Evidence map›Paper›PMID 26896284›Full record

ArticleHealth and quality of life outcomes2016

Interpreting change from patient reported outcome (PRO) endpoints: patient global ratings of concept versus patient global ratings of change, a case study among osteoporosis patients.

Annabel Nixon, Helen Doll, Cicely Kerr, Russel Burge, April N Naegeli

Abstract readEvaluation Study
In one paragraph

Article in Health and quality of life outcomes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

  1. Trial
  2. Confounding factors associated with oral mucositis assessment in patients receiving chemoradiotherapy for head and neck cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2017
    Trial
  3. Triangulation of multiple meaningful change thresholds for patient-reported outcome scores.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2021
    Review
  4. Article
  5. Moving from significance to real-world meaning: methods for interpreting change in clinical outcome assessment scores.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2018
    Article
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

5 authors.

Annabel NixonChilli Consultancy, Salisbury, UK.
Helen DollICON Patient Reported Outcomes, Oxford, UK.
Cicely KerrFormerly ICON Patient Reported Outcomes, Oxford, UK.
Russel BurgeEli Lilly and Company LCC, DC, 1730, 46285, Indianapolis, IN, USA.
April N NaegeliEli Lilly and Company LCC, DC, 1730, 46285, Indianapolis, IN, USA. naegelian@lilly.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRegulatory guidance recommends anchor-based methods for interpretation of treatment effects measured by PRO endpoints. Methodological pros and cons of patient global ratings of change vs. patient global ratings of concept have been discussed but empirical evidence in support of either approach is lacking. This study evaluated the performance of patient global ratings of change and patient global ratings of concept for interpreting patient stability and patient improvement.

methodsPatient global ratings of change and patient global ratings of concept were included in a psychometric validation study of an osteoporosis-targeted PRO instrument (the OPAQ-PF) to assess its ability to detect change and to derive responder definitions. 144 female osteoporosis patients with (n = 37) or without (n = 107) a recent (within 6 weeks) fragility fracture completed the OPAQ-PF and global items at baseline, 2 weeks (no recent fracture), and 12 weeks (recent fracture) post-baseline.

resultsResults differed between the two methods. Recent fracture patients reported more improvement while patients without recent fracture reported more stability on ratings of change than ratings of concept. However, correlations with OPAQ-PF score change were stronger for ratings of concept than ratings of change (both groups). Effect sizes for OPAQ-PF score change increased consistently with level of change in ratings of concept but inconsistently with ratings of change, with the mean AUC for prediction of a one-point change being 0.72 vs. 0.56.

conclusionsThis study provides initial empirical support for methodological and regulatory recommendations to use patient global ratings of concept rather than ratings of change when interpreting change captured by PRO instruments in studies evaluating treatment effects. These findings warrant being confirmed in a purpose-designed larger scale analysis.

Indexed as

OsteoporosisQuality of LifeActivities of Daily LivingAdultAgedFemaleHumansMaleMiddle AgedOutcome Assessment, Health CarePrognosisPsychometricsSurveys and Questionnaires

Identifiers

PMID26896284
PMCPMC4759933

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.