# Assessing Social Participation Among Kidney Transplant Recipients Using PROMIS Computer Adaptive Testing

## TL;DR

This study tested a new tool to measure social participation in kidney transplant patients and found it reliable and valid.

## Contribution

The study validates the PROMIS-SP CAT as a reliable and valid measure of social participation for kidney transplant recipients.

## Key findings

- The PROMIS-SP CAT showed excellent reliability (r = 0.93) and test-retest reliability (ICC = 0.97).
- Strong correlations were found between PROMIS-SP CAT and other social participation measures like the SDI and EQ5D5L.
- Scores differed significantly between known groups, supporting the tool's construct validity.

## Abstract

Social participation is a valued aspect of quality of life among kidney transplant recipients; however, few validated measures exist to assess it. This study aimed to explore the reliability and validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities (PROMIS-SP), administered as a computer adaptive test (CAT), among kidney transplant recipients.

This was a cross-sectional study involving a convenience sample of adult recipients from Toronto, Canada. Participants completed the PROMIS-SP CAT and legacy measures of social participation on an electronic data capture platform. Reliability of the PROMIS-SP CAT was determined using standard error of measurement (SEM) and test-retest reliability using intraclass correlation coefficient. Convergent validity was assessed by calculating Spearman’s correlation between the PROMIS-SP CAT and legacy measures, and construct validity was assessed using known group comparisons.

We recruited 284 participants with a mean (SD) age of 53 (14) years and a median of 5.5 years since kidney transplantation; 61% were male, 53% were White, and 30% had diabetes. The mean (SD) PROMIS T-score was 51 (9). Reliability (r = 0.93) and test-retest reliability (intraclass correlation coefficient = 0.97) of the PROMIS-SP CAT were excellent. Strong correlations were observed between PROMIS-SP CAT and social difficulty inventory (SDI) (rho = −0.65), SDI “everyday living” (rho = −0.68), and EuroQol-5 Dimensions-5 Levels (EQ5D5L) “usual activities” (rho = −0.66). PROMIS-SP CAT scores were significantly different between known groups in the expected direction.

Our results support the validity and reliability of PROMIS-SP CAT among kidney transplant recipients, and suggest that this tool can be used to identify recipients with restricted social participation.