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Sims J, Sloesen B, Bentley S, Naujoks C, Arbuckle R, Chiva-Razavi S, Pascoe B, Stochl J, Findley A, O'Brien P, Wolffsohn JS. Psychometric evaluation of the near activity visual questionnaire presbyopia (NAVQ-P) and additional patient-reported outcome items. J Patient Rep Outcomes 2024; 8:41. [PMID: 38592339 PMCID: PMC11004101 DOI: 10.1186/s41687-024-00717-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The Near Visual Acuity Questionnaire Presbyopia (NAVQ-P) is a patient-reported outcome (PRO) measure that was developed in a phakic presbyopia population to assess near vision function impacts. The study refined and explored the psychometric properties and score interpretability of the NAVQ-P and additional PRO items assessing near vision correction independence (NVCI), near vision satisfaction (NVS), and near vision correction preference (NVCP). METHODS This was a psychometric validation study conducted using PRO data collected as part of a Phase IIb clinical trial (CUN8R44 A2202) consisting of 235 randomized adults with presbyopia from the US, Japan, Australia, and Canada. Data collected at baseline, week 2, and months 1, 2, and 3 during the 3-month trial treatment period were included in the analyses to assess item (question) properties, NAVQ-P dimensionality and scoring, reliability, validity, and score interpretation. RESULTS Item responses were distributed across the full response scale for most NAVQ-P and additional PRO items. Confirmatory factor analysis supported the pre-defined unidimensional structure and calculation of a NAVQ-P total score as a measure of near vision function. Item deletion informed by item response distributions, dimensionality analyses, item response theory, and previous qualitative findings, including clinical input, supported retention of 14 NAVQ-P items. The 14-item NAVQ-P total score had excellent internal consistency (α = 0.979) and high test-retest reliability (Intraclass Correlation Coefficients > = 0.898). There was good evidence of construct-related validity for all PROs supported by strong correlations with concurrent measures. Excellent results for known-groups validity and ability to detect change analyses were also demonstrated. Anchor-based and distribution-based methods supported interpretation of scores through generation of group-level and within-individual estimates of meaningful change thresholds. A meaningful within-patient change in the range of 8-15-point improvement on the NAVQ-P total score (score range 0-42) was recommended, including a more specific responder definition of 10-point improvement. CONCLUSIONS The NAVQ-P, NVCI, and NVS are valid and reliable instruments which have the ability to detect change over time. Findings strongly support the use of these measures as outcome assessments in clinical/research studies and in clinical practice in the presbyopia population.
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Affiliation(s)
- Joel Sims
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK.
| | | | - Sarah Bentley
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | - Ben Pascoe
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | - Jan Stochl
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
- Charles University, Prague, Czechia
| | - Amy Findley
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Silverberg JI, Agner T, Baranowski K, Plohberger U, Thoning H, Arbuckle R, Grant L, Skingley G, Bissonnette R. Validation of the Investigator Global Assessment of Chronic Hand Eczema (IGA-CHE): a new clinician reported outcome measure of CHE severity. Arch Dermatol Res 2024; 316:110. [PMID: 38507100 PMCID: PMC10955004 DOI: 10.1007/s00403-024-02818-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 12/20/2023] [Accepted: 01/11/2024] [Indexed: 03/22/2024]
Abstract
The Investigator Global Assessment of Chronic Hand Eczema (IGA-CHE) is a novel Clinician-Reported Outcome measure that allows investigators to assess cross-sectional CHE global disease severity using clinical characteristics of erythema, scaling, lichenification/hyperkeratosis, vesiculation, oedema, and fissures as guidelines for overall severity assessment. This study aimed to evaluate the psychometric properties of the IGA-CHE for use as an outcome measure in CHE clinical trials and clinical practice. Psychometric analyses were performed using data from a sample of 280 patients with moderate to severe CHE from a phase 3 trial of delgocitinib cream, pooled across treatment groups. Test-retest reliability results were moderate to strong with kappa coefficients ranging from 0.63 to 0.76. Correlations with measures assessing related concepts were moderate or strong (range 0.65-0.72) and exceeded a priori hypotheses, providing evidence of convergent validity. Known-groups validity was supported by statistically significant differences between severity groups (< 0.001). Within-group effect sizes were consistently larger for improved groups compared to stable groups, providing evidence of ability to detect change. Anchor-based analyses generated within-subject meaningful change estimates ranging from - 0.8 to - 2.3. A correlation weighted average suggested a single value of - 1.7 in change from baseline. These findings provide evidence the IGA-CHE scale has strong reliability, construct validity, and ability to detect change, supporting its use as an endpoint in CHE clinical trials and clinical practice. Based on the evidence, 2-level changes in IGA-CHE score are considered a conservative meaningful change threshold; however, findings also indicate 1-level change in IGA-CHE scores reflects a clinically meaningful improvement for patients.Clinical trial registration: NCT04871711.
