Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies

Abstract Background Patient reported outcome (PRO) instruments are important for assessing the effects of new therapeutics; however, no PRO measures have been specifically developed for use in Nephrotic Syndrome (NS) with documented evidence of content validity. Methodology The Nephrotic Syndrome Sy...

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Main Authors: Joshua Maher, An-Qi Hu, Sagar U. Nigwekar, Julie Lin
Format: Article
Language:English
Published: SpringerOpen 2025-08-01
Series:Journal of Patient-Reported Outcomes
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Online Access:https://doi.org/10.1186/s41687-025-00937-7
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author Joshua Maher
An-Qi Hu
Sagar U. Nigwekar
Julie Lin
author_facet Joshua Maher
An-Qi Hu
Sagar U. Nigwekar
Julie Lin
author_sort Joshua Maher
collection DOAJ
description Abstract Background Patient reported outcome (PRO) instruments are important for assessing the effects of new therapeutics; however, no PRO measures have been specifically developed for use in Nephrotic Syndrome (NS) with documented evidence of content validity. Methodology The Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) tool was developed following a literature review, concept elicitation (CE) interviews with patients with NS and clinicians, item generation, and cognitive debriefing (CD) interviews with patients with NS. The CE interviews were conducted with four nephrologists and among adults (aged ≥ 18 years) and adolescents (aged 12–17 years) diagnosed with NS. Results In total, 45 adult and adolescent patients were interviewed across all CE and CD interviews. In the adult CE interviews, the most frequently reported symptoms were swelling in the feet/legs (n = 14/16), general tiredness (n = 13/16), change in appetite (n = 13/16), foamy urine (n = 12/16), and shortness of breath (n = 12/16); impacts included emotional health, physical function limitations, sleep difficulties, and social/lifestyle limitations (n = 13/16). In adolescents, the most frequently reported symptoms were tiredness/fatigue (n = 13/15), stomachache (n = 11/15), headache (n = 8/15), foamy/frothy urine (n = 7/15), swelling in face/eyes (n = 6/15), swelling in legs/ankles (n = 5/15), and change in appetite (n = 5/15), while the most common impacts were impact on schooling (n = 10/15), reduced ability to practice sports (n = 7/15), and impact on friendship (n = 7/15). A conceptual model was developed and used to inform item generation for the NephroSSI-PRO. During CD interviews, there were no challenges in understanding and relating to instrument instructions, items, and response options. Conclusions We have developed a PRO instrument to evaluate the symptoms and impacts of NS in adult and adolescent patients. In this study, the evidence from a literature review, and direct patient input from CE and CD support its content validity. Further work supporting the instrument’s validity will be performed in a future clinical trial.
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spelling doaj-art-aaac7cf9f78b4ea0ac8683216fc054842025-08-24T11:32:39ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202025-08-019111310.1186/s41687-025-00937-7Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathiesJoshua Maher0An-Qi Hu1Sagar U. Nigwekar2Julie Lin3SanofiSanofiDivision of Nephrology, Department of Medicine, Massachusetts General BrighamSanofiAbstract Background Patient reported outcome (PRO) instruments are important for assessing the effects of new therapeutics; however, no PRO measures have been specifically developed for use in Nephrotic Syndrome (NS) with documented evidence of content validity. Methodology The Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) tool was developed following a literature review, concept elicitation (CE) interviews with patients with NS and clinicians, item generation, and cognitive debriefing (CD) interviews with patients with NS. The CE interviews were conducted with four nephrologists and among adults (aged ≥ 18 years) and adolescents (aged 12–17 years) diagnosed with NS. Results In total, 45 adult and adolescent patients were interviewed across all CE and CD interviews. In the adult CE interviews, the most frequently reported symptoms were swelling in the feet/legs (n = 14/16), general tiredness (n = 13/16), change in appetite (n = 13/16), foamy urine (n = 12/16), and shortness of breath (n = 12/16); impacts included emotional health, physical function limitations, sleep difficulties, and social/lifestyle limitations (n = 13/16). In adolescents, the most frequently reported symptoms were tiredness/fatigue (n = 13/15), stomachache (n = 11/15), headache (n = 8/15), foamy/frothy urine (n = 7/15), swelling in face/eyes (n = 6/15), swelling in legs/ankles (n = 5/15), and change in appetite (n = 5/15), while the most common impacts were impact on schooling (n = 10/15), reduced ability to practice sports (n = 7/15), and impact on friendship (n = 7/15). A conceptual model was developed and used to inform item generation for the NephroSSI-PRO. During CD interviews, there were no challenges in understanding and relating to instrument instructions, items, and response options. Conclusions We have developed a PRO instrument to evaluate the symptoms and impacts of NS in adult and adolescent patients. In this study, the evidence from a literature review, and direct patient input from CE and CD support its content validity. Further work supporting the instrument’s validity will be performed in a future clinical trial.https://doi.org/10.1186/s41687-025-00937-7Clinical outcome assessmentsDisease impactsDisease symptomsHealth-related quality of lifeNephrotic syndromePatient-reported outcomes
spellingShingle Joshua Maher
An-Qi Hu
Sagar U. Nigwekar
Julie Lin
Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies
Journal of Patient-Reported Outcomes
Clinical outcome assessments
Disease impacts
Disease symptoms
Health-related quality of life
Nephrotic syndrome
Patient-reported outcomes
title Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies
title_full Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies
title_fullStr Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies
title_full_unstemmed Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies
title_short Development of the Nephrotic Syndrome Symptom and Impact Patient Reported Outcome (NephroSSI-PRO) measure for use in adults and adolescents with primary glomerulopathies
title_sort development of the nephrotic syndrome symptom and impact patient reported outcome nephrossi pro measure for use in adults and adolescents with primary glomerulopathies
topic Clinical outcome assessments
Disease impacts
Disease symptoms
Health-related quality of life
Nephrotic syndrome
Patient-reported outcomes
url https://doi.org/10.1186/s41687-025-00937-7
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