Validation and calibration of the patient-reported outcomes measurement information system: Pediatric PROMIS® Emotional Distress domain item banks, Portuguese version (Brazil/Portugal)



This paper goal was to validate the Portuguese version (Brazil/Portugal) of the Anger, Anxiety, and Depressive Symptoms item banks of the Pediatric PROMIS® Emotional Distress domain (version 1.0) for the Brazilian and Portuguese pediatric population.


The total of 1216 participants answered a self-applied version of the Portuguese Anger, Anxiety, and Depressive Symptoms item banks. Reliability was assessed through internal consistency, test–retest reliability, and total information curve (TIC). Confirmatory Factor Analysis (CFA) with a bifactor model was used to confirm construct validity and IRT assumptions. Item calibration was performed according to Graded Response Model (GRM). Differential Item Functioning (DIF) was analyzed according the participants’ age, gender, health condition (healthy versus chronic disease), and language.


Internal consistency reliability (Cronbach's alpha coefficient = 0.84) and test–retest reliability (intraclass correlation = 0.93) were accurate. Unidimensionality, Local Independency, and construct validity were verified by CFA (CFI = 0.93; TLI = 0.93; RMSEA = 0.05; χ2 = 3052.4 with DIF = 557 and P value = 0.595). GRM was adjusted, and Emotional Distress had a satisfactory coverage. DIF was not significant.


The results obtained indicate the adequacy of the psychometric properties of the Portuguese version (Brazil/Portugal) of the Anger, Anxiety, and Depressive Symptoms item banks of the Pediatric PROMIS® Emotional Distress domain.

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The authors would like to thank the PROMIS® team for their collaboration and technical assistance in the transcultural adaptation process, in particular, the researchers of the Medical Social Science Department at Northwestern University (Chicago—USA) David Cella, PhD and Helena Correia and to FACITtrans director, Benjamin Arnold (Elmhurst, USA). The authors also thank the State of Minas Gerais Foundation for Research Support (FAPEMIG) for the financial support and the Quality of Life research group of the Faculty of Medicine at the Federal University of Uberlândia (FAMED-UFU).


This study was funded by the State of Minas Gerais Foundation for Research Support (Fapemig) (PPM-00306–08).

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Correspondence to Márcia N. F. de C. Pinto.

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Pinto, M.N.F.C., Pinto, R.M.C., Mendonça, T.M.S. et al. Validation and calibration of the patient-reported outcomes measurement information system: Pediatric PROMIS® Emotional Distress domain item banks, Portuguese version (Brazil/Portugal). Qual Life Res 29, 1987–1997 (2020).

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  • Emotional distress
  • Self-reported
  • Children
  • Validation