Minimally important differences were estimated for six Patient-Reported Outcomes Measurement Information System-Cancer scales in advanced-stage cancer patients
Open accessAbstract
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.
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PROMIS measures were initially developed with cancer patients' input, and a growing body of research has documented their reliability and validity for use with cancer patients, including those with advanced disease.
“PROMIS measures were initially developed with cancer patients’ input [32], and a growing body of research has documented the measures’ reliability and validity for use with cancer patients, including those with advanced disease [33–35].”
From Symptom experiences in metastatic breast cancer patients: relationships to activity engagement, value-based living, and psychological inflexibility (2017) · cites this paper as [35]
The Methods (sections 2.1–2.4; page unavailable) describe administering six PROMIS-Cancer scales to patients with stage III or IV cancer and assessing measurement precision and correlations with other measures. This provides some evidence about their use in advanced cancer, but the paper focuses on minimally important differences and does not establish the broader claim that research has documented both reliability and validity. The separate claim about patients’ input is attached to citation [32], not this source. (LLM, conf=0.82)
Experimental — accuracy not yet measuredMIDs for fatigue measures have substantially varied in studies of patients with advanced disease or those undergoing cancer treatment.
“MIDs for fatigue measures have substantially varied in studies of patients with advanced disease or those undergoing cancer treatment [35–38] and have yet to be evaluated among post-treatment survivors.”
From Comparative responsiveness and minimally important difference of fatigue symptom inventory (FSI) scales and the FSI-3 in trials with cancer survivors (2022) · cites this paper as [36]
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- Authors
- Yost, K. J., Eton, D. T., Garcia, S. F., & Cella, D.
- Affiliations
- Mayo Clinic (US)
- Northwestern University (US)
- Corresponding author
- Yost, Kathleen J.
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 64
- Issue
- 5
- Pages
- 507-516
- ISSN
- 0895-4356 (ISSN-L)
- PMC
- PMC3076200
- OpenAlex
- W1993773733
- Cited by
- 597
- References
- 37
- Citations by year
- 2026: 21 · 2025: 33 · 2024: 34 · 2023: 48 · 2022: 77 · 2021: 64 · 2020: 58 · 2019: 55 · 2018: 56 · 2017: 35 · 2016: 34 · 2015: 35 · 2014: 23 · 2013: 12 · 2012: 9
- FWCI
- 7.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NorthShore University HealthSystem
- National Institutes of Health
- National Cancer Institute (R01CA060068)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR052177)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- minimally important difference, patient-reported outcomes, advanced cancer, anchor-based methods, distribution-based methods, fatigue, pain interference, physical function, emotional distress, anxiety, depression, standard error of measurement, item response theory
- MeSH terms
- Adult, Aged, Aged, 80 and over, Chicago, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Neoplasms, Outcome and Process Assessment, Health Care, Psychometrics, Quality of Life, Surveys and Questionnaires, Treatment Outcome, Patient Satisfaction, Sickness Impact Profile, Quality Indicators, Health Care
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