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Quality of Life Research
Gepubliceerd in: Quality of Life Research 5/2023

03-08-2022 | Special Section: Methodologies for Meaningful Change

Likely change indexes improve estimates of individual change on patient-reported outcomes

Auteurs: John Devin Peipert, Ron D. Hays, David Cella

Gepubliceerd in: Quality of Life Research | Uitgave 5/2023

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Abstract

Purpose

Individual change on a patient-reported outcome (PRO) measure can be assessed by statistical significance and meaningfulness to patients. We explored the relationship between these two criteria by varying the confidence levels of the coefficient of repeatability (CR) on the Patient-Reported Outcomes Measurement Information System (R) Physical Function (PF) 10a (PF10a) measure.

Methods

In a sample of 1129 adult cancer patients, we estimated individual-change thresholds on the PF10a from baseline to 6 weeks later with the CR at 50%, 68%, and 95% confidence. We also assessed agreement with group- and individual-level thresholds from anchor-based methods [mean change and receiver operating characteristic (ROC) curve] using a PF-specific patient global impression of change (PGIC).

Results

CRs at 50%, 68%, and 95% confidence were 3, 4, and 7 raw score points, respectively. The ROC- and mean-change-based thresholds for deterioration were −4 and −6; for improvement they were both 2. Kappas for agreement between anchor-based thresholds and CRs for deterioration ranged between κ = 0.65 and 1.00, while for improvement, they ranged between 0.35 and 0.83. Agreement between the PGIC and all CRs always fell below “good” (κ < 0.40) for deterioration (0.30–0.33) and were lower for improvement (0.16–0.28).

Conclusions

In comparison to the CR at 95% confidence, CRs at 50% and 68% confidence (considered likely change indexes) have the advantage of maximizing the proportion of patients appropriately classified as changed according to statistical significance and meaningfulness.
vorige artikel A qualitative study to examine meaningful change in physical function associated with weight-loss
volgende artikel Correction: Likely change indexes improve estimates of individual change on patient‑reported outcomes
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Metagegevens
Titel
Likely change indexes improve estimates of individual change on patient-reported outcomes
Auteurs
John Devin Peipert
Ron D. Hays
David Cella
Publicatiedatum
03-08-2022
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 5/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-022-03200-4

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