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Affiliation(s)
- Jonathan I Silverberg
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
| | - Tove Agner
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Laura Grant
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - George Skingley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
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Molin S, Larsen LS, Joensson P, Oesterdal ML, Arbuckle R, Grant L, Skingley G, Schuttelaar MLA. Development and Psychometric Validation of a Patient-Reported Outcome Measure to Assess the Signs and Symptoms of Chronic Hand Eczema: The Hand Eczema Symptom Diary (HESD). Dermatol Ther (Heidelb) 2024; 14:643-669. [PMID: 38485862 DOI: 10.1007/s13555-024-01114-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/09/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Chronic Hand Eczema (CHE) is an inflammatory skin disease of the hands. The Hand Eczema Symptom Diary (HESD) is a new patient-reported outcome measure of worst severity of core CHE signs/symptoms. This study aimed to evaluate content and psychometric validity of the HESD. METHODS The HESD was developed based on the literature and concept elicitation interviews. Qualitative cognitive debriefing interviews were conducted with CHE patients to assess relevance and understanding of items, response options and recall period. Psychometric properties of the HESD (item performance, dimensionality, reliability, validity, responsiveness and estimation of meaningful change thresholds) were then assessed, first using data from a phase 2b trial (NCT03683719), and confirmed using data from the first 280 participants completing the 16-week treatment phase of a phase 3 trial (NCT04871711). RESULTS Cognitive debriefing supported item refinement and removal of items and confirmed all items were well understood and relevant to patients. Item properties and dimensionality analyses in the phase 2b data supported removal of additional items, resulting in the 6-item HESD included in the phase 3 trial. Unidimensionality was supported by inter-item correlations (all > 0.70) and Rasch analysis. Internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (Intraclass Correlation Coefficient > 0.89) results were very strong. Construct validity was supported by moderate correlations with concurrent measures (0.53-0.64) and significant differences between severity groups (p < 0.001). Large effect sizes for mean change scores in participants that improved and significant differences between change groups indicated the ability to detect change. Anchor-based analyses supported within-individual responder definitions of ≥ 4-points for improvements in 7-day average HESD scores. CONCLUSION The HESD is the first CHE-specific, patient-reported outcome measure of CHE signs/symptoms developed and validated in line with regulatory guidance. This article provides evidence of strong content validity and psychometric validity and shows improvements of ≥ 4 points on 7-day average HESD scores represent clinically meaningful, important changes. TRIAL REGISTRATION NCT03683719, NCT04871711.
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Affiliation(s)
- Sonja Molin
- Division of Dermatology, Queen's University, Kingston, ON, Canada.
| | | | | | | | - Rob Arbuckle
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Laura Grant
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - George Skingley
- Adelphi Values Ltd, Patient-Centered Outcomes, Bollington, Cheshire, UK
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Karpecki PM, Findley A, Sloesen BJ, Hodson N, Bentley S, Arbuckle R, O'Brien P, Montecchi-Palmer M, Naujoks C, Hamrah P. Qualitative Research to Understand the Patient Experience and Evaluate Content Validity of the Chronic Ocular Pain Questionnaire (COP-Q). Ophthalmol Ther 2024; 13:615-633. [PMID: 38183618 PMCID: PMC10787728 DOI: 10.1007/s40123-023-00860-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 11/21/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Chronic ocular surface pain (COSP) is described as a persistent, moderate-to-severe pain at the ocular surface lasting more than 3 months. Symptoms of COSP have a significant impact on patients' vision-dependent activities of daily living (ADL) and distal health-related quality of life (HRQoL). To adequately capture patient perspectives in clinical trials, patient-reported outcome (PRO) measures must demonstrate sufficient evidence of content validity in the target population. This study aimed to explore the patient experience of living with COSP and evaluate content validity of the newly developed Chronic Ocular Pain Questionnaire (COP-Q) for use in COSP clinical trials. METHODS Qualitative, combined concept elicitation (CE) and cognitive debriefing (CD) interviews were conducted with 24 patients experiencing COSP symptoms in the USA. Interviews were supplemented with real-time data collection via a daily diary app task in a subset of patients (n = 15) to explore the day-to-day patient experience. Three healthcare professionals (HCPs) from the USA, Canada, and France were also interviewed to provide a clinical perspective. CE results were used to further inform development of a conceptual model and to refine PRO items/response options. CD interviews assessed relevance and understanding of the COP-Q. Interviews were conducted across multiple rounds to allow item modifications and subsequent testing. RESULTS Eye pain, eye itch, burning sensation, eye dryness, eye irritation, foreign body sensation, eye fatigue, and eye grittiness were the most frequently reported symptoms impacting vision-dependent ADL (e.g., reading, using digital devices, driving) and wider HRQoL (e.g., emotional wellbeing, social functioning, work). COP-Q instructions, items, and response scales were understood, and concepts were considered relevant. Feedback supported modifications to instruction/item wording and confirmed the most appropriate recall periods. CONCLUSIONS Findings support content validity of the COP-Q for use in COSP populations. Ongoing research to evaluate psychometric validity of the COP-Q will support future use of the instrument in clinical trial efficacy endpoints.
