Assessing the Clinical Value of the Pediatric Evaluation of Disability Inventory – Computerized Adaptive Test (PEDI-CAT) in Measuring Self-Reported Disability in Youth Undergoing Intensive Interdisciplinary Pain Treatment (IIPT)

OBJECTIVES: This study investigated the clinical utility of the Pediatric Evaluation of Disability Inventory - Computerized Adaptive Test (PEDI-CAT), adapted as a self-report measure of disability among youth with chronic pain. METHODS: Participants (N=199) completed the PEDI-CAT Daily Activities and Mobility subtests and biopsychosocial questionnaires at intensive interdisciplinary pain treatment (IIPT) admission and discharge. First, we conducted cognitive interviews (N=5) to understand participants' interpretation of the items when administered via self-report. Then, we evaluated 1) responsiveness of the PEDI-CAT subtests, 2) convergent validity of PEDI-CAT admission T-scores, and 3) factors associated with average (i.e., recovered) PEDI-CAT T-scores at discharge. RESULTS: Cognitive interviews supported using the PEDI-CAT as a self-reported outcome in youth with chronic pain. PEDI-CAT Daily Activities T-scores significantly correlated with all outcomes at admission except pain intensity and body coordination. Mobility T-scores significantly correlated with outcomes of functioning and risk for poor prognosis on the PPST but did not correlate with psychological outcomes or pain intensity. Daily Activities and Mobility T-scores significantly improved after IIPT (P<0.001). Mean Daily Activities T-scores were average at admission and discharge. Most participants reported below average Mobility T-scores at admission and discharge. Multivariable logistic regression showed less anxiety, younger age, higher admission scores, and shorter length of stay increased odds of reporting average (i.e., recovered) Mobility at discharge. DISCUSSION: The PEDI-CAT adapted for self-report measured meaningful improvements in disability in youth with chronic pain undergoing IIPT. Further evaluation of the PEDI-CAT psychometrics in youth with chronic pain is warranted.