EVALUATING THE SCREENING ABILITY OF PATIENT-REPORTED OUTCOME INSTRUMENTS

Author(s)

Coon C1, McLeod L1, Arnold L2, Chandran A3, Martin S41RTI Health Solutions, Research Triangle Park, NC, USA, 2University of Cincinnati College of Medicine, Cincinnati, OH, USA, 3Pfizer, Inc., New York, NY, USA, 4RTI Health Solutions, Ann Arbor, MI, USA

OBJECTIVES: Assessments composed of patient-reported outcome (PRO) measures can be used in health care settings as screeners for various conditions. The objective of developing and using a PRO screening measure may be to quickly identify patients who are likely to benefit from a formal diagnostic evaluation. Alternatively, the development objective may be to avoid unnecessary diagnostic procedures, particularly when these are time or resource-intensive or invasive in nature. The PRO screener may also be administered to simply rule out the existence of a particular condition. The evaluation of a PRO screening assessment ideally occurs through analyses using a “gold standard” diagnosis of the condition of interest. METHODS: A number of existing statistical and psychometric methods may be used in such an evaluation, including sensitivity and specificity, positive and negative predictive value, kappa, accuracy, odds ratio, and likelihood ratio. RESULTS: The evaluation method selected depends on the objective of the screener itself. If the formal diagnostic procedures are particularly invasive or time- or resource-intensive, then screeners should minimize false positives; in contrast, diseases with exceptional risks when left undiagnosed call for screeners that minimize false negatives. In this research, we explore these methods using data from a study comparing various fibromyalgia screening instruments with the currently accepted gold standard diagnosis for fibromyalgia, namely the American College of Rheumatology 1990 diagnostic criteria (Wolfe et al., 1990). CONCLUSIONS: Using the example application, we illustrate the pros and cons of a battery of statistical methods and how they can be used to select the “best” candidate screener.

Conference/Value in Health Info

2011-05, ISPOR 2011, Baltimore, MD, USA

Value in Health, Vol. 14, No. 3 (May 2011)

Code

PRM34

Topic

Patient-Centered Research

Topic Subcategory

Patient-reported Outcomes & Quality of Life Outcomes

Disease

Multiple Diseases

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