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Affiliation(s)
- Paul M Karpecki
- University of Pikeville Kentucky College of Optometry, Pikeville, KY, USA
- Kentucky Eye Institute, Lexington, KY, USA
| | - Amy Findley
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK
- Novo Norisk, Copenhagen, Denmark
| | | | - Nicola Hodson
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK.
| | - Sarah Bentley
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK
| | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values Ltd., Bollington, Cheshire, UK
| | - Paul O'Brien
- Novartis Ireland Ltd., Dublin, Ireland
- ViiV Healthcare, London, UK
| | | | | | - Pedram Hamrah
- Department of Ophthalmology, New England Eye Center and Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Bradley H, Trennery C, Jones AM, Lydon A, White F, Williams-Hall R, Arbuckle R, Tomaszewski E, Shih VH, Haughney J, Eisen A, Winders T, Coons SJ, Eremenco S. Assessing asthma symptoms in children: qualitative research supporting the development of the Pediatric Asthma Diary-Child (PAD-C) and Pediatric Asthma Diary-Observer (PAD-O). J Patient Rep Outcomes 2023; 7:104. [PMID: 37863864 PMCID: PMC10589163 DOI: 10.1186/s41687-023-00639-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Pediatric asthma has been identified by regulators, clinicians, clinical trial sponsors, and caregivers as an area in need of novel fit-for-purpose clinical outcome assessments (COAs) developed in accordance with the U.S. Food and Drug Administration's (FDA's) regulatory guidance for evaluating clinical benefit in treatment trials. To address this gap, the Patient-Reported Outcome (PRO) Consortium's Pediatric Asthma Working Group has continued development of 2 COAs to assess asthma signs and symptoms in pediatric asthma clinical trials to support efficacy endpoints: a PRO measure, the Pediatric Asthma Diary-Child (PAD-C) for children 8-11 years old (y.o.) and an observer-reported outcome measure, the Pediatric Asthma Diary-Observer (PAD-O) for caregivers of children 4-11 y.o. This qualitative research aimed to generate evidence regarding the content validity of the PAD-C and PAD-O. METHODS Semi-structured combined concept elicitation and cognitive interviews were conducted with a diverse sample of U.S. participants (15 children 8-11 y.o. and 30 caregivers of children 4-11 y.o.). All children had clinician-diagnosed mild to severe asthma. Interviews explored the experience of pediatric asthma and assessed the understanding and relevance of both measures. Interviews were conducted across 3 iterative rounds to allow for modifications. RESULTS Concept elicitation findings demonstrated that the core sign/symptom and impact concepts assessed in the PAD-C (cough, hard to breathe, out of breath, wheezing, chest tightness, and nighttime awakenings/symptoms) and PAD-O (cough, difficulty breathing, short of breath, wheezing, and nighttime awakenings/signs) correspond to those most frequently reported by participants; concept saturation was achieved. All PAD-C and PAD-O instructions and core items were well understood and considered relevant by most participants. Feedback from participants, the Pediatric Asthma Working Group, advisory panel, and FDA supported modifications to the measures, including addition of 1 new item to both measures and removal of 1 caregiver item. CONCLUSIONS Findings provide strong support for the content validity of both measures. The cross-sectional measurement properties of both measures and their user experience and feasibility in electronic format will be assessed in a future quantitative pilot study with qualitative exit interviews, intended to support the reliability, construct validity, final content, and, ultimately, FDA qualification of the measures.
