OBJECTIVES

Patient-reported outcome measures are increasingly being utilized in clinical care and research to evaluate outcomes following stroke. In order to optimize the clinical utility of these measures, we aimed to quantify meaningful change through establishing minimal important differences (MIDs), or responder definitions, for 6 domains on Patient Reported Outcome Measurement Information System (PROMIS) scales in ischemic and hemorrhagic stroke patients.

METHODS

We performed a retrospective cohort study of stroke patients seen in the Cleveland Clinic cerebrovascular center between 9/2/12-11/7/17. To determine the responder definition for PROMIS domain scales from time of stroke to 6 months post-stroke, we estimated MIDs using an empirical anchor-based approach based on a global impression of change question and supported the findings using a distribution-based method of minimal detectable change (MDC). Cumulative distribution functions (CDF) assessed appropriateness of responder thresholds. MIDs were additionally derived across varying levels of stroke severity as defined by Rankin Score.

RESULTS

was between 3.5-4.3 points for all domains. CDF plots demonstrated 25% of patients reached meaningful change 6 months post-stroke for the majority of domains. MIDs remained consistent across levels of stroke severity.

CONCLUSIONS

MIDs for PROMIS scales ranged from 3-5 points for functional status, fatigue, anxiety, sleep, and executive functioning, and from 4-8 points for social role satisfaction in stroke patients from time of stroke to 6 months post-stroke. Our study is the first to evaluate interpretability of changes in PROMIS scores for stroke survivors. Future studies can utilize these thresholds to identify responders of stroke interventions.