Minimal Important Difference in Patient Reported Outcome Measures in Persons with Severe Mental Illness, a Post-hoc Pre-Post Analysis

2020 ◽  
Author(s):  
Titus Beentjes ◽  
Steven Teerenstra ◽  
Hester Vermeulen ◽  
Maria W.G. Nijhuis-van der Sanden ◽  
Betsie G.I. van Gaal ◽  
...  

Abstract Background: Complementary interventions for persons with severe mental illness (SMI) provide broad strategies for recovery and illness self-management. It is not known which outcome measure can be considered to be relevant for persons with SMI. This knowledge can motivate a professional to offer and stimulate a person to participate in that intervention. This paper aimed to identify the outcome measures that determine the most relevant and meaningful change and capture the benefits of a complementary intervention. Methods: By using anchor-based and distribution-based methods, we estimated the minimal important difference (MID) to determine which outcome measure persons improved in beyond the MID to reflect a relevant change in pre-post effect of a complementary intervention, in casu the Illness Management and Recovery programme (IMR).Results: The anchor MID was based on the results of the measure Rand General Health Perception (Rand-GHP). On all MIDs, the Mental Health Recovery Measure (MHRM) had the highest score on the effect compared to its MIDs, and also on all MIDs the MHRM had the highest percentages of participants that scored above the MID. Conclusion: The Rand-GHP is considered to be an excellent measure for investigating the MID as a result of an intervention. The results of our study can be used in shared decision-making processes to determine which intervention is suitable for a person with SMI. A person who desires a recovery outcome, as measured by the MHRM, can be recommended to do the IMR programme.

Author(s):  
Titus A. A. Beentjes ◽  
Steven Teerenstra ◽  
Hester Vermeulen ◽  
Peter J. J. Goossens ◽  
Maria W. G. Nijhuis-van der Sanden ◽  
...  

Abstract Purpose Complementary interventions for persons with severe mental illness (SMI) focus on both personal recovery and illness self-management. This paper aimed to identify the patient-reported outcome measures (PROMs) associated with the most relevant and meaningful change in persons with SMI who attended the Illness Management and Recovery Programme (IMR). Methods The effect of the IMR was measured with PROMs concerning recovery, illness self-management, burden of symptoms and quality of life (QoL). From the QoL measures, an anchor was chosen based on the most statistically significant correlations with the PROMs. Then, we estimated the minimal important difference (MID) for all PROMs using an anchor-based method supported by distribution-based methods. The PROM with the highest outcome for effect score divided by MID (the effect/MID index) was considered to be a measure of the most relevant and meaningful change. Results All PROMs showed significant pre–post-effects. The QoL measure ‘General Health Perception (Rand-GHP)’ was identified as the anchor. Based on the anchor method, the Mental Health Recovery Measure (MHRM) showed the highest effect/MID index, which was supported by the distribution-based methods. Because of the modifying gender covariate, we stratified the MID calculations. In most MIDs, the MHRM showed the highest effect/MID indexes. Conclusion Taking into account the low sample size and the gender covariate, we conclude that the MHRM was capable of showing the most relevant and meaningful change as a result of the IMR in persons with SMI.


Author(s):  
Ekkehard Fabian ◽  
Max Birkl ◽  
Franz Benstetter ◽  
Philipp Eberwein ◽  
Ulrich Seher ◽  
...  

Abstract Background Results of medical interventions must be documented and evaluated. In studies, this is done with clinical outcomes data (clinician/clinical reported outcome measure, CROM). In the past, less weight has been given to patient surveys with questionnaires (patient reported outcome measure, PROM). Patients/Materials and Methods This retrospective study included 104 eyes from 53 patients. Of these, 35 patients had cataract surgery and 15 patients had a refractive lens exchange. The implanted lenses included 62 trifocal IOLs (Asphina trifiocal 839, Zeiss), 34 trifocal toric IOLs (Asphina trifocal toric 939, Zeiss) and 8 bifocal IOLs (Asphina 808, Zeiss) with the same IOL platform. Patients completed a modified questionnaire before surgery and one year after surgery. We made changes to the CatQuest-9SF questionnaire so as to also document side effects. Results The effort required by the patients to answer the questionnaire was a burden. Transcribing the data into electronic files so as they could be saved and analyzed was a lot of work for the staff. Among the patients, 88.7% were spectacle-independent in everyday life, and 77.5% for reading. 44.4% had a halo problem. 92% reported the operation as a success. 100% had a prediction error of ≤ ± 0.75 dpt. Conclusion There is a high rate of patient satisfaction with the outcome of the intervention. New questionnaires are needed for new IOLs. The Catquest-9SF is from 2009. Accordingly, revisions and new validation is necessary. Beyond that, only automatic data transfer will reduce the amount of work involved in data input.


Spine ◽  
2018 ◽  
Vol 43 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Robert K. Merrill ◽  
Lukas P. Zebala ◽  
Colleen Peters ◽  
Sheeraz A. Qureshi ◽  
Steven J. McAnany

Hand ◽  
2021 ◽  
pp. 155894472097412
Author(s):  
Ali Aneizi ◽  
Dominique Gelmann ◽  
Dominic J. Ventimiglia ◽  
Patrick M. J. Sajak ◽  
Vidushan Nadarajah ◽  
...  

Background: The objectives of this study were to determine the baseline patient characteristics associated with preoperative opioid use and to establish whether preoperative opioid use is associated with baseline patient-reported outcome measures in patients undergoing common hand surgeries. Methods: Patients undergoing common hand surgeries from 2015 to 2018 were retrospectively reviewed from a prospective orthopedic registry at a single academic institution. Medical records were reviewed to determine whether patients were opioid users versus nonusers. On enrollment in the registry, patients completed 6 Patient-Reported Outcomes Measurement Information System (PROMIS) domains (Physical Function, Pain Interference, Fatigue, Social Satisfaction, Anxiety, and Depression), the Brief Michigan Hand Questionnaire (BMHQ), a surgical expectations questionnaire, and Numeric Pain Scale (NPS). Statistical analysis included multivariable regression to determine whether preoperative opioid use was associated with patient characteristics and preoperative scores on patient-reported outcome measures. Results: After controlling for covariates, an analysis of 353 patients (opioid users, n = 122; nonusers, n = 231) showed that preoperative opioid use was associated with higher American Society of Anesthesiologists class (odds ratio [OR], 2.88), current smoking (OR, 1.91), and lower body mass index (OR, 0.95). Preoperative opioid use was also associated with significantly worse baseline PROMIS scores across 6 domains, lower BMHQ scores, and NPS hand scores. Conclusions: Preoperative opioid use is common in hand surgery patients with a rate of 35%. Preoperative opioid use is associated with multiple baseline patient characteristics and is predictive of worse baseline scores on patient-reported outcome measures. Future studies should determine whether such associations persist in the postoperative setting between opioid users and nonusers.


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