Article
Convergent Validity of PODCI and PROMIS domains in Congenital Upper Limb Anomalies
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Authors
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Charles Goldfarb
- Washington University School of Medicine, Shriners Hospital For Children, St Louis Childrens Hospital, Saint Louis, United States
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Lindley Wall
- Washington University School of Medicine, Shriners Hospital, Saint Louis Childrens Hospital, Saint Louis, United States
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Donald Bae
- Boston Childrens Hospital, Harvard Medical School, Boston, United States
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Carley Vuillermin
- Boston Childrens Hospital, Harvard Medical School, Boston, United States
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Patricia Miller
- Boston Childrens Hospital, Harvard Medical School, Boston, United States
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: This study evaluates the patient reported functional and psychosocial impact of upper limb congenital anomalies in patients prior to surgical intervention utilizing the PODCI and PROMIS. We hypothesized that patients will have scores that are in the normal range. Secondarily we sought to assess the similarities between the PODCI subscales and PROMIS domains and hypothesize that the two outcomes measures will have strong convergent validity.
Methods: A multi-center prospectively collected database of congenital upper limb patients, the CoULD (Congenital Upper Limb Differences) registry, was utilized for this study. All patients with complete PODCI and PROMIS data prior to surgical intervention were included in this study. Demographic information was collected and all anomalies were classified by the Oberg-Manske-Tonkin (OMT) classification. Scores for PODCI subscales of UE function, pain/comfort, and happiness and PROMIS domain of UE function, pain, depression, anxiety, and peer relations were collected. Ceiling and floor effects were examined and convergent validity for PODCI and PROMIS domains were assess using Spearman's correlation coefficients.
Results: 359 patients were included in the study. 241 patients had a diagnosis of malformation of the entire limb and 231 had a malformation of the hand plate. Four, patients had a diagnosis of deformation, 118 had a dysplasia, and 45 patients had a syndrome. Median PODCI and PROMIS scores are seen in Table 1.
There was no difference between the PODCI and PROMIS ceiling or floor effects for the upper extremity domains. The ceiling effect for the PROMIS pain domain (46%) was not different than the floor effect of the PODCI pain subscale and there was no difference seen between the floor effect of PODCI happiness and PROMIS depression domains. Convergent validity was achieved between the PROMIS and PODCI upper extremity domains (r = 0.82; 95% CI = 0.78 to 0.85; p<0.001), between the PROMIS pain domain and PODCI pain/comfort subscale (r = -0.60; 95% CI = -0.66 to -0.53; p<0.001), and between the PROMIS depression domain and PODCI happiness subscale (r = -0.53; 95% CI = -0.60 to -0.45; p<0.001).
Conclusion: For assessment of pediatric patient perceptions of congenital upper extremity anomalies, PROMIS domains for the upper extremity function, pain, and depression are comparable to PODCI domain scores. Consideration can be made for replacing the PODCI with the shorter and more widely utilized PROMIS questionnaire.
