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Generation and Validation of the PROMIS Itch Questionnaire – Child to Measure the Impact of Itch on Life Quality

Published:October 29, 2021DOI:https://doi.org/10.1016/j.jid.2021.10.015

      ABSTRACT

      Itch compromises quality of life, but most itch assessments focus only on itch intensity. We aimed to develop and validate a comprehensive PROMIS (Patient Reported Outcomes Measurement Information System®) pediatric measure for itch symptoms and itch impact, defined as the effect specifically of itch on physical, mental, and social health, all of which can affect life quality. After literature review, concept elicitation and cognitive interviews with parents and children with itch, and repeated content-expert review, an item pool was generated and refined. The pool was calibrated with data from 499 pruritic children using exploratory and confirmatory factor analyses, item response theory, and item fit analysis. The resultant 45-item bank, PROMIS Itch Questionnaire - Child (PIQ-C), showed good convergent and discriminant validity in 181 children 8-17 years of age, discriminating children with different levels of severity, and was responsive to change. Strong correlations (rho>.60) were observed with pain and sleep measures, and moderate correlations with other pediatric PROMIS measures. PIQ-C comprehensively measures itch intensity and burden, providing an itch-specific alternative for assessing life quality. The independent calibration of each item/question allows for flexibility in generating short-forms or computerized adaptive testing for efficient use in research and office practice.

      Keywords

      Abbreviations:

      BSA (Body surface area), CAT (Computerized adaptive testing), CDLQI (Children’s Dermatology Life Quality Index), DLQI (Dermatology Life Quality Index), EASI (Eczema Area and Severity Index), GRM (Graded Response Model), IGA (Investigator’s Global Assessment), IGA*BSA (The product of the IGA and BSA), IRT (Item response theory), NRS (Numeric rating scale), PIQ-C (PROMIS Itch Questionnaire - Child), POEM (Patient-Oriented Eczema Measure), PROMIS (Patient-Reported Outcome Measurement Information System), SCORAD (SCORing Atopic Dermatis), SD (Standard deviation)
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