Characterising the potential for recall bias in anchor‐based MCID calculation of patient‐reported outcome measures for chronic rhinosinusitis

McCann, Adam; Phillips, Katie; Trope, Michal; Caradonna, David S.; Gray, Stacey T.; Sedaghat, Ahmad R.

doi:10.1111/coa.13589

Cited by 8 publications

(6 citation statements)

References 40 publications

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“…Recall bias happens when a patient remembers best what has happened most recently and has a less clear memory of the more distant past. 17 , 21 , 26 In addition, the patient report of change could be reflective of the patient’s current health status rather than the amount of change from baseline. 26 …”

Section: Discussionmentioning

confidence: 99%

The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods

et al. 2023

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Background: The minimal clinically important difference (MCID) for patient-reported outcome measures (PROMs) expresses both the extent of the improvement and the value that patients place on it. MCID use is becoming increasingly widespread to understand the clinical efficacy of a given treatment, define guidelines for clinical practice, and properly interpret trial results. However, there is still large heterogeneity in the different calculation methods. Purpose: To calculate and compare the MCID threshold values of a PROM by applying various methods and analyzing their effect on the study results interpretation. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: The data set used to investigate the different MCID calculation approaches was based on a database of 312 patients affected by knee osteoarthritis and treated with intra-articular platelet-rich plasma. MCID values were calculated on the International Knee Documentation Committee (IKDC) subjective score at 6 months using 2 approaches: 9 methodologies referred to an anchor-based approach and 8 methodologies to a distribution-based approach. The obtained threshold values were applied to the same series of patients to understand the effect of using different MCID methods in evaluating patient response to treatment. Results: The different methods employed led to MCID values ranging from 1.8 to 25.9 points. The anchor-based methods ranged from 6.3 to 25.9, while the distribution-based ones were from 1.8 to 13.8 points, showing a 4.1× variation of the MCID values within the anchor-based methods and a 7.6× variation within the distribution-based methods. The percentage of patients who reached the MCID for the IKDC subjective score changed based on the specific calculation method used. Among the anchor-based methods, this value varied from 24.0% to 66.0%, while among the distribution-based methods, the percentage of patients reaching the MCID varied from 44.6% to 75.9%. Conclusion: This study proved that different MCID calculation methods lead to highly heterogeneous values, which significantly affect the percentage of patients achieving the MCID in a given population. The wide-ranging thresholds obtained with the different methodologies make it difficult to evaluate the real effectiveness of a given treatment questioning the usefulness of MCID, as currently available, in the clinical research.

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Section: Discussionmentioning

confidence: 99%

The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods

et al. 2023

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“…This variation in MCID calculation that we observed highlights the necessity of using different methods for calculating an MCID so that a spurious value is not identified by chance selection of one method and instead, an MCID value is determined through the convergence of results from multiple methods. Moreover, our results (36) , this is nevertheless a caveat of our study. Additionally, while all patients were treated with a regimen deemed to be reflective of appropriate medical management that was based on saline irrigations and intranasal corticosteroids, there was variability in exact medical treatment regimens.…”

Section: Discussionmentioning

confidence: 53%

Multi-institutional minimal clinically important difference of the 22-item Sinonasal Outcome Test in medically managed chronic rhinosinusitis

