Evidence map›Paper›PMID 17156420›Full record

ReviewHealth and quality of life outcomes2006

Combining scores from different patient reported outcome measures in meta-analyses: when is it justified?

Milo A Puhan, Irene Soesilo, Gordon H Guyatt, Holger J Schünemann

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Health and quality of life outcomes, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 28 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 28 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 28 syntheses or guidelines pooled it.

  1. Pooled it
  2. Quality of life of primary caregivers by severity and control of children's asthma: a systematic review and meta-analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
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  3. Understanding factors impacting patient-reported outcome measures integration in routine clinical practice: an umbrella review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
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  19. Mind and body therapy for fibromyalgia.The Cochrane database of systematic reviews · 2015
    Pooled it
  20. Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Milo A PuhanHorten Centre, University of Zurich, Switzerland. milo.puhan@usz.ch
Irene Soesilo
Gordon H Guyatt
Holger J Schünemann

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCombining outcomes and the use of standardized effect measures such as effect size and standardized response mean across instruments allows more comprehensive meta-analyses and should avoid selection bias. However, such analysis ideally requires that the instruments correlate strongly and that the underlying assumption of similar responsiveness is fulfilled. The aim of the study was to assess the correlation between two widely used health-related quality of life instruments for patients with chronic obstructive pulmonary disease and to compare the instruments' responsiveness on a study level.

methodsWe systematically identified all longitudinal studies that used both the Chronic Respiratory Questionnaire (CRQ) and the St. George's Respiratory Questionnaire (SGRQ) through electronic searches of MEDLINE, EMBASE, CENTRAL and PubMed. We assessed the correlation between CRQ (scale 1-7) and SGRQ (scale 1-100) change scores and compared responsiveness of the two instruments by comparing standardized response means (change scores divided by their standard deviation).

resultsWe identified 15 studies with 23 patient groups. CRQ change scores ranged from -0.19 to 1.87 (median 0.35, IQR 0.14-0.68) and from -16.00 to 3.00 (median -3.00, IQR -4.73-0.25) for SGRQ change scores. The correlation between CRQ and SGRQ change scores was 0.88. Standardized response means of the CRQ (median 0.51, IQR 0.19-0.98) were significantly higher (p < 0.001) than for the SGRQ (median 0.26, IQR -0.03-0.40).

conclusionInvestigators should be cautious about pooling the results from different instruments in meta-analysis even if they appear to measure similar constructs. Despite high correlation in changes scores, responsiveness of instruments may differ substantially and could lead to important between-study heterogeneity and biased meta-analyses.

Indexed as

Meta-Analysis as TopicSickness Impact ProfileDatabases, BibliographicData Interpretation, StatisticalHumansOutcome Assessment, Health CarePulmonary Disease, Chronic ObstructiveQuality of LifeSurveys and Questionnaires

Identifiers

PMID17156420
PMCPMC1712224

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.