Samuel M. Vorbach, MD, Resident Radiation Oncology at Medizinische Universität Innsbruck, shared on LinkedIn:
“Are you interested in using patient-reported outcomes (PROs) in clinical routine for patients with prostate cancer – or in using PROs for responder analyses or time-to-deterioration/improvement analyses?
While normative and reference values help contextualize PRO scores, and minimally important differences help interpret changes over time, interpreting an individual patient’s questionnaire score at a single time point remains challenging.
This is where thresholds for clinical importance (TCIs) come into play. TCIs represent absolute score thresholds intended to facilitate the interpretation of PRO scores from individual patients at a single time point and to identify symptoms or functional problems that may warrant further attention.
I am very happy to share our work on behalf of the EORTC – European Organisation for Research and Treatment of Cancer Quality of Life Group, in which we established TCIs for the prostate cancer-specific EORTC QLQ-PR25, now published in Radiotherapy and Oncology.
But what makes a symptom or functional problem clinically important? Building on previous mixed-methods work involving patients and healthcare professionals, clinical importance was operationalized around three key consequences of a health problem:
- Limitations in daily life
- Need for help or care
- Worries for the patient or their family/partner
In this prospective multicentre study, 261 patients with prostate cancer from seven countries completed the EORTC QLQ-PR25 alongside anchor items assessing these three aspects.
Receiver operating characteristic analyses were then used to derive TCIs for the QLQ-PR25 scales based on a binary criterion of clinical importance.
The result: thresholds that can help translate an abstract questionnaire score into something more directly meaningful for clinical practice and research.
Dive into the details (journal pre-proofs) and find the respective TCIs for the QLQ-PR25 scales.
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Title: From patient-reported outcome scores to clinical meaning: defining thresholds for clinical importance for the EORTC QLQ-PR25 questionnaire for patients with prostate cancer
Authors: Samuel M. Vorbach, Micha J. Pilz, Maike Thumfart, Lionne D.F. Venderbos, Juan I. Arraras, Renée Bultijnck, Ronita Mahilall, Esther Jimenez-Jimenez, Jörg-Andreas Müller, Heike Schmidt, Romaana Mir, Tara Chalk, John Ramage, Lisa Storz, Anna M.M. Thurner, Johannes M. Giesinger
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Thank you to all co-authors and collaborators who made this international study possible, and especially to Prof. Johannes M. Giesinger and Micha J. Pilz for the opportunity to be part of this work.
Most importantly, thank you to all patients who participated and contributed their time and perspective to this research.”
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