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Affiliation(s)
| | | | - Amy M Jones
- Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Aoife Lydon
- Adelphi Values Ltd, Bollington, Cheshire, UK
| | | | | | | | | | | | - John Haughney
- NHS Greater Glasgow and Clyde R&I, Queen Elizabeth University Hospital, Glasgow, UK
| | | | - Tonya Winders
- Global Allergy and Airways Patient Platform, Vienna, Austria
| | - Stephen Joel Coons
- Patient-Reported Outcome Consortium, Critical Path Institute, Tucson, AZ, USA
| | - Sonya Eremenco
- Patient-Reported Outcome Consortium, Critical Path Institute, Tucson, AZ, USA
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Webber A, Randhawa S, Felizzi F, Soos M, Arbuckle R, O'Brien P, Harrad R, Khuddus N, Bouchet C, Panter C. The Amblyopia Quality of Life (AmbQoL): Development and Content Validation of a Novel Health-Related Quality of Life Instrument for Use in Adult and Pediatric Amblyopia Populations. Ophthalmol Ther 2023; 12:1281-1313. [PMID: 36828953 PMCID: PMC10011248 DOI: 10.1007/s40123-023-00668-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/27/2023] [Indexed: 02/26/2023] Open
Abstract
INTRODUCTION Amblyopia is a neurodevelopmental vision disorder, characterized by poor vision in one or both eyes. Given the lack of existing clinical outcome assessments (COA) considered fit-for-purpose for amblyopia clinical trials, this study developed new COAs to assess amblyopia symptoms and health-related quality of life (HRQoL) impacts in adult and pediatric amblyopia populations that conform with best practice standards and regulatory guidelines. METHODS Findings from a targeted qualitative literature review informed the development of three versions of the new Amblyopia Quality of Life Questionnaire (AmbQoL): a patient-reported outcome measure (PRO) for individuals aged 13 years and older, a PRO for children aged 9-12 years, and an observer-reported outcome measure (ObsRO) for caregivers of children aged 4-8 years. Qualitative interviews were conducted with the target populations, and with ophthalmologists experienced in treating amblyopia patients to evaluate the content validity for further development of the AmbQoL. A translatability assessment was conducted to ensure cultural appropriateness and usability across multiple languages. Feedback from Food and Drug Administration (FDA) was also sought on the instruments, and clinical experts provided input at key stages. RESULTS Interviews were conducted with 112 patients/caregivers and ten ophthalmologists from the USA, France, and Germany. The instructions, items, and response options were well understood across all AmbQoL versions. Feedback from the patients, caregivers, ophthalmologists, the translatability assessment, the FDA, and the expert clinicians informed minor wording modifications to enhance clarity and translatability. Some items were removed due to low relevance. The study resulted in a 23-item adult/adolescent PRO, 24-item child PRO, and 12-item ObsRO, each employing a 7-day recall period. CONCLUSION Each AmbQoL version has documented support for its face and content validity for use in amblyopia populations aged ≥ 4 years. Further research is necessary to evaluate the psychometric measurement properties of the AmbQoL instruments to enable their use in amblyopia treatment trials.
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Affiliation(s)
- Ann Webber
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Findley A, Sharma G, Bentley S, Arbuckle R, Patalano F, Naujoks C, Kommineni J, Tyagi N, Lehane A, Wolffsohn JS, Chiva-Razavi S. Comparison of Literature Review, Social Media Listening, and Qualitative Interview Research Methods in Generating Patient-Reported Symptom and Functional Impact Concepts of Presbyopia. Ophthalmol Ther 2023; 12:501-516. [PMID: 36502495 PMCID: PMC9834465 DOI: 10.1007/s40123-022-00620-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION To compare the insights obtained about the experience of individuals with presbyopia (age-related impaired near vision) across three different sources of qualitative data: a structured targeted literature review, a social media listening (SML) review, and qualitative concept elicitation (CE) interviews with individuals with presbyopia and healthcare professionals (HCPs). The number of concepts identified, depth of data, cost and time implications, and value of the patient insights generated were explored and compared for each method. METHODS Keyword searches in bibliographic databases and review of abstracts identified 120 relevant publications; in-depth targeted literature review of the qualitative studies identified key symptoms/functioning concepts. SML was conducted using publicly accessible social media sources with focus on ophthalmologic diseases using a pre-defined search string. Relevant posts from individuals with presbyopia (n = 270) were analysed and key concepts identified. Semi-structured CE interviews were conducted with individuals with presbyopia (US n = 30, Germany n = 10, France n = 10), and HCPs (US = 3, France n = 2, Germany n = 1, Japan n = 1) who were experienced in treating presbyopia. Verbatim transcripts were coded using thematic analysis. A conceptual model summarised concepts identified across sources RESULTS: Out of the total of 158 concepts identified across the three sources, qualitative CE interviews yielded the highest number of concepts (n = 151/158, 96%), with SML yielding a third of the concepts (n = 51/158, 32%) and the literature review yielding the fewest concepts (n = 33/158, 21%). Qualitative CE interviews provided greater depth of data than SML and literature reviews. SML and literature reviews were less costly and quicker to run than qualitative CE interviews and also were less burdensome for participants. CONCLUSION Qualitative CE interviews are considered the gold standard in providing greater depth of understanding of the patient experience, and more robust data. However, research requirements, budget, and available time should be considered when choosing the most appropriate research method. More time and cost-effective SML and literature review methods can be used to supplement qualitative CE interview data and provide early identification of measurement concepts. More research and regulatory guidance into less traditional qualitative methods, however, are needed to increase the value of SML and literature review data.
