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A Guide to PROMs Methodology and Selection Criteria

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Patient Reported Outcome Measures in Rheumatic Diseases

Abstract

Patient reported outcome (PRO), as defined by the US Food and Drug Administration, is any report entailing the status of a person’s health condition that comes directly from him/her, without interpretation of the person’s response by anyone else including the treating clinician. Though medical technology has facilitated the measurement of the patient’s physical, physiological, as well as biochemical parameters, it is not yet able to quantify the patient reported treatment outcomes or the impact of the disease on the patients’ lives from their own perspectives. There are several patient reported outcome measures (PROMs) instruments available in the literature for different rheumatic conditions; some are generic whereas others are specific. Choosing the appropriate tool is always a challenge for healthcare professionals who plan to implement PROMs in their day-to-day practice. This chapter gives a guide toward the criteria for selection of the appropriate PROMs tool. This includes clarification of the relevant statistical concepts such as validity, reliability, and responsiveness, as well as type of response categories. Item response theory basics and models are also described in a very simplified way. The aim is to provide the reader with all the basic knowledge about PROMs methodology and give clues for proper PROMs tool selection.

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References

  1. Singh DP. Quality of life in cancer patients receiving palliative care. Indian J Palliat Care. 2010;16:36–43.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kozma CM, Reeder CE, Schulz RM. Economic, clinical, and humanistic outcomes: a planning model for pharmacoeconomic research. Clin Ther. 1993;15:1121–32. Discussion 1120.

    CAS  PubMed  Google Scholar 

  3. International Alliance of Patients’ Organizations. What is patient centred health care? A review of definitions and principles. 2nd ed. London: IAPO; 2007. p. 1–34.

    Google Scholar 

  4. Chin R, Lee BY. Economics and patient reported outcomes, principles and practice of clinical trial medicine. London: Elsevier; 2008. p. 145–66.

    Book  Google Scholar 

  5. U.S. Department of Health and Human Services Food and Drug Administration Guidance for Industry: Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. U.S. FDA, Clinical/Medical. 2009. [http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM193282.pdf]. Accessed 17 Aug 2015.

  6. Fitzpatrick R, Davey C, Buxton MJ, Jones DR. Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess. 1998;2:1–74.

    CAS  PubMed  Google Scholar 

  7. Chen H, Taichman DB, Doyle RL. Health-related quality of life and patient-reported outcomes in pulmonary arterial hypertension. Proc Am Thorac Soc. 2008;5:623–30.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chao J, Nau DP, Aikens JE. Patient-reported perceptions of side effects of antihyperglycemic medication and adherence to medication regimens in persons with diabetes mellitus. Clin Ther. 2007;29:177–80.

    Article  PubMed  Google Scholar 

  9. Erickson P, Taeuber RC, Scott J. Operational aspects of quality-of-life assessment: choosing the right instrument: review article. PharmacoEconomics. 1995;7:39–48.

    Article  CAS  PubMed  Google Scholar 

  10. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med. 1996;334:835–40.

    Article  CAS  PubMed  Google Scholar 

  11. El Miedany Y, El Gaafary M, Youssef S, Palmer D. Incorporating patient reported outcome measures in clinical practice: development and validation of a questionnaire for inflammatory arthritis. Clin Exp Rheumatol. 2010;28:734–44.

    PubMed  Google Scholar 

  12. Singh G, Athreya B, Fries J, Goldsmith D. Measurement of health status in children with juvenile rheumatoid arthritis. Arthritis Rheum. 1994;37(12):1761–9.

    Article  CAS  PubMed  Google Scholar 

  13. Beck A, Ward C, Medelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.

    Article  CAS  PubMed  Google Scholar 

  14. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): i. Conceptual framework and item selection. Med Care. 1992;30:473–83.

    Article  PubMed  Google Scholar 

  15. Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF-36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? Br Med J. 1993;306:1440–3.

    Article  CAS  Google Scholar 

  16. Ware JE, Kosinski M, Bayliss MS, McHorney C, Rogers WH, Raczek A. Comparison of methods for scoring and statistical analysis of the SF-36 health profile and summary measures: summary of results from the medical outcomes study. Med Care. 1995;33:S264–79.

    Article  Google Scholar 

  17. Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey. Construction of scales and preliminary tests of validity and reliability. Med Care. 1995;34:220–33.

    Article  Google Scholar 

  18. Ruta DA, Garratt AM, Leng M, Russell IT, Macdonald LM. A new approach to the measurement of quality of life: the patient-generated index. Med Care. 1994;11:1109–26. 8.