Phillips

Houssein

Boeckermann

et al. 2021

Rhin

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Background: With a rapid proliferation of clinical trials to study novel medical treatments for CRS, the objective of this study was to study the minimal clinically important difference (MCID) of the 22-item Sinonasal Outcome Test (SNOT-22) in medically-managed CRS patients. Methods: A total of 183 medically-treated CRS patients were recruited. All patients completed a SNOT-22 at enrollment and subsequent follow up visit. Distribution and anchor-based methods were used for MCID calculation. These data were combined with data from a previously published study on SNOT-22 MCID in 247 medically managed CRS patients to determine a final recommended MCID value using the combined cohort of 430 patients. Results: In our cohort, distribution- and anchor-based methods—using both sinus-specific and general health anchors—provided greatest support for a 12-point SNOT-22 MCID, which had approximately 55% sensitivity but 81% specificity for detecting patients explicitly reporting improvement in their sinus symptoms and general health. In the combined cohort of 430 patients, we also found greatest support for a 12-point SNOT-22 MCID, which had approximately 57% sensitivity and 81% specificity for detecting patients explicitly reporting improvement in their sinus symptoms and general health. We also find evidence that the MCID value may be higher in CRS patients without nasal polyps compared to those with nasal polyps. Conclusions: Our results - which include data from patients from two different institutions and regions - confirm a SNOT-22 MCID of 12 in medically managed CRS patients. The SNOT-22 MCID was specific but not sensitive for identifying CRS patients experiencing improvement in symptoms or general health.

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“…There may be a recall bias among the pregnant women when recalling their HRQoL during their second trimester of pregnancy. Studies on general HRQoL assessment with the EQ-5D-3L appear largely free of recall bias within follow-up visits of 2-12 months [ 30 ], and agreement of HRQoL determined using the EQ-5D-3L between conventional (1 week) and retrospective change (3 months later) is fair [ 31 ], indicating that the recall bias could be accepted. Second, there may be a considerable selection bias due to the low feasibility of a random sampling owing to the particularity of HIV-positive pregnant women themselves.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life of HIV-Positive and HIV-Negative Pregnant Women in an Impoverished Area: Cross-sectional Study

Wang

et al. 2022

JMIR Public Health Surveill

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Background Liangshan prefecture of Sichuan province was an impoverished mountainous area in China, where the annual number of HIV-positive pregnant women accounted for approximately 10% of China’s total population in the decades before 2020. In general, pregnant women living here are likely to be physically and mentally different from those in other places. Objective This study aims to explore the health-related quality of life (HRQoL) of pregnant women living with HIV in an impoverished area. Methods From December 2018 to January 2019, HIV-positive and HIV-negative parturients within 18 months after delivery were recruited in Liangshan Prefecture, Sichuan Province. Questionnaires were designed to collect their demographic data, while the EuroQol 5-Dimension, 3-Level questionnaire was used to measure their HRQoL when they were in the second trimester from 4 to 6 months of pregnancy, and their quantitative health scores were converted to corresponding healthy utility values by using the Chinese Utility Value Integral System (time trade-off coefficient). Results A total of 250 pregnant women (133 HIV-positive and 117 HIV-negative) were enrolled in the study. Among them, 55 (41.35%) and 75 (64.10%) of HIV-positive and HIV-negative pregnant women self-reported full health (healthy state 11111), respectively. The median health utility value of the 250 pregnant women was 0.961 (IQR –0.046 to 0.961), and those of the HIV-positive and HIV-negative pregnant women were 0.875 (0.424-0.961) and 0.961 (IQR –0.046 to 0.961), respectively. We observed a significant difference only in the dimension of anxiety or depression between the two groups (P=.002) and no significant difference in the distribution of health utility indices between the two groups in terms of maternal age, education level, occupation, annual household income, prenatal care visits, family size, and medical insurance category. Multivariate ordinal logistic regression analysis showed that age (odds ratio [OR] 0.62, P<.05) and prenatal care visit (OR 0.29, P<.01) were independent risk factors for health status. Conclusions Most pregnant women self-reported satisfactory HRQoL in this impoverished mountainous area. HIV-negative pregnant women had an edge over HIV-positive pregnant women, and there were significant differences in anxiety or depression dimensions between the two groups.

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Characterising the potential for recall bias in anchor‐based MCID calculation of patient‐reported outcome measures for chronic rhinosinusitis

Cited by 8 publications

References 40 publications

The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods

The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods

Multi-institutional minimal clinically important difference of the 22-item Sinonasal Outcome Test in medically managed chronic rhinosinusitis

Health-Related Quality of Life of HIV-Positive and HIV-Negative Pregnant Women in an Impoverished Area: Cross-sectional Study

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