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Affiliation(s)
- Amy Findley
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK.
| | - Garima Sharma
- Novartis Business Services (NBS) CONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Sarah Bentley
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Rob Arbuckle
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK
| | | | | | - Jyothi Kommineni
- Novartis Business Services (NBS) CONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Nishith Tyagi
- Novartis Business Services (NBS) CONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Asha Lehane
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK
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Arbuckle R, Marshall C, Grant L, Burrows K, Albrecht HH, Shea T. Development and content validity testing of patient-reported outcome (PRO) items to assess chest congestion associated with the common cold for use in children and adolescents. J Patient Rep Outcomes 2022; 6:56. [PMID: 35633410 PMCID: PMC9148330 DOI: 10.1186/s41687-022-00465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This article describes qualitative interviews conducted with children (aged 6-11), adolescents (aged 12-17), and adults with the common cold as well as parents/caregivers of the 6-8-year-old children. The aim was to support the refinement and content validity testing of patient-reported outcome (PRO) items assessing chest congestion that could be used as pediatric clinical trial endpoints. Feasibility and acceptability of administering the PRO items electronically on a hand-held touch-screen device were also evaluated. The sample included children aged 6-8 years (n = 14), 9-11 years (n = 13), adolescents aged 12-17 years (n = 12), and adults (n = 10), all of who had current (n = 38) or recent (n = 11) cold. Both concept elicitation (CE) and cognitive debriefing (CD) interviews were conducted with all of these participants, conducted over in two rounds. Ten parents/caregivers of participants aged 6-8 years were also interviewed (separately from their child) regarding how they thought their children would understand the items. The CE interviews explored the qualitative experience of having chest congestion and related symptoms of the common cold. Following their CE interview, participants completed draft items on an electronic patient-reported outcome (ePRO) device twice daily for 2-5 days prior to their CD interview. During the CD interview participants were asked about relevance, understanding and interpretation of the draft PRO items. Qualitative analysis of the interview data and descriptive analyses of the ePRO data were conducted following both rounds of interviews, with modifications to the items implemented following Round 1 and tested in Round 2. RESULTS Eight symptoms were reported by children during concept elicitation. Findings from the child, adolescent, and adult/parent interviews supported revisions to the items and enabled the selection of the best performing items. The results provided evidence that the final items were well understood by participants and relevant to their experiences of chest congestion as part of a common cold. Findings also provide support for using the same items across age groups. CONCLUSIONS The results of the CE and CD interviews provide evidence supporting the content validity of new PRO items assessing the experience of chest congestion symptoms associated with common cold experienced by children, adolescents, and adults.
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Affiliation(s)
- Rob Arbuckle
- Adelphi Values Patient-Centered Outcomes, Bollington, UK.
| | - Chris Marshall
- Adelphi Values Patient-Centered Outcomes (at the time research was conducted), Bollington, UK
| | - Laura Grant
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Kate Burrows
- Adelphi Values Patient-Centered Outcomes (at the time research was conducted), Bollington, UK
| | - Helmut H Albrecht
- Herbert Wertheim College of Medicine, Cellular Biology and Pharmacology, Florida International University, Miami, FL, USA
| | - Tim Shea
- RB Health (US), LLC, Parsippany, New Jersey, USA
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Tatlock S, Bentley S, Arbuckle R, Abetz-Webb L, Scott J. Content validation of a caregiver diary to monitor severity and recovery of pediatric patients with respiratory syncytial virus infection. J Patient Rep Outcomes 2022; 6:48. [PMID: 35554751 PMCID: PMC9098775 DOI: 10.1186/s41687-022-00442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Respiratory Syncytial Virus (RSV) is a leading cause of hospitalization and serious respiratory illness in infants/young children. The objectives of this study were to (1) identify important RSV-related signs of illness in infants that were observed by the parent/caregiver of the child and (2) assess content validity and usability of the Pediatric RSV Electronic Severity and Outcomes Rating System (PRESORS) to monitor signs of RSV-related illness. METHODS Review of medical literature identified signs of pediatric RSV-related illness in PRESORS. Semi-structured interviews with caregivers of infants (0-24 months of age) hospitalized with laboratory-confirmed RSV infection (in the two months prior to recruitment) were conducted to spontaneously elicit signs and impacts of the infant's illness from caregiver observations. Caregivers completed PRESORS using a "think-aloud" protocol to confirm comprehension, relevance, and usability of the smartphone application. Verbatim transcripts were analyzed using thematic analysis methods and Atlas.ti software. RESULTS Interviews with 21 caregivers confirmed PRESORS captured 23/26 signs caregivers spontaneously reported. Cough, difficulty breathing, problems sleeping, and reduced feeding/drinking were the most worrying signs of severe RSV-related illness described. Cognitive debriefing indicated that caregivers: understood the wording of all PRESORS items and response options (except how to count heartbeats), recall periods were appropriate, and the PRESORS smartphone application was easy to use. Minor changes to enhance content validity were identified. CONCLUSIONS In-depth interviews confirmed content validity and usability of the PRESORS by caregivers of infants with RSV. Next steps are to assess the revised PRESORS in clinical studies and evaluate its measurement properties.