    Article  Google Scholar 

  19. Ruta DA, Garratt AM, Russell IT. Patient centred assessment of quality of life for patients with four common conditions. Qual Health Care. 1999;8:22–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Group EQ. EuroQol—a new facility for the measurement of health related quality of life. Health Policy. 1990;16:199–208.

    Article  Google Scholar 

  21. Brooks R with the EuroQol Group. EuroQol: the current state of play. Health Policy. 1996;37:53–72.

    Article  Google Scholar 

  22. Ware JE. Standards for validating health measures: definition and content. J Chronic Dis. 1987;40:473–80.

    Article  PubMed  Google Scholar 

  23. Kirshner B, Guyatt G. A methodological framework for assessing health indices. J Chronic Dis. 1985;38:27–36.

    Article  CAS  PubMed  Google Scholar 

  24. Cox DR, Fitzpatrick R, Fletcher AE, Gore SM, Spiegelhalter DJ, Jones DR. Quality of life measurement: can we keep it simple? J R Stat Soc. 1992;155:353–93.

    Article  Google Scholar 

  25. Garratt AM, Ruta DA, Abdalla MI, Russell IT. Responsiveness of the SF-36 and a condition-specific measure of health for patients with varicose veins. Qual Life Res. 1996;5:223–34.

    Article  CAS  PubMed  Google Scholar 

  26. Bullinger M. Ensuring international equivalence of quality of life measures. In: Orley J, Kuykken W, editors. Quality of life assessment: international perspectives. Berlin: Springer; 1994. p. 33–40.

    Chapter  Google Scholar 

  27. Leplege A, Verdier A. The adaptation of health status measures: methodological aspects of the translation procedure. In: Shumaker S, Berzon R, editors. The international assessment of health-related quality of life: theory, translation, measurement and analysis. Oxford: Rapid Communications of Oxford; 1995. p. 93–101.

    Google Scholar 

  28. Sprangers MA, Cull A, Bjordal K, Groenvold M, Aaronson NK. The European organization for research and treatment of cancer. Approach to quality of life assessment: guidelines for developing questionnaire modules. EORTC study group on quality of life. Qual Life Res. 1993;2:287–95.

    Article  CAS  PubMed  Google Scholar 

  29. Aarsonson NK. Assessing the quality of life of patients in cancer clinical trials: common problems and common sense solutions. Eur J Cancer. 1992;28A:1304–7.

    Article  Google Scholar 

  30. Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10:407–15.

    Article  CAS  PubMed  Google Scholar 

  31. Juniper EF, Guyatt GH, Willan A, Griffith LE. Determining a minimal important change in a disease-specific quality of life questionnaire. J Clin Epidemiol. 1994;47:81–7.

    Article  CAS  PubMed  Google Scholar 

  32. Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD, McGlynn EA, Ware JE. Functional status and well-being of patients with chronic conditions: results from the medical outcomes study. J Am Med Assoc. 1989;262:907–13.

    Article  CAS  Google Scholar 

  33. Garratt AM, Ruta DA, Abdalla MI, Russell IT. The SF-36 health survey questionnaire: ii responsiveness to changes in health status in four common clinical conditions. Qual Health Care. 1994;3:186–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Feeny DH, Furlong W, Boyle M, Torrance GW. Multi-attribute health status classification systems: Health Utilities Index. PharmacoEconomics. 1995;7:490–502.

    Article  CAS  PubMed  Google Scholar 

  35. Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985;35:185–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  36. Bergner M, Bobbitt RA, Carter WB, Gilson BS. The sickness impact profile: development and final revision of a health status measure. Med Care. 1981;19:787–805.

    Article  CAS  PubMed  Google Scholar 

  37. Bindman AB, Keane D, Lurie N. Measuring health changes among severely ill patients: the floor phenomenon. Med Care. 1990;28:1142–52.

    Article  CAS  PubMed  Google Scholar 

  38. Gardiner PV, Sykes HR, Hassey GA, Walker DJ. An evaluation of the health assessment questionnaire in long-term follow-up of disability in rheumatoid arthritis. Br J Rheumatol. 1993;32:724–8.

    Article  CAS  PubMed  Google Scholar 

  39. Stucki G, Daltroy L, Katz JN, Johannesson M, Liang MH. Interpretation of change scores in ordinal clinical scale and health status measures: the whole may not equal the sum of the parts. J Clin Epidemiol. 1996;49:711–7.

