The PROMIS-A CAT demonstrated strong convergent validity with the GAD-7 (rho = 0.78) and excellent discrimination (AUROC 0.885) for detecting moderate to severe anxiety in hospitalized heart failure patients.
Cross-Sectional (n=333)
Yes
Is the PROMIS-Anxiety CAT a valid and reliable tool for assessing anxiety in patients hospitalized for heart failure compared to GAD-7?
The PROMIS-Anxiety CAT is a valid and reliable tool for assessing anxiety in patients hospitalized for heart failure, with a T-score of 60 identifying moderate/severe anxiety.
Effect estimate: rho 0.78 (95% CI 0.73-0.82)
p-value: p=<0.001
Introduction Anxiety is highly prevalent among patients with heart failure (HF), negatively affecting health related quality of life (HRQOL). The Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety item bank computer adaptive testing (CAT) precisely assesses anxiety symptom severity. This study aims to assess construct validity and reliability of PROMIS-Anxiety CAT among patients hospitalized for HF. Methods A cross-sectional convenience sample of adult patients hospitalized for HF, who completed PROMIS-A CAT, generalized anxiety disorder 7 (GAD-7), and other questionnaires electronically. Convergent validity was assessed by Spearman's rank correlation between PROMIS-A CAT, GAD-7, and other legacy measures. Known group analysis compared PROMIS-A CAT and GAD-7 scores between groups expected to have different levels of anxiety. Reliability of PROMIS-A CAT was calculated on the individual and group level from standard error of measurement, according to item response theory. Area under receiver-operating characteristics (ROC) curve and Youden's J statistic were used to identify a T -score cut-off for moderate/severe anxiety. Results Of 333 participants, 87 (26%) had moderate/severe anxiety based on GAD-7 score (≥ 10). Participants completed on average (median IQR) 4(1) vs. 7(0) items, with PROMIS-A CAT and GAD-7, respectively. PROMIS-A CAT T -scores were strongly correlated with GAD-7 scores (rho = 0.78) and moderately correlated with other legacy measures. Known-group analysis provided further support for construct validity of PROMIS-A CAT. Individual reliability for PROMIS-A CAT T -scores was 0.9 for 87% of the sample; mean reliability was 0.91. Based on ROC and Youden's J analyses, a T -score of 60 can be used to identify individuals with moderate/severe anxiety. Conclusion These results support the validity and reliability of PROMIS-A CAT among patients hospitalized for HF.
Marblestone et al. (Thu,) conducted a cross-sectional in Heart failure (n=333). PROMIS-A CAT vs. GAD-7 was evaluated on Convergent validity (correlation with GAD-7) (rho 0.78, 95% CI 0.73-0.82, p=<0.001). The PROMIS-A CAT demonstrated strong convergent validity with the GAD-7 (rho = 0.78) and excellent discrimination (AUROC 0.885) for detecting moderate to severe anxiety in hospitalized heart failure patients.