PROMIS-29 AS A VALID AND COMPARABLE PATIENT-REPORTED OUTCOME MEASURE TO THE SF-36 IN TURKISH DIALYSIS PATIENTS

 

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https://storage.unitedwebnetwork.com/files/1099/783423e5b132651d8900e19b501c4973.pdf
PROMIS-29 AS A VALID AND COMPARABLE PATIENT-REPORTED OUTCOME MEASURE TO THE SF-36 IN TURKISH DIALYSIS PATIENTS

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Ngoc Pham ngoc.pham@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany * Charite Center for Patient-Centered Outcomes Research Berlin Germany
Krister Cromm krister.cromm@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany - Charite Center for Patient-Centered Outcomes Research Berlin Germany
Özlem Kuman Tuncel kumanozlem@yahoo.com Ege University School of Medicine Izmir Turkey -
Giovanni Strippoli gfmstrippoli@gmail.com University of Bari Department of Precision and Regenerative Medicine and Ionian Area (Dimepre-J) Bari Italy - University of Sydney School of Public Health Sydney Australia
Tatiana de los Rios tatiana.de-los-rios@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Saynab Atiye saynab.atiye@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Mirja Humpert mc.humpert@arcor.de Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Manuela Stauss-Grabo Manuela.Stauss-Grabo1@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Gülay Asci gulayas@hotmail.com Ege University School of Medicine Izmir Turkey -
Ercan Ok ercanok61@gmail.com Ege University School of Medicine Izmir Turkey -
Hayriye Elbi hayriye.elbi@yahoo.com Ege University School of Medicine Izmir Turkey -
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Patient-reported outcome measures (PROMs) provide insight into how dialysis patients experience their health beyond laboratory or clinical indicators. The Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) is a widely used questionnaire assessing health-related quality of life (HrQOL) domains including physical function, fatigue, pain interference, depression, anxiety, social participation, sleep disturbance and pain intensity. However, data on its performance in Turkish-speaking populations remain limited. As part of the multicenter DOPRO study on HrQOL in Turkish dialysis patients, we evaluated the reliability and validity of the Turkish PROMIS-29 and compared it to the SF-36, a traditional HrQOL instrument frequently used in nephrology.

Participants on maintenance hemodialysis completed the PROMIS-29 electronically at two time points separated by at least 7 days. Psychometric testing included analyses of internal consistency (how well items within a domain measure the same concept), item-total correlations (how strongly each question contributes to its overall domain) and test-retest reliability (stability of scores over time). Validity was examined through inter-item correlation patterns and through correlations between PROMIS-29 domains and corresponding SF-36 domains.

A total of 177 adults on maintenance hemodialysis participated (mean age = 55.5 ± 13.4 years; 87.5% in-center, 12.5% home hemodialysis). All PROMIS-29 domains demonstrated good internal consistency (α ≥ 0.70) and acceptable test–retest reliability (ICC = 0.59-0.83). Items within each domain were well aligned, confirming that they consistently measured the intended health aspect. Inter-item correlations showed clear clustering of related questions, supporting the conceptual structure of the tool. Ceiling and floor effects were minimal (< 10% per domain). Most correlations between PROMIS-29 and SF-36 domains were moderate to strong (r = 0.18-0.71), indicating that both instruments capture comparable HrQOL dimensions (see Table below). PROMIS-29 scores appeared slightly more responsive to psychosocial factors such as self-efficacy than the SF-36, suggesting that it may better reflect patient-perceived health differences relevant to clinical care.


Values represent polychoric correlations between PROMIS-29 and SF-36 domain scores to examine convergent validity. Colored cells indicate the highest associations between domains. Green shading marks domains assessing similar concepts across instruments, while orange shading represents associations between related but not conceptually identical domains.

The Turkish PROMIS-29 showed strong measurement performance in dialysis patients, reliably capturing both physical and mental aspects of HrQOL. Its close alignment with SF-36 results, combined with simpler scoring and broader domain coverage, supports its use as a valid and efficient alternative in nephrology practice and research to better understand patients’ daily functioning and well-being.

Kewords