    Article  CAS  PubMed  Google Scholar 

  40. Tennant A, Hillman M, Fear J, Pickering A, Chamberlain MA. Are we making the most of the Stanford health assessment questionnaire. Br J Rheumatol. 1996;35:574–8.

    Article  CAS  PubMed  Google Scholar 

  41. Garratt AM in collaboration with UKBEAM. Rasch analysis of the Roland disability questionnaire. Spine. 2003;28:79–84.

    Article  Google Scholar 

  42. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.

    Article  Google Scholar 

  43. Streiner GL, Norman RD. Health measurement scales: a practical guide to their development and use. 2nd ed. Oxford: Oxford University Press; 1995.

    Google Scholar 

  44. Guyatt GH, Cook DJ. Health status, quality of life and the individual. J Am Med Assoc. 1994;272:630–1.

    Article  CAS  Google Scholar 

  45. McDowell I, Jenkinson C. Development standards for health measures. J Health Serv Res Policy. 1996;1:238–46.

    CAS  PubMed  Google Scholar 

  46. Jolliffe IT, Morgan BJT. Principal component analysis and exploratory factor analysis. Stat Methods Med Res. 1992;1:69–95.

    Article  Google Scholar 

  47. Garratt AM, Hutchinson A, Russell IT. The UK version of the Seattle Angina Questionnaire (SAQ-UK): reliability, validity and responsiveness. J Clin Epidemiol. 2001;54:907–15.

    Article  CAS  PubMed  Google Scholar 

  48. Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care. 1989;27:MS178–89.

    Article  Google Scholar 

  49. Liang MH, Fossel AH, Larson MG. Comparisons of five health status instruments for orthopedic evaluation. Med Care. 1990;28:632–42.

    Article  CAS  PubMed  Google Scholar 

  50. Guyatt G, Walter S, Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis. 1987;40:171–8.

    Article  CAS  PubMed  Google Scholar 

  51. Acquadro C, Berzon R, Dubois D, Leidy NK, Marquis P, Revicki D, et al. Incorporating the patient’s perspective into drug development and communication: an ad hoc task force report of the patient-reported outcomes (PRO) harmonization group meeting at the food and drug administration, February 16, 2001. Value Health. 2003;6:522–31.

    Article  PubMed  Google Scholar 

  52. Deshpande PR, Rajan S, Lakshmi Sudeepthi B, Abdul Nazir CP. Patient-reported outcomes: a new era in clinical research. Perspect Clin Res. 2011;2(4):137–44.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Pashos CL, Klein EG, Wanke LA, editors. ISPOR Lexicon™. Princeton: International Society for Pharmacoeconomics and Outcomes Research; 1998.

    Google Scholar 

  54. Goreck C, Brown JM, Cano S, Lamping DL, Briggs M, Coleman S, Dealey C, McGinnis E, Nelson AE, Stubbs N, Wilson L, Nixon J. Development and validation of a new patient-reported outcome measure for patients with pressure ulcers: the PU-QOL instrument. Health Qual Life Outcomes. 2013;11:95.

    Article  Google Scholar 

  55. Luo Y, Yang J, Zhang Y. Development and validation of a patient-reported outcome measure for stroke patients. Health Qual Life Outcomes. 2015;13:53.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Embretson SE, Reise S. Item response theory for psychologists. Mahwah: Lawrence Erlbaum; 2000.

    Google Scholar 

  57. Reeve BB, Fayers P. Applying item response theory modeling for evaluating questionnaire item and scale properties. In: Fayers P, Hays RD, editors. Assessing quality of life in clinical trials: methods of practice. 2nd ed. New York: Oxford University Press; 2005. p. 53–73.

    Google Scholar 

  58. Furr M, Bacharach VR. Chapter 13. Item response theory and Rasch models, Psychometrics: an introduction. New York: Sage; 2007.

    Google Scholar 

  59. Smith LL, Reise SP. Gender differences on negative affectivity: an IRT study of differential item functioning on the multi-dimensional personality questionnaire stress reaction scale. J Pers Soc Psychol. 1998;75:1350–62.

    Article  CAS  PubMed  Google Scholar 

  60. Meijer RR, Sijtsma K. Methodology review: evaluating person fit. Appl Psychol Meas. 2001;25(2):107–35.

    Article  Google Scholar 

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El Gaafary, M. (2016). A Guide to PROMs Methodology and Selection Criteria. In: El Miedany, Y. (eds) Patient Reported Outcome Measures in Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-32851-5_2

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  • DOI: https://doi.org/10.1007/978-3-319-32851-5_2

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