Browsing by Subject "Responsiveness"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Comparative responsiveness of pain outcome measures among primary care patients with musculoskeletal pain
    (Wolters Kluwer, 2010-11) Krebs, Erin E.; Bair, Matthew J.; Damush, Teresa M.; Tu, Wanzhu; Wu, Jingwei; Kroenke, Kurt; Department of Medicine, IU School of Medicine
    BACKGROUND: Comparative responsiveness data are needed to inform choices about pain outcome measures. OBJECTIVES: To compare responsiveness of pain intensity, pain-related function, and composite measures, using data from a randomized trial and observational study. RESEARCH DESIGN: Analysis of responsiveness. SUBJECTS: A total of 427 adults with persistent back, hip, or knee pain were recruited from primary care. METHODS: Participants completed Brief Pain Inventory, Chronic Pain Grade (CPG), Roland disability, SF-36 bodily pain, and pain global rating of change measures. We used the global rating as the anchor for standardized response mean and receiver operating characteristic curve analyses. We used the distribution-based standard error of measurement to estimate minimally important change. To assess responsiveness to the trial intervention, we evaluated standardized effect size statistics stratified by trial arm. RESULTS: All measures were responsive to global improvement and all had fair-to-good accuracy in discriminating between participants with and without improvement. SF bodily pain was less responsive than other measures in several analyses. The 3-item PEG was similarly responsive to full Brief Pain Inventory scales. CPG and SF bodily pain were less responsive to the trial intervention and did not perform well among participants with hip/knee pain. Agreement between anchor and distribution-based methods was modest. CONCLUSIONS: If a brief measure is desired, the 3-item PEG is more responsive than the SF bodily pain scale. CPG and SF bodily pain scales may be relatively poor choices for trial outcome assessment. Both anchor and distribution-based methods should be considered when determining clinically important change.
  • Thumbnail Image
    Item
    Longitudinal Comparison of Three Depression Measures in Adult Cancer Patients
    (Elsevier, 2013) Johns, Shelley A.; Kroenke, Kurt; Krebs, Erin E.; Theobald, Dale E.; Wu, Jingwei; Tu, Wanzhu; School of Nursing
    Context: Although a number of depression measures have been used with cancer patients, longitudinal comparisons of several measures in the same patient population have been infrequently reported. Objectives: To compare the Hopkins Symptom Checklist 20-item depression scale, Short-Form 36 Mental Health Inventory five-item distress scale, and Patient Health Questionnaire nine-item depression scale in adults with cancer. Methods: Of the 309 cancer patients enrolled in a telecare management trial for depression, 247 completed the three depression measures at both baseline and at three months and a retrospective assessment of global rating of change in depression at three months. Internal consistency and construct validity of each measure were evaluated. Responsiveness was compared by calculating standardized response means and receiver operating characteristic area under the curve, using global rating of change as the external comparator measure. Differences between intervention and control groups in depression change scores were compared by calculating standardized effect sizes (SESs). Results: Internal reliability coefficients for the three measures were ≥0.77 at baseline and ≥0.84 at three months. Construct validity was supported with strong correlations of the depression measures among themselves, moderately strong correlations with other measures of mental health, and moderate correlations with vitality and disability. In terms of responsiveness, standardized response means for all measures significantly differentiated between three groups (improved, unchanged, and worse) as classified by patient-reported global rating of change in depression at three months. The three measures were able to detect a modest treatment effect in the intervention group compared with the control group (SES ranging from 0.21 to 0.43) in the full sample, whereas detecting a greater treatment effect in depressed participants with comorbid pain (SES ranging from 0.30 to 0.58). Finally, the three measures performed similarly in detecting patients with improvement. Conclusion: The Hopkins Symptom Checklist 20-item depression scale, Mental Health Inventory five-item distress scale, and Patient Health Questionnaire nine-item depression scale were established as reliable, valid, and responsive depression measures in adults with cancer. Given the current recommendations for measurement-based care, our study shows that clinicians treating depressed cancer patients have several measures from which to choose.
  • Thumbnail Image
    Item
    Responsiveness of PROMIS and Patient Health Questionnaire (PHQ) Depression Scales in three clinical trials
    (BMC, 2021-02-02) Kroenke, Kurt; Stump, Timothy E.; Chen, Chen X.; Kean, Jacob; Damush, Teresa M.; Bair, Matthew J.; Krebs, Erin E.; Monahan, Patrick O.
    The PROMIS depression scales are reliable and valid measures that have extensive normative data in general population samples. However, less is known about how responsive they are to detect change in clinical settings and how their responsiveness compares to legacy measures. The purpose of this study was to assess and compare the responsiveness of the PROMIS and Patient Health Questionnaire (PHQ) depression scales in three separate samples.