Estimating minimally important difference (MID) in PROMIS pediatric measures using the scale-judgment method

Abstract

Objective To assess minimally important differences (MID) for several pediatric self-report item banks from the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System® (PROMIS®). Methods We presented vignettes comprising sets of two completed PROMIS questionnaires and asked judges to declare whether the individual completing those questionnaires had an important change or not. We enrolled judges (including adolescents, parents, and clinicians) who responded to 24 vignettes (six for each domain of depression, pain interference, fatigue, and mobility). We used item response theory (IRT) to model responses to the vignettes across different judges and estimated MID as the point at which 50% of the judges would declare an important change. Results We enrolled 246 judges (78 adolescents, 85 parents, and 83 clinicians). The MID estimated with clinician data was about 2 points on the PROMIS T-score scale, and the MID estimated with adolescent and parent data was about 3 points on that same scale. Conclusions The MIDs enhance the value of PROMIS Pediatric measures in clinical research studies to identify meaningful changes in health status over time.

Establishing clinical meaning and defining important differences for Patient-Reported Outcomes Measurement Information System (PROMIS®) measures in juvenile idiopathic arthritis using standard setting with patients, parents, and providers

“…Furthermore, the scale-judgment method seemed subject to respondent error as evidenced by wrong-direction judgments. While Thissen et al elicited differences in MID from various stakeholder perspectives in fact their valuations were relatively similar [34] when contrasted with our study which showed more marked variability, although this may in part be a reflection of our relatively small sample size.…”

“…One could envision a clinical application that matches potential treatment benefit of a novel treatment with a personalized valuation of the likely required benefit. While the MID scale–judgment technique [34] took a similar approach of respondents reviewing items and identifying importance of change in item responses, the items and amount of change were pre-selected rather than actively selected by the respondent as in our study. Furthermore, the scale-judgment method seemed subject to respondent error as evidenced by wrong-direction judgments.…”

The Impact of Ostomy on Quality of Life and Functional Status of Crohnʼs Disease Patients

“…However, in cancer patients, chronic pain patients and healthy pediatric patients, research has revealed a range of MIDs of 2 to 6 for several of the PROMIS domains. 18–20 The mean t-scores within the general population for the domains of sexual interest and satisfaction are gender-specific: 50 (10) in men and 42 (14) in women for sexual interest and 51 (9) in men and 49 (11) in women for sexual satisfaction. 21 …”

Patient-Reported Outcomes Measurement Information System in Children with Crohn's Disease

“…(23) Though MIDs are not yet well established in PROMIS pediatric measures, new research utilizing adolescent patients, parents, and physicians as judges of clinically important differences in scores, suggests MIDs of 2–3 for multiple pediatric PROMIS instruments. (24) Higher scores in any PROMIS domain indicate more of the domain being measured – therefore, higher scores for anxiety, depression, fatigue, and pain interference indicate poorer wellbeing, whereas higher scores for peer relationships indicate better relationships with peers and therefore better wellbeing.…”