title: Development and validation of the Proxy-Reported Pulmonary Outcomes Scale for premature infants.
abstract: OBJECTIVE
  Test the feasibility of using a bedside nurse-reported tool (Proxy-Reported Pulmonary Outcome Scale, PRPOS) for evaluating the severity of bronchopulmonary dysplasia (BPD) by assessing functional, disease-related measures.
  
  
  METHODS
  Bedside nurses tested the 26-item instrument by observing preterm infants (23-30 weeks at birth) at 36 to 37(4/7) weeks postmenstrual age before, during, and after a care time. We analyzed item reliability, validity, and model fit to determine the six items to include in the final measurement tool.
  
  
  RESULTS
  We completed assessments on 188 preterm infants. The frequency of an abnormal PRPOS item score increased with increasing National Institute of Child Health and Development (NICHD) BPD category. The six-candidate items produced an internally consistent scale. Addition of the NICHD BPD classification increased reliability moderately; addition of feeding items decreased reliability. The PRPOS score correlated with postmenstrual age at discharge. Infants discharged on oxygen or diuretics had higher median PRPOS scores than did infants who were not prescribed those therapies.
  
  
  CONCLUSIONS
  The PRPOS is an internally consistent, proxy-reported measure of respiratory function in premature infants, based on observable, functional performance measures. Initial testing demonstrates known-groups validity and ongoing testing can assess predictive validity.
authors.affiliation: Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Price
authors.affiliation: Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Sofia R
authors.initials: SR
authors.lastname: Aliaga
authors.affiliation: Center for Public Health Quality, Raleigh, North Carolina.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Massie
authors.affiliation: Learning and Diffusion Group, Centers for Medicare and Medicaid Services, Baltimore, Maryland.
authors.forename: Darren A
authors.initials: DA
authors.lastname: DeWalt
authors.affiliation: Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Laughon
authors.affiliation: Department of Pediatrics, Duke University, Durham, North Carolina.
authors.forename: William F
authors.initials: WF
authors.lastname: Malcolm
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine and Lucile Salter Packard Children's Hospital, Palo Alto, California.
authors.forename: Krisa
authors.initials: K
authors.lastname: Van Meurs
authors.affiliation: Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Klein
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: George
authors.initials: G
authors.lastname: El-Ferzli
authors.affiliation: Department of Psychology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Brooke E
authors.initials: BE
authors.lastname: Magnus
authors.affiliation: Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Sue
authors.initials: S
authors.lastname: Tolleson-Rinehart
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis* / Q000628:therapy; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D010100:Oxygen / Q000627:therapeutic use; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D004232:Diuretics; D010100:Oxygen