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Meaningful Score Differences and Meaningful Score Regions of the Patient-Reported Outcomes Measurement Information
Jing Yuan1, Li Lin1, Kevin Weinfurt1
1Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Insights
This study establishes meaningful score differences and regions for the PROMIS Pediatric Asthma Impact Scale, improving interpretation of pediatric asthma outcomes in research. These findings help assess the meaningful impact of asthma on children.
Area of Science:
- Pediatric Health Outcomes Research
- Clinical Measurement Science
- Asthma Management
Background:
- Interpreting patient-reported outcome measures (PROMs) is crucial for clinical research.
- The PROMIS Pediatric Asthma Impact Scale (PAIS) measures asthma's effect on children.
- Establishing meaningful score differences (MSDs) and regions (MSRs) enhances PROM interpretability.
Purpose of the Study:
- To estimate MSDs and MSRs for the PROMIS Pediatric Asthma Impact Scale.
- To improve the interpretability of scores and score changes in pediatric asthma research.
- To align with FDA guidance on clinical outcome assessments.
Main Methods:
- Secondary analysis of 106 children (8-17 years) with asthma completing weekly surveys.
- Used Global Impact of Change (GIC) scores as anchors for MSD calculation via mixed models.
- Employed receiver operating characteristic analysis with GINA, ACT/cACT, and ASR as anchors for MSR calculation.
Main Results:
- PROMIS PAIS T-scores correlated with GIC-Asthma (r=0.45) and GIC-Health (r=0.34).
- Estimated MSDs were 2.3-2.5 points for improvement and 3.5-3.6 points for deterioration.
- Defined MSR cutoffs for GINA, ACT/cACT, and ASR, indicating varying asthma control levels.
Conclusions:
- Estimated MSDs and MSRs for the PROMIS PAIS enhance score interpretation in pediatric asthma studies.
- These metrics facilitate understanding the meaningful impact of asthma on children's lives.
- Supports FDA recommendations for patient-focused drug development and clinical outcome assessments.
Objectives:
To estimate meaningful score differences (MSDs) and meaningful score regions (MSRs) for the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Pediatric Asthma Impact Scale to enhance score interpretability.
Methods:
Secondary analysis included 106 children with asthma (8-17 years of age) who completed weekly surveys for 4 weeks. Repeated measures correlations examined the magnitude of association of the PROMIS Pediatric Asthma Impact Scale with other asthma measures. MSDs were calculated using mixed models with the Global Impact of Change (GIC) on Asthma and Health scores as anchors. MSRs were calculated using the receiver operating characteristics analysis with Self-Reported Asthma Symptom Rating (ASR), Global Initiative for Asthma (GINA) control criteria, and Asthma Control Test (ACT) or Childhood Asthma Control Test (cACT) as anchors.
Results:
Changes in PROMIS Pediatric Asthma Impact T-scores were correlated with GIC-Asthma (r = 0.45) and GIC-Health (r = 0.34). MSDs were 2.3 to 2.5 points for improvement and 3.5 to 3.6 points for deterioration. PROMIS Pediatric Asthma Impact T-scores were correlated with GINA (r = -0.22), ACT (r = -0.42), cACT (r = -0.41), and ASR (r = -0.47). The MSR cutoff T-scores for GINA were 38.7 and 49.2 between controlled, partly controlled, and uncontrolled asthma; for ACT/cACT, 45.6 between controlled and uncontrolled; and for ASR, 47.9, 50.1, and 55.8 between very good, good, a little good, and bad.
Conclusions:
Following recommendations from the US Food and Drug Administration's patient-focused drug development guidance on clinical outcome assessments, estimated MSDs and MSRs aid the interpretation of scores and changes in scores observed in clinical research studies to reflect the meaningful impact of asthma on children.
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