Yuan Jing, Lin Li, Weinfurt Kevin, Lucas Nicole, Burbank Allison J, Hernandez Michelle L, Huang I-Chan, Reeve Bryce B
Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Division of Allergy and Immunology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA; Children's Research Institute, University of North Carolina, Chapel Hill, NC, USA.
Value Health. 2025 Jun 5. doi: 10.1016/j.jval.2025.05.010.
To estimate meaningful score differences (MSDs) and meaningful score regions (MSRs) for the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Pediatric Asthma Impact Scale to enhance score interpretability.
Secondary analysis included 106 children with asthma (8-17 years of age) who completed weekly surveys for 4 weeks. Repeated measures correlations examined the magnitude of association of the PROMIS Pediatric Asthma Impact Scale with other asthma measures. MSDs were calculated using mixed models with the Global Impact of Change (GIC) on Asthma and Health scores as anchors. MSRs were calculated using the receiver operating characteristics analysis with Self-Reported Asthma Symptom Rating (ASR), Global Initiative for Asthma (GINA) control criteria, and Asthma Control Test (ACT) or Childhood Asthma Control Test (cACT) as anchors.
Changes in PROMIS Pediatric Asthma Impact T-scores were correlated with GIC-Asthma (r = 0.45) and GIC-Health (r = 0.34). MSDs were 2.3 to 2.5 points for improvement and 3.5 to 3.6 points for deterioration. PROMIS Pediatric Asthma Impact T-scores were correlated with GINA (r = -0.22), ACT (r = -0.42), cACT (r = -0.41), and ASR (r = -0.47). The MSR cutoff T-scores for GINA were 38.7 and 49.2 between controlled, partly controlled, and uncontrolled asthma; for ACT/cACT, 45.6 between controlled and uncontrolled; and for ASR, 47.9, 50.1, and 55.8 between very good, good, a little good, and bad.
Following recommendations from the US Food and Drug Administration's patient-focused drug development guidance on clinical outcome assessments, estimated MSDs and MSRs aid the interpretation of scores and changes in scores observed in clinical research studies to reflect the meaningful impact of asthma on children.
评估患者报告结果测量信息系统(PROMIS®)儿童哮喘影响量表的有意义得分差异(MSD)和有意义得分区域(MSR),以提高得分的可解释性。
二次分析纳入了106名8至17岁的哮喘儿童,他们连续4周每周完成一次调查。重复测量相关性检验了PROMIS儿童哮喘影响量表与其他哮喘测量指标之间的关联程度。使用以哮喘和健康的全球变化影响(GIC)评分作为锚点的混合模型计算MSD。使用以自我报告的哮喘症状评分(ASR)、全球哮喘防治创议(GINA)控制标准以及哮喘控制测试(ACT)或儿童哮喘控制测试(cACT)作为锚点的受试者工作特征分析来计算MSR。
PROMIS儿童哮喘影响T评分的变化与GIC-哮喘(r = 0.45)和GIC-健康(r = 0.34)相关。改善的MSD为2.3至2.5分,恶化的MSD为3.5至3.6分。PROMIS儿童哮喘影响T评分与GINA(r = -0.22)、ACT(r = -0.42)、cACT(r = -0.41)和ASR(r = -0.47)相关。GINA的MSR临界T评分在哮喘控制、部分控制和未控制之间分别为38.7和49.2;ACT/cACT在控制和未控制之间为45.6;ASR在非常好、好、尚可和差之间分别为47.9、50.1和55.8。
遵循美国食品药品监督管理局以患者为中心的药物研发指南中关于临床结局评估的建议,估计的MSD和MSR有助于解释临床研究中观察到的得分及得分变化,以反映哮喘对儿童的有意义影响。