Cognitive interviewing methodology in the development of a pediatric item bank: a patient reported outcomes measurement information system (PROMIS) study

Debra E. Irwin · James W. Varni · Karin Yeatts · Darren A. DeWalt

290 citations0/0 files storedHealth and Quality of Life Outcomes

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Psychometric Methodologies and Testing Survey Methodology and Nonresponse Health Education and Validation

Abstract

BACKGROUND: The evaluation of patient-reported outcomes (PROs) in health care has seen greater use in recent years, and methods to improve the reliability and validity of PRO instruments are advancing. This paper discusses the cognitive interviewing procedures employed by the Patient Reported Outcomes Measurement Information System (PROMIS) pediatrics group for the purpose of developing a dynamic, electronic item bank for field testing with children and adolescents using novel computer technology. The primary objective of this study was to conduct cognitive interviews with children and adolescents to gain feedback on items measuring physical functioning, emotional health, social health, fatigue, pain, and asthma-specific symptoms. METHODS: A total of 88 cognitive interviews were conducted with 77 children and adolescents across two sites on 318 items. From this initial item bank, 25 items were deleted and 35 were revised and underwent a second round of cognitive interviews. A total of 293 items were retained for field testing. RESULTS: Children as young as 8 years of age were able to comprehend the majority of items, response options, directions, recall period, and identify problems with language that was difficult for them to understand. Cognitive interviews indicated issues with item comprehension on several items which led to alternative wording for these items. CONCLUSION: Children ages 8-17 years were able to comprehend most item stems and response options in the present study. Field testing with the resulting items and response options is presently being conducted as part of the PROMIS Pediatric Item Bank development process.

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References

2000The Psychology of Survey Response 2007The Patient-Reported Outcomes Measurement Information System (PROMIS)2004Cognitive Interviewing: A Tool for Improving Questionnaire Design 2005Cognitive Interviewing 1995Thinking About Answers: The Application of Cognitive Processes to Survey Methodology 2005KIDSCREEN-52 quality-of-life measure for children and adolescents 1996Thinking about Answers: The Application of Cognitive Process to Survey Methodology 2007Evaluation of Item Candidates

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2015PROMIS® pediatric self-report scales distinguish subgroups of children within and across six common pediatric chronic health conditions 2013Psychometric properties of the PROMIS® pediatric scales: precision, stability, and comparison of different scoring and administration options 2012Improving Survey Methods With Cognitive Interviews in Small- and Medium-Scale Evaluations 2013PROMIS Pediatric Peer Relationships Scale: Development of a peer relationships item bank as part of social health measurement.2020Development and validation of an interpretive guide for PROMIS scores

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