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Patient preferences and linear scoring rules for patient-reported outcomes
Ateesha F Mohamed1, A Brett Hauber, F Reed Johnson
1Research Triangle Institute, Research Triangle Park, North Carolina, USA.
The Patient
|January 26, 2012
Summary
Conventional scoring of patient-reported outcomes (PRO) may misrepresent patient priorities. Preference-weighted scores, using conjoint analysis, better reflect individual item importance for improved patient well-being.
Area of Science:
- Health Outcomes Research
- Psychometrics
- Health Economics
Background:
- Patient-reported outcomes (PRO) instruments commonly use linear scoring (averaging/summing Likert responses).
- This approach yields domain-specific or total scores for the entire instrument.
- Linear scoring may not accurately reflect the relative importance of different aspects of patient well-being.
Purpose of the Study:
- To compare conventional linear scoring with preference-weighted scoring for PRO instruments.
- To evaluate these scoring methods in the contexts of asthma, oncology, and obesity.
- To determine how scoring differences impact the interpretation of treatment effects.
Main Methods:
- Employed choice-format conjoint analysis (discrete-choice experiments) to estimate preference-weighted scores.
- Applied methods to items and response categories within the Onset-of-Effect Questionnaire (OEQ), EORTC Quality of Life Questionnaire (QLQ)-C30, and IWQOL-Lite.
- Quantified patient preferences for different response levels across various PRO instruments.
Main Results:
- Conventional linear scoring can misrepresent the importance of specific domains to patients.
- Improvements in some domains may be overstated, while others are understated in importance.
- Preference-weighted scores reveal a more nuanced understanding of patient priorities.
Conclusions:
- Preference-weighted scores, derived from conjoint analysis, capture non-linearities in patient preferences.
- These scores better account for the individual contribution of items and domains to overall patient well-being.
- Differences between linear and preference-weighted scores can lead to divergent conclusions regarding patient-reported treatment effects.
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