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Affiliation(s)
| | | | - Rob Arbuckle
- Adelphi Values, Bollington, Cheshire, SK10 5JB, UK
| | - Linda Abetz-Webb
- Patient-Centered Outcome Assessments, Bollington, Cheshire, SK10 5LQ, UK
| | - Jane Scott
- Janssen Pharmaceuticals Inc., Raritan, NJ, 08869, USA
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Eliason L, Grant L, Francis A, Cardellino A, Culver K, Chawla SP, Arbuckle R, Pokras S. Qualitative study to characterize patient experience and relevance of patient-reported outcome measures for patients with metastatic synovial sarcoma. J Patient Rep Outcomes 2022; 6:43. [PMID: 35507231 PMCID: PMC9068846 DOI: 10.1186/s41687-022-00450-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/20/2022] [Indexed: 11/12/2022] Open
Abstract
Background The outlook for patients with metastatic synovial sarcoma (mSS) is poor. Better understanding of patient experience in this setting, beyond clinical measures, may guide improvements in management. Validated patient-reported outcome (PRO) instruments specific to many types of cancer exist, but for rare cancers this is often not the case. Methods This study aimed to characterize patient experiences of symptoms and impacts of mSS and evaluate the content validity and relevance of the novel European Organization for Research and Treatment of Cancer Item Library 31 (EORTC IL31) Disease Symptoms PRO tool assessing synovial sarcoma symptoms. This tool comprises items from preexisting, validated cancer-specific PRO instruments from the EORTC Item Library. It was developed as an mSS-specific add-on to the EORTC Quality of Life Questionnaire Core 30 (QLQ-C30), which evaluates general cancer and treatment-related symptoms and functioning. This was a non-interventional, qualitative interview study involving semi-structured, concept elicitation (CE) and cognitive debriefing (CD) telephone interviews in adults with mSS. CE explored symptoms and their impact on functioning and quality of life; CD assessed participant understanding and relevance of the PRO tools. Results Among the 8 participants, the most common disease-related symptoms reported during CE were fatigue and pain, while shortness of breath was one of the most bothersome. The greatest negative impacts of mSS occurred in domains of physical functioning and sleep. Key treatment priorities for patients were to improve disrupted sleep and ability to undertake strenuous activities. Conclusions The interviews showed that, when used together, the EORTC IL31 and EORTC QLQ-C30 covered symptoms and impacts of most relevance and importance to patients with mSS, with no notable gaps and good conceptual coverage. This study therefore supports the content validity of 2 tools in mSS, advocating their use in clinical trials to assess treatment impact on PRO measures of importance to these patients. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00450-1.
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Affiliation(s)
- Laurie Eliason
- Value Evidence & Outcomes, GlaxoSmithKline, Collegeville, PA, 19426, USA
| | - Laura Grant
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, SK10 5JB, UK
| | - Anya Francis
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, SK10 5JB, UK
| | - Anna Cardellino
- Value Evidence & Outcomes, GlaxoSmithKline, Collegeville, PA, 19426, USA
| | - Ken Culver
- Value Evidence & Outcomes, GlaxoSmithKline, Collegeville, PA, 19426, USA
| | - Sant P Chawla
- Sarcoma Oncology Center, Santa Monica, CA, 90403, USA
| | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, SK10 5JB, UK
| | - Shibani Pokras
- Value Evidence & Outcomes, GlaxoSmithKline, Collegeville, PA, 19426, USA.
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11
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Bentley S, Morgan L, Exall E, Arbuckle R, Rossom RC, Roche N, Khunti K, Higgins V, Piercy J. Qualitative Interviews to Support Development and Cognitive Debriefing of the Adelphi Adherence Questionnaire (ADAQ©): A Patient-Reported Measure of Medication Adherence Developed for Use in a Range of Diseases, Treatment Modalities, and Countries. Patient Prefer Adherence 2022; 16:2579-2592. [PMID: 36133076 PMCID: PMC9484566 DOI: 10.2147/ppa.s358046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The Adelphi Adherence Questionnaire (ADAQ©) is a newly developed generic patient-reported outcome (PRO) assessment of medication adherence. The aim was to assess its content validity by conducting cognitive debriefing (CD) interviews with patients prescribed medication(s) of various treatment modalities in a range of therapy areas. MATERIALS AND METHODS Targeted literature/instrument review and concept elicitation interviews informed development of the ADAQ©. CD interviews were conducted with 57 adults from the United States of America (USA; n = 21), Spain (n = 18), and Germany (n = 18) who prescribed medication for hypertension, diabetes, depression, schizophrenia, asthma, multiple myeloma, psoriasis, and/or multiple sclerosis. Interviews were conducted in two rounds to explore the relevance and understanding of the item wording, instructions, recall period and response options. Verbatim transcripts were analysed in ATLAS.Ti using thematic analysis. Three expert clinicians provided guidance throughout the study. RESULTS ADAQ© items/instructions were well understood and relevant to participants. Key modifications following round 1 included revising instructions to refer to current medication(s) for one condition to reduce cognitive burden, removing two items with lower relevance (specifically those assessing running out of medication and social discouragement), and adding a response option for participants to indicate if they had stopped taking a medication. Minor wording modifications were made following round 2. Subgroup differences in item relevance were explored based on clinical characteristics. Cost of medication was more relevant amongst US participants. CONCLUSION Content validity of the ADAQ© was confirmed in demographically and clinically diverse participants. Psychometric properties of the ADAQ© will be explored in future studies.
