Validity, cut-points, and minimally important differences for two hot flash-related daily interference scales
Janet S Carpenter1, Giorgos Bakoyannis, Julie L Otte
11School of Nursing, Indiana University, Indianapolis, IN 2Department of Biostatistics, Fairbanks School of Public Health, School of Medicine, Indiana University, Indianapolis, IN 3Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, IN 4University of Washington School of Nursing, Seattle, WA 5Group Health Research Institute, Seattle, WA 6Brigham and Women's Hospital, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 7Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, MA 8Departments of Obstetrics/Gynecology and Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 9MsFLASH Data Coordinating Center, Fred Hutchinson Cancer Research Center, Seattle, WA.
A new Hot Flash Interference (HFI) scale effectively measures vasomotor symptom interference. This brief scale aids clinical assessment and research, providing useful cut-points and minimally important differences for treatment guidance.
Area of Science:
- Reproductive Medicine
- Clinical Psychometrics
- Women's Health
Background:
- Vasomotor symptoms (VMS) significantly impact midlife women's quality of life.
- The Hot Flash-Related Daily Interference Scale (HFRDIS) is a comprehensive measure of VMS interference.
- A shorter, validated scale is needed for efficient clinical and research use.
Purpose of the Study:
- To develop and validate a condensed version of the HFRDIS, named the Hot Flash Interference (HFI) scale.
- To establish reliable cut-points for both the HFRDIS and HFI scales.
- To determine minimally important differences (MIDs) for both scales to interpret treatment effects.
Main Methods:
- Psychometric analysis of pooled patient-reported data from 899 women across three randomized trials.
- Item reduction of the HFRDIS based on expert content validity and confirmatory factor analysis.
- Evaluation of scale cut-points and MIDs through mapping to other established measures.
Main Results:
- The three-item HFI demonstrated strong internal consistency (alphas 0.830-0.856) and unidimensionality.
- The HFI showed strong convergent validity with the HFRDIS, VMS frequency, and menopausal quality of life.
- Established cut-points (mild, moderate, severe) and MIDs (HFRDIS: 1.66; HFI: 2.34) correlate with symptom severity and treatment response indicators.
Conclusions:
- The HFI is a brief, psychometrically sound tool for assessing VMS interference in clinical and research settings.
- The developed cut-points and MIDs will aid in identifying patients needing treatment and monitoring therapeutic outcomes.
- The HFI scale reduces participant burden while maintaining reliable assessment of VMS impact.
