Understanding the impact of tuberous sclerosis complex: development and validation of the TSC-PROM.

Journal: BMC medicine

Volume: 21

Issue: 1

Year of Publication: 2023

Affiliated Institutions:  's Heeren Loo, Amersfoort, The Netherlands. Amsterdam Public Health Research Institute, Methodology and Mental Health and Personalized Medicine, Amsterdam, The Netherlands. Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Department of Nephrology and Arterial Hypertension, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel, Brussels, Belgium. Department of Child and Adolescent Psychiatry/Psychology and ENCORE Expertise Center, Erasmus Medical Center Sophia Children's Hospital, Rotterdam, The Netherlands. Center for Adults With Rare Genetic Syndromes, Division of Endocrinology, Department of Internal Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. Department of Pediatric Neurology and ENCORE Expertise Center, Erasmus Medical Center Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, Brussels, Belgium. Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA. Department of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Centre for Autism Research in Africa (CARA), Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa. 's Heeren Loo, Amersfoort, The Netherlands. a.m.vaneeghen@amsterdamumc.nl.

Abstract summary 

Tuberous sclerosis complex (TSC) is a rare and complex genetic disorder, associated with tumor growth in various organ systems, epilepsy, and a range of neuropsychiatric manifestations including intellectual disability. With improving patient-centered care and targeted therapies, patient-reported outcome measures (PROMs) are needed to measure the impact of TSC manifestations on daily functioning. The aim of this study was to develop a TSC-specific PROM for adults that captures the impact of TSC on physical functions, mental functions, activity and participation, and the social support individuals with TSC receive, called the TSC-PROM.COSMIN methodology was used to develop a self-reported and proxy-reported version. Development and validation consisted of the following studies: PROM development, content validity, structural validity, internal consistency, and construct validity. The International Classification of Functioning and Disability was used as a framework. Content validity was examined by a multidisciplinary expert group and cognitive interview study. Structural and construct validity, and internal consistency were examined in a large cohort, using confirmatory factor analysis, hypotheses testing, and Cronbach's alpha.The study resulted in an 82-item self version and 75-item proxy version of the TSC-PROM with four subscales (physical functions 18 and 19 items, mental functions 37 and 28 items, activities and participation 13 and 14 items, social support 13 items, for self version and proxy version respectively). Sufficient results were found for structural validity with sufficient unidimensionality for each subscale. With regard to construct validity, 82% of the hypotheses were met for the self version and 59% for the proxy version. The PROM showed good internal consistency (Cronbach's alpha 0.78-0.97).We developed a PROM for adults with TSC, named TSC-PROM, showing sufficient evidence for reliability and validity that can be used in clinical and research settings to systematically gain insight into their experiences. It is the first PROM in TSC that addresses the impact of specific TSC manifestations on functioning, providing a valuable, patient-centered addition to the current clinical outcomes.

Authors & Co-authors:  Müller Annelieke R AR Luijten Michiel A J MAJ Haverman Lotte L de Ranitz-Greven Wendela L WL Janssens Peter P Rietman André B AB Ten Hoopen Leontine W LW de Graaff Laura C G LCG de Wit Marie-Claire MC Jansen Anna C AC Gipson Tanjala T Capal Jamie K JK de Vries Petrus J PJ van Eeghen Agnies M AM

Study Outcome 

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Statistics
Citations :  Northrup H, Krueger DA, Roberds S, Smith K, Sampson J, Korf B, et al. Tuberous sclerosis complex diagnostic criteria update: recommendations of the 2012 International Tuberous Sclerosis Complex Consensus Conference. Pediatr Neurol. 2013;49(4):243–54.
Authors :  14
Identifiers
Doi : 298
SSN : 1741-7015
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Adults;Functioning;Intellectual disability;Patient-reported outcome measure;Quality of life;Rare genetic disorder;Tuberous sclerosis complex;Validity
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England