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Affiliation(s)
- Sarah Bentley
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
| | - Lucy Morgan
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
| | - Elizabeth Exall
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
| | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
- Correspondence: Rob Arbuckle, Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK, Tel +44 7720 880884, Email
| | - Rebecca C Rossom
- HealthPartners Institute, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nicholas Roche
- Respiratory Medicine, Cochin Hospital, APHP Centre University Paris Cité, Institut Cochin (UMR1016), Paris, France
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester University, Leicester, UK
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12
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Bentley S, Findley A, Chiva-Razavi S, Naujoks C, Patalano F, Johnson C, Arbuckle R, Wolffsohn JS. Understanding the visual function symptoms and associated functional impacts of phakic presbyopia. J Patient Rep Outcomes 2021; 5:114. [PMID: 34731344 PMCID: PMC8566618 DOI: 10.1186/s41687-021-00383-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Presbyopia is defined as the age-related deterioration in the ability to focus on close objects, causing difficulty with near vision tasks. The study aim was to understand the lived experience of phakic presbyopia and identify all relevant visual function symptoms and associated functional impacts. METHODS Fifty individuals with clinician-confirmed phakic presbyopia (US n = 30, France n = 10, Germany n = 10) and seven healthcare professionals (HCPs) participated in in-depth, face-to-face, qualitative concept elicitation interviews. Verbatim transcripts were analyzed using thematic analysis methods. RESULTS Visual function symptoms reported by participants with phakic presbyopia were categorized as: primary near vision functioning symptoms (impaired near visual acuity, n = 50/50, 100%; difficulty with near vision in dim light, n = 42/50, 84%; difficulty focusing at close distances, n = 30/50, 60%; difficulty seeing things when glare is present, n = 30/50, 60%) and secondary symptoms (eye strain, n = 37/50, 74%; dry eyes, n = 35/50, 70%; headaches, n = 30/50, 60%). Proximal impacts on functional vision included difficulty reading in near vision (n = 49/50, 98%, including printed text and handwriting), seeing objects in near vision n = 48/50, 96%, and performing activities of daily living that require near vision (n = 49/50, 98%, including using a smartphone or computer). Distal impacts on functional vision included emotional, work, financial and social impacts. HCP interviews supported participant findings. CONCLUSION Findings provide a comprehensive understanding of the lived experience of phakic presbyopia which informed the development of a presbyopia conceptual model and patient-reported outcome assessments of vision correction independence and near vision functioning. The sample did not include those whose vision cannot be adequately corrected with lenses or surgery.
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13
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Bentley S, Findley A, Chiva-Razavi S, Naujoks C, Patalano F, Johnson C, Arbuckle R, Wolffsohn JS. Evaluation of the content validity of patient-reported outcome (PRO) instruments developed for use with individuals with phakic presbyopia, including the Near Activity Visual Questionnaire-presbyopia (NAVQ-P) and the near vision correction independence (NVCI) instrument. J Patient Rep Outcomes 2021; 5:109. [PMID: 34689253 PMCID: PMC8542063 DOI: 10.1186/s41687-021-00379-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/15/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Presbyopia is the age-related deterioration in the ability to focus on close objects. In order to develop a patient-reported outcome (PRO) instrument to assess near vision functioning, the Near Activity Visual Questionnaire (NAVQ) was adapted to incorporate modern technology (e.g. smartphones) and to be appropriate for use in phakic presbyopia, leading to the development of the NAVQ-Presbyopia (NAVQ-P). Additional single-item instruments of near vision correction independence (NVCI), correction preference (NVCP), and vision satisfaction (NVS) were also developed. The study aimed to evaluate the content validity of the NAVQ-P and additional instruments in individuals with phakic presbyopia. METHODS Participants in the US (n = 15), Germany (n = 10) and France (n = 10) took part in face-to-face, qualitative, cognitive debriefing interviews. Seven healthcare professionals (HCPs) were also interviewed to assess the clinical relevance of the PRO instruments. Interviews started with open-ended qualitative concept elicitation questioning; participants then completed the PRO instruments on an electronic tablet using a "think-aloud" process and were asked about their understanding and relevance of each item, instruction, response scale and recall period. Interviews were conducted in two rounds allowing for modifications between rounds. RESULTS The participants interpreted the majority of the PRO instruments and recall period correctly and consistently. They were able to select an appropriate response option without difficulty. Minor modifications were made to the PRO instruments based on interview findings. Instruction/item wording was modified to include reference to use of a magnifying glass, in addition to glasses and contact lenses. Two items were added to assess difficulty with precision tasks (e.g. sewing) and taking longer to adjust from distance to near vision. HCPs confirmed the relevance of the concepts being measured for presbyopia and recommended the addition of an item assessing contrast sensitivity. CONCLUSIONS Developed in accordance with the FDA PRO Guidance, the findings support content validity of the NAVQ-P as a suitable, well-understood instrument of relevant near vision functioning concepts in individuals with phakic presbyopia. The NVCI and additional PRO instruments are appropriate to assess near vision correction independence, correction preference, and vision satisfaction. Future work will assess the psychometric properties of the NAVQ-P and additional PRO instruments.
