PROMIS fatigue scores are moderately correlated with heart failure severity in pediatrics
Lindsay J. May, MD, MSCI,
Josef Stehlik, MD, MPH,
Zhining Ou, MS,
Linda M. Lambert, APRN,
Chiu-Yu Chen, MD,
David N. Rosenthal, MD,
Desiree S. Machado, MD,
Dalia Lopez-Colon, MS,
Renata Shih, MD,
Taylor Gibbons, BS,
Brian Madden, MD,
Kae Watanabe, MD,
Angela P. Presson, PhD,
Amy M. Cizik, PhD, MPH,
Heather T. Keenan, MDCM, PhD
Affiliations
Lindsay J. May, MD, MSCI
Department of Pediatrics, University of Utah, Salt Lake City, Utah; Corresponding author: Lindsay J. May, MD, MSCI, Pediatrics University of Utah, 81 N Mario Capecchi Drive, Salt Lake City, UT 84112.
Josef Stehlik, MD, MPH
Department of Internal Medicine, University of Utah, Salt Lake City, Utah
Zhining Ou, MS
Department of Internal Medicine, University of Utah, Salt Lake City, Utah
Linda M. Lambert, APRN
Department of Surgery, University of Utah, Salt Lake City, Utah
Chiu-Yu Chen, MD
Department of Pediatrics, Stanford University, Palo Alto, California
David N. Rosenthal, MD
Department of Pediatrics, Stanford University, Palo Alto, California
Desiree S. Machado, MD
Department of Pediatrics, Division of Critical Care, University of Miami Miller School of Medicine, Holtz Children’s Hospital, Miami, Florida
Dalia Lopez-Colon, MS
Department of Pediatrics, University of Florida, Gainesville, Florida
Renata Shih, MD
Department of Pediatrics, University of Florida, Gainesville, Florida
Taylor Gibbons, BS
Department of Pediatrics, Northwestern University, Chicago, Illinois
Brian Madden, MD
Department of Pediatrics, Northwestern University, Chicago, Illinois
Kae Watanabe, MD
Department of Pediatrics, Baylor College of Medicine, Houston, Texas
Angela P. Presson, PhD
Department of Internal Medicine, University of Utah, Salt Lake City, Utah
Amy M. Cizik, PhD, MPH
Department of Orthopedics, University of Utah, Salt Lake City, Utah
Heather T. Keenan, MDCM, PhD
Department of Pediatrics, University of Utah, Salt Lake City, Utah
Background: Patient-reported outcome measures (PROMs) correlate with heart failure (HF) severity among adults and are adjunct tools in clinical care. Limited data exist regarding the validity of PROMs in pediatric HF. Hypothesis: Patient-Reported Outcome Measurement Information System (PROMIS) Pediatric Fatigue correlates with HF severity, measured by the New York University Pediatric Heart Failure Index (NYU PHFI). Methods: Children ≥8 and <18 years old were enrolled prospectively at 4 hospitals, from September 2019 to February 2023, while receiving inpatient HF care. NYU PHFI and pediatric self-report PROMIS measures were administered to inpatient and outpatient patients. PROMIS measures: Mobility, Anxiety, Depressive symptoms, Peer relationships, and Fatigue (primary outcome). Paired t-tests compared PROMIS and NYU PHFI scores across time. A mixed-effects model generated correlation coefficients. Results: In the 41-patient cohort, 20 (48.8%) were discharged without ventricular assist device/transplant, 18 completed inpatient and outpatient assessments. Mean PROMIS Fatigue t-scores improved: 58.1 ± 12.9 to 48.9 ± 16.9; p = 0.007. Clinically meaningful improvements were observed in other PROMIS t-scores, except Peer relationships. NYU PHFI scores improved: 13.3 ± 2.6 to 7.8 ± 3.4; p < 0.001. PROMIS Fatigue and NYU PHFI moderately correlated (r = 0.5; 95% confidence interval 0.3, 0.6). Conclusions: PROMIS Fatigue t-scores moderately correlated with HF severity in children suggesting that Fatigue could be useful in longitudinal monitoring and clinical trials.
