title: Refining scores based on patient reported outcomes – statistical and medical perspectives
creator: Feißt, Manuel
creator: Hennigs, André
creator: Heil, Jörg
creator: Moosbrugger, Helfried
creator: Kelava, Augustin
creator: Stolpner, Ilona
creator: Kieser, Meinhard
creator: Rauch, Geraldine
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: Patient Reported Outcomes (PRO) are gaining more and more importance in the context of clinical trials. The assessment of PRO is frequently performed by questionnaires where the multiple items of a questionnaire are usually pooled within summarizing scores. These scores are used as variables to measure subjective aspects of treatments and diseases. In clinical research, the calculation of these scores is mostly kept very simple, e.g. by a simple summation of item values. In the medical literature, there is hardly any guidance for performing a refinements of questionnaires and for deducing adequate scores. In contrast, in psychometric literature, there are plenty of more sophisticated methods, which overcome typical assumptions made in traditional (sum) scores, however to the prize of more complicated algorithms, which might be difficult to communicate. When faced with the practical task to refine an existing questionnaire, there exist a clear gap of guidance for applied medical researchers. By this article we try to fill this important gap between psychometric theory and medical application by illustrating our methodological choices on the example of a clinical PRO questionnaire.       Methods: Based on our experiences with the refinement of the BCTOS, a PRO questionnaire to assess aesthetic and function after breast conserving therapy in breast cancer patients, we present the following general steps that we performed by refining the BCTOS questionnaire and its scores: 1. Refinement of the length of the questionnaire and the (item-factor) structure. 2. Selection of the factor score estimation method. 3. Validation of the refined questionnaire and scores with respect to validity, reliability and structure based on a validation cohort.    Results: Our step-step-step procedure helped us to shorten the current form of the BCTOS and to redefine the factor structure. By this, the compliance of patients can be increased and the interpretation of the results becomes more coherent.    Conclusions: We present a step-by-step procedure to refine an existing medical questionnaire along with its scores illustrated and discussed by the refinement of the BCTOS.    Trial registration: Due to the character of the study (no intervention study), no registration was performed.
publisher: BioMed Central ; Springer
date: 2019
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/26939/1/12874_2019_Article_806.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-269393
identifier:   Feißt, Manuel ; Hennigs, André ; Heil, Jörg ; Moosbrugger, Helfried ; Kelava, Augustin ; Stolpner, Ilona ; Kieser, Meinhard ; Rauch, Geraldine  (2019) Refining scores based on patient reported outcomes – statistical and medical perspectives.  BMC Medical Research Methodology, 19 (167).  pp. 1-9.  ISSN 1471-2288     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/26939/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng