youden’s J Index in receiver-operating curve (ROC) analysis. Measurement agreement was assessed using Cohen’s kappa, test-retest reliability was assessed using the intraclass correlation coefficient (ICC).
*Results: Mean(SD) age of 164 KTRs was 55(13) years, 56% were male, 59% were Caucasian, and 9% had moderate/severe sleep problems based on ISI cutoff of 15. PROMIS CAT SD was strongly correlated with ISI (rho=0.741, p<0.001). In known group comparisons, PROMIS CAT SD scores were marginally higher in patients with eGFR (in mL/min/1.73m2) >60 compared to <45 (52(8) vs 49(7), p=0.06). PROMIS CAT SD scores were higher in the first vs third tertile of KDQoL SF-12 Mental Composite scores (54(8) vs 46(8), p<0.001). KTRs with GAD scores >10 vs ≤10 also had higher scores on PROMIS CAT SD (58(6) vs 50(8), p<0.001). A cutoff of 60 for the PROMIS CAT SD score showed good discrimination when the ISI score 15 was considered to define clinically significant sleep problems with area under ROC curve of 0.908 (95% CI: (0.832, 0.983)). PROMIS CAT Sleep Disturbance showed good agreement with ISI (kappa=0.622) and excellent test-retest reliability (ICC = 0.777).
*Conclusions: These data contribute new evidence of the reliability and validity of PROMIS CAT Sleep Disturbance measure in KTRs and support its use in research and care.
To cite this abstract in AMA style:
Hussain J, Chawla G, Ullah N, Rafiqzad H, Bartlett SJ, Li M, Howell D, Peipert JD, Novak M, Mucsi I. Validation of PROMIS Computer Adaptive Testing (CAT) Sleep Disturbance Item Bank in Kidney Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/validation-of-promis-computer-adaptive-testing-cat-sleep-disturbance-item-bank-in-kidney-transplant-recipients/. Accessed May 12, 2025.« Back to 2020 American Transplant Congress