Development of a Patient Reported Measure of Experimental Transplants with HIV and Ethics in the United States (PROMETHEUS)

Shanti Seaman, Diane Brown, Ann Eno, Sile Yu, Allan B. Massie, Aaron A.R. Tobian, Christine M. Durand, Dorry L. Segev, Albert W. Wu, Jeremy Sugarman

Research output: Contribution to journalArticlepeer-review


Background: Transplantation of HIV-positive (HIV+) donor organs for HIV+ recipients (HIV D+/R+) is now being performed as research in the United States, but raises ethical concerns. While patient-reported outcome measures are increasingly used to evaluate clinical interventions, there is no published measure to aptly capture patients’ experiences in the unique context of experimental HIV D+/R+ transplantation. Therefore, we developed PROMETHEUS (patient-reported measure of experimental transplants with HIV and ethics in the United States). To do so, we created a conceptual framework, drafted a pilot battery using existing and new measures related to this context, and refined it based on cognitive and pilot testing. PROMETHEUS was administered 6-months post-transplant in a clinical trial evaluating these transplants. We analyzed data from the first 20 patient-participants for reliability and validity by calculating Cronbach’s alpha and reviewing item performance characteristics. Results: PROMETHEUS 1.0 consisted of 29 items with 5 putative subscales: Emotions; Trust; Decision Making; Transplant; and Decision Satisfaction. Overall, responses were positive. Cronbach’s alpha was > 0.8 for all subscales except Transplant, which was 0.38. Two Transplant subscale items were removed due to poor reliability and construct validity. Conclusions: We developed PROMETHEUS to systematically capture patient-reported experiences with this novel experimental transplantation program, nested it in an actual clinical trial, and obtained preliminary data regarding its performance.

Original languageEnglish (US)
Article number28
JournalJournal of Patient-Reported Outcomes
Issue number1
StatePublished - Dec 2021


  • Acquired immunodeficiency syndrome
  • Care delivery
  • Ethics
  • Organ procurement and transplantation
  • Patient safety
  • Patient-reported experiences
  • Quality of care

ASJC Scopus subject areas

  • Health Informatics
  • Health Information Management


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