Patrick O Monahan1,2, Kurt Kroenke3,4,5, Timothy E Stump3. 1. School of Medicine, Indiana University, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202-3002, USA. pmonahan@iu.edu. 2. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA. pmonahan@iu.edu. 3. School of Medicine, Indiana University, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202-3002, USA. 4. Center for Health Information and Communication, VA HSR&D, Washington DC, USA. 5. Regenstrief Institute, Inc., Indianapolis, IN, USA.
Abstract
BACKGROUND: Patient- and caregiver-reported 23-item SymTrak scales were validated for monitoring clinically actionable symptoms and impairments associated with multiple chronic conditions (MCCs) in older adults. Items capture physical and emotional symptoms and impairments in physical and cognitive functioning. An abbreviated SymTrak is desirable when response burden is a concern. OBJECTIVE: Develop and validate the 8-item SymTrak. DESIGN AND PARTICIPANTS: Secondary analysis of SymTrak validation study; 600 participants (200 patient-caregiver dyads; 200 patients without an identified caregiver). MAIN MEASURES: Demographic questions, SymTrak, and Health Utility Index Mark 3 (HUI3). KEY RESULTS: SymTrak-8 demonstrated good fit to a one-factor model using confirmatory factor analysis (CFA). Concurrent criterion validity was supported by high standardized linear regression coefficients (STB) between baseline SymTrak-8 total score (independent variable) and baseline HUI3 preference-based overall HRQOL utility score (dependent variable; 0 = death, 1 = perfect health), after adjusting for demographics, comorbid conditions, and medications, with strength comparable to SymTrak-23 (STB = - 0.81 and - 0.84, respectively, for SymTrak-8 and SymTrak-23, when patient-reported; and - 0.60 and - 0.62, respectively, when caregiver-reported). Coefficient alpha (0.74; 0.76) and 24-h test-retest reliability (0.83; 0.87) were high for SymTrak-8 for patients and caregivers, respectively. The convergent correlation between brief and parent SymTrak scales was high (0.94). SymTrak-8 demonstrated approximate normality and a linear relationship with SymTrak-23 and HUI3. Importantly, a 3-month change in SymTrak-8 was sensitive to detecting the criterion (3-month reliable change categories; improved, stable, declined in HUI3 overall utility), with results comparable to SymTrak-23. CONCLUSIONS: SymTrak-8 total score demonstrates internal reliably, test-retest reliability, criterion validity, and sensitivity to change that are comparable to SymTrak-23. Thus, patient- or caregiver-reported SymTrak-8 is a viable option for identifying and monitoring the aggregate effect of symptoms and functional impairments in patients with multimorbidity when response burden is a concern.
BACKGROUND: Patient- and caregiver-reported 23-item SymTrak scales were validated for monitoring clinically actionable symptoms and impairments associated with multiple chronic conditions (MCCs) in older adults. Items capture physical and emotional symptoms and impairments in physical and cognitive functioning. An abbreviated SymTrak is desirable when response burden is a concern. OBJECTIVE: Develop and validate the 8-item SymTrak. DESIGN AND PARTICIPANTS: Secondary analysis of SymTrak validation study; 600 participants (200 patient-caregiver dyads; 200 patients without an identified caregiver). MAIN MEASURES: Demographic questions, SymTrak, and Health Utility Index Mark 3 (HUI3). KEY RESULTS: SymTrak-8 demonstrated good fit to a one-factor model using confirmatory factor analysis (CFA). Concurrent criterion validity was supported by high standardized linear regression coefficients (STB) between baseline SymTrak-8 total score (independent variable) and baseline HUI3 preference-based overall HRQOL utility score (dependent variable; 0 = death, 1 = perfect health), after adjusting for demographics, comorbid conditions, and medications, with strength comparable to SymTrak-23 (STB = - 0.81 and - 0.84, respectively, for SymTrak-8 and SymTrak-23, when patient-reported; and - 0.60 and - 0.62, respectively, when caregiver-reported). Coefficient alpha (0.74; 0.76) and 24-h test-retest reliability (0.83; 0.87) were high for SymTrak-8 for patients and caregivers, respectively. The convergent correlation between brief and parent SymTrak scales was high (0.94). SymTrak-8 demonstrated approximate normality and a linear relationship with SymTrak-23 and HUI3. Importantly, a 3-month change in SymTrak-8 was sensitive to detecting the criterion (3-month reliable change categories; improved, stable, declined in HUI3 overall utility), with results comparable to SymTrak-23. CONCLUSIONS: SymTrak-8 total score demonstrates internal reliably, test-retest reliability, criterion validity, and sensitivity to change that are comparable to SymTrak-23. Thus, patient- or caregiver-reported SymTrak-8 is a viable option for identifying and monitoring the aggregate effect of symptoms and functional impairments in patients with multimorbidity when response burden is a concern.
Authors: Patrick O Monahan; Kurt Kroenke; Christopher M Callahan; Tamilyn Bakas; Amanda Harrawood; Phillip Lofton; Danielle Frye; Claire Draucker; Timothy Stump; Debra Saliba; James E Galvin; Amanda Keegan; Mary G Austrom; Malaz Boustani Journal: J Gen Intern Med Date: 2019-03-25 Impact factor: 5.128
Authors: Anna J Koné Pefoyo; Susan E Bronskill; Andrea Gruneir; Andrew Calzavara; Kednapa Thavorn; Yelena Petrosyan; Colleen J Maxwell; YuQing Bai; Walter P Wodchis Journal: BMC Public Health Date: 2015-04-23 Impact factor: 3.295