ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2023
Establishing thresholds for meaningful within-individual change using longitudinal item response theory.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Selecting the optimal MIC for five patient-reported outcome measures in patients with upper extremity injuries, using a systematic search and step-by-step decision tree.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Pooled it
- Coefficients of Repeatability for Likely Change: Comparison between PROMIS Computer Adaptive Tests and Short Forms.Advances in patient-reported outcomes · 2026Article
- Estimating the minimal important change of single-item measures using the adjusted predictive modeling method or the longitudinal confirmatory factor analysis method.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- A weighted predictive modeling method for estimating thresholds of meaningful within-individual change for patient-reported outcomes.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Advances in the calculation of minimal important change estimates for patient-reported outcome measures.Nature reviews. Rheumatology · 2025Article
- Conceptualizing meaningful between-group difference in change over time: a demonstration of possible viewpoints.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Effect of present state bias on minimal important change estimates: a simulation study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Anchor-based minimal important difference values are often sensitive to the distribution of the change score.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Estimating anchor-based minimal important change using longitudinal confirmatory factor analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Meaningful score changes for SF-36v2, FACIT-fatigue, and RASIQ in rheumatoid arthritis.Journal of patient-reported outcomes · 2024Article
- Estimating meaningful thresholds for multi-item questionnaires using item response theory.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Article
- Interpretation of Change in Novel Digital Measures: A Statistical Review and Tutorial.Digital biomarkersReview
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Authors and funding
6 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThresholds for meaningful within-individual change (MWIC) are useful for interpreting patient-reported outcome measures (PROM). Transition ratings (TR) have been recommended as anchors to establish MWIC. Traditional statistical methods for analyzing MWIC such as mean change analysis, receiver operating characteristic (ROC) analysis, and predictive modeling ignore problems of floor/ceiling effects and measurement error in the PROM scores and the TR item. We present a novel approach to MWIC estimation for multi-item scales using longitudinal item response theory (LIRT).
methodsA Graded Response LIRT model for baseline and follow-up PROM data was expanded to include a TR item measuring latent change. The LIRT threshold parameter for the TR established the MWIC threshold on the latent metric, from which the observed PROM score MWIC threshold was estimated. We compared the LIRT approach and traditional methods using an example data set with baseline and three follow-up assessments differing by magnitude of score improvement, variance of score improvement, and baseline-follow-up score correlation.
resultsThe LIRT model provided good fit to the data. LIRT estimates of observed PROM MWIC varied between 3 and 4 points score improvement. In contrast, results from traditional methods varied from 2 to 10 points-strongly associated with proportion of self-rated improvement. Best agreement between methods was seen when approximately 50% rated their health as improved.
conclusionResults from traditional analyses of anchor-based MWIC are impacted by study conditions. LIRT constitutes a promising and more robust analytic approach to identifying thresholds for MWIC.
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