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Quality of Life Research
Gepubliceerd in: Quality of Life Research 3/2017

02-12-2016

Establishing clinical meaning and defining important differences for Patient-Reported Outcomes Measurement Information System (PROMIS®) measures in juvenile idiopathic arthritis using standard setting with patients, parents, and providers

Auteurs: Esi M. Morgan, Constance A. Mara, Bin Huang, Kimberly Barnett, Adam C. Carle, Jennifer E. Farrell, Karon F. Cook

Gepubliceerd in: Quality of Life Research | Uitgave 3/2017

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Abstract

Background

Patient-Reported Outcomes Measurement Information System (PROMIS) measures are used increasingly in clinical care. However, for juvenile idiopathic arthritis (JIA), scores lack a framework for interpretation of clinical severity, and minimally important differences (MID) have not been established, which are necessary to evaluate the importance of change.

Methods

We identified clinical severity thresholds for pediatric PROMIS measures of mobility, upper extremity function (UE), fatigue, and pain interference working with adolescents with JIA, parents of JIA patients, and clinicians, using a standard setting methodology modified from educational testing. Item parameters were used to develop clinical vignettes across a range of symptom severity. Vignettes were ordered by severity, and panelists identified adjacent vignettes considered to represent upper and lower boundaries separating category cut-points (i.e., from none/mild problems to moderate/severe). To define MIDs, panelists reviewed a full score report for the vignettes and indicated which items would need to change and by how much to represent “just enough improvement to make a difference.”

Results

For fatigue and UE, cut-points among panels were within 0.5 SD of each other. For mobility and pain interference, cut-scores among panels were more divergent, with parents setting the lowest cut-scores for increasing severity. The size of MIDs varied by stakeholders (parents estimated largest, followed by patients, then clinicians). MIDs also varied by severity classification of the symptom.

Conclusions

We estimated clinically relevant severity cut-points and MIDs for PROMIS measures for JIA from the perspectives of multiple stakeholders and found notable differences in perspectives.
vorige artikel Impact of IRT item misfit on score estimates and severity classifications: an examination of PROMIS depression and pain interference item banks
volgende artikel Are intensive data collection methods in pain research feasible in those with physical disability? A study in persons with chronic pain and spinal cord injury
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Metagegevens
Titel
Establishing clinical meaning and defining important differences for Patient-Reported Outcomes Measurement Information System (PROMIS®) measures in juvenile idiopathic arthritis using standard setting with patients, parents, and providers
Auteurs
Esi M. Morgan
Constance A. Mara
Bin Huang
Kimberly Barnett
Adam C. Carle
Jennifer E. Farrell
Karon F. Cook
Publicatiedatum
02-12-2016
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 3/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-016-1468-2

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