Minimally important differences were estimated for six Patient-Reported Outcomes Measurement Information System-Cancer scales in advanced-stage cancer patients

Kathleen J. Yost, David T. Eton, Sofia F. Garcia, David Cella

Research output: Contribution to journalArticlepeer-review

514 Scopus citations

Abstract

Objective: We combined anchor- and distribution-based methods to establish minimally important differences (MIDs) for six Patient-Reported Outcomes Measurement Information System (PROMIS)-Cancer scales in advanced-stage cancer patients. Study Design and Setting: Participants completed 6 PROMIS-Cancer scales and 23 anchor measures at an initial (n = 101) assessment and a follow-up (n = 88) assessment 6-12 weeks later. Three a priori criteria were used to identify usable cross-sectional and longitudinal anchor-based MID estimates. The mean standard error of measurement was also computed for each scale. The focus of the analysis was on item response theory-based MIDs estimated on a T-score scale. Raw score MIDs were estimated for comparison purposes. Results: Many cross-sectional (64%) and longitudinal (73%) T-score anchor-based MID estimates were excluded because they did not meet a priori criteria. The following are the recommended T-score MID ranges: 17-item Fatigue (2.5-4.5), 7-item Fatigue (3.0-5.0), 10-item Pain Interference (4.0-6.0), 10-item Physical Functioning (4.0-6.0), 9-item Emotional Distress-Anxiety (3.0-4.5), and 10-item Emotional Distress-Depression (3.0-4.5). Effect sizes corresponding to these MIDs averaged between 0.40 and 0.63. Conclusions: This study is the first to address MIDs for PROMIS measures. Studies are currently being conducted to confirm these MIDs in other patient populations and to determine whether these MIDs vary by patients' level of functioning.

Original languageEnglish (US)
Pages (from-to)507-516
Number of pages10
JournalJournal of Clinical Epidemiology
Volume64
Issue number5
DOIs
StatePublished - May 2011

Funding

This work was supported by the National Institutes of Health grants U01 AR052177 and R01 CA60068 . The authors thank Seung Choi, PhD, for calculating the IRT-based T -scores; Sarah Rosenbloom, PhD, for directing and Jacquelyn George for coordinating the parent grant, of which this study was a part; Maria Corona, Yvette Garcia, Natalie Gela, and Ramya Iyer for recruiting patients and collecting data; Michael Bass for programming the assessment software; and Katy Wortman for assisting with data management. They also thank all the study participants at the Kellogg Cancer Care Center of the NorthShore University HealthSystem and John H. Stroger, Jr, Hospital of Cook County.

Keywords

  • Cancer
  • Clinical significance
  • Item response theory
  • Minimally important difference
  • Outcomes assessment
  • Psychometrics

ASJC Scopus subject areas

  • Epidemiology

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