186 Chapter 7 of the scores were reliable) or good (>70% of the scores were reliable) for almost all measures, except for the CAT Mobility (56.2% of the scores was reliable). The reliability of the legacy instruments was excellent with Cronbach α ranging 0.92 to 0.99. The mean number of completed items per PROMIS pediatric measure varied from 8.8 items (range, 5-12) for the item bank Peer Relationships to 11.6 items (range, 8-12) for the item bank Anxiety. For the Haemo-QoL, the number of completed items varied from 6 items for the subscale Haemo-QoL Other People to 8 items for the subscale Haemo-QoL Feeling. The total number of items for the HaemoQoL were 64 (8-12 years) and 77 items (13-17 years). The PedHAL consisted of 53 items. The selected set of PROMIS pediatric measures contained an average of 80.4 items (range, 49-90), while the selected legacy instruments contained 117 items for children aged 8-12 years and 130 items for children aged 13-17 years. This means a reduction of items by 31% for patients aged 8-12 years and a reduction of 38% for patients aged 13-17 years. Floor and ceiling effects were present in both the PROMIS pediatric measures and the legacy instruments. For the PROMIS pediatric measures, floor effects were observed in 4 CATs: Pain Interference, Fatigue, Anxiety, and Depressive Symptoms. A ceiling effect was observed in the CAT Mobility. In case of floor or ceiling effects, participants had to complete the maximum of 12 items. For the legacy instruments, floor effects were observed for the Haemo-QoL Physical Health, Feeling, and Other People. Ceiling effects were observed for the Haemo-QoL Physical Health, Feeling, Other People, and PedHAL (total score). 3.3. Construct validity The correlations between the PROMIS pediatric measures and the legacy instruments are shown in Table 1. Of the 13 hypothesized correlations for convergent validity, 10 correlations were confirmed. The correlations between PROMIS Depressive Symptoms and Haemo-QoL Feeling 13 to 17 years (weak correlation), PROMIS Peer Relations and Haemo-QoL Other People 13-17 years (negligible correlation), and PROMIS Global Health and Haemo-QoL total scores 13-17 years (weak correlation) did not meet the predefined correlations. Secondary analysis showed that boys with severe hemophilia reported more fatigue (41.2 vs. 38.0, p = 0.04, d = 0.42) compared to boys with non-severe hemophilia.
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