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14
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Duong T, Braid J, Staunton H, Barriere A, Petridis F, Reithinger J, Cruz R, Jarecki J, De Lemus M, Gusset N, Broekgaarden R, Randhawa S, Flynn J, Arbuckle R, Reif S, Yang L, De Martini A, Vuillerot C. Correction to: Understanding the relationship between the 32-item motor function measure and daily activities from an individual with spinal muscular atrophy and their caregivers' perspective: a two-part study. BMC Neurol 2021; 21:354. [PMID: 34517827 PMCID: PMC8436519 DOI: 10.1186/s12883-021-02307-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Tina Duong
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | | | | | - Aurelie Barriere
- Department of Pediatric Physical Medicine and Rehabilitation, Hôpital Mère Enfant, CHU-Lyon, Lyon University, Lyon, France
| | | | | | | | | | - Mencia De Lemus
- SMA Europe Freiburg, Freiburg, Germany.,FundAME, Madrid, Spain
| | - Nicole Gusset
- SMA Europe Freiburg, Freiburg, Germany.,SMA Schweiz, Swiss Patient Organisation for Spinal Muscular Atrophy, Heimberg, Switzerland
| | - Ria Broekgaarden
- SMA Europe Freiburg, Freiburg, Germany.,SMA Europe and Vereniging Spierziekten Nederland, Baarn, The Netherlands
| | - Sharan Randhawa
- Adelphi Values, Patient-Centered Outcomes, Adelphi Mill, Bollington, Cheshire, UK
| | - Jessica Flynn
- Adelphi Values, Patient-Centered Outcomes, Adelphi Mill, Bollington, Cheshire, UK
| | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Adelphi Mill, Bollington, Cheshire, UK
| | - Sonia Reif
- Charles River Associates Inc, Zurich, Switzerland
| | - Lida Yang
- Charles River Associates Inc, Zurich, Switzerland
| | | | - Carole Vuillerot
- Department of Pediatric Physical Medicine and Rehabilitation, Hôpital Mère Enfant, CHU-Lyon, Lyon University, Lyon, France.,Neuromyogen Institute, CNRS UMR 5310 - INSERM U1217, Université de Lyon, Lyon, France
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15
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Staunton H, Trennery C, Arbuckle R, Guridi M, Zhuravleva E, Furlong P, Fischer R, Hall R. Development of a Clinical Global Impression of Change (CGI-C) and a Caregiver Global Impression of Change (CaGI-C) measure for ambulant individuals with Duchenne muscular dystrophy. Health Qual Life Outcomes 2021; 19:184. [PMID: 34311756 PMCID: PMC8314490 DOI: 10.1186/s12955-021-01813-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 06/28/2021] [Indexed: 01/14/2023] Open
Abstract
Background In clinical trials for rare diseases, such as Duchenne muscular dystrophy, clinical outcome assessments (COA) used to assess treatment benefit are often generic and may not be sensitive enough to detect change in specific patient populations. Thus, there is a need for disease specific COAs that track meaningful change among individuals. When developing such measures, input from clinicians, caregivers and patients is critical for assessing clinically relevant concepts and ensuring validity of the measure. Method The aim of this study was to develop two Duchenne-specific global impression items for use in clinical trials. The development of the Duchenne Clinical Global Impression of Change (CGI-C) and Caregiver Global Impression of Change (CaGI-C) was informed by findings from concept elicitation (CE) interviews with clinicians, caregivers and individuals with Duchenne. Through cognitive debriefing (CD) interviews, clinicians and caregivers evaluated draft CGI-C and CaGI-C items to ensure relevance and understanding of the items and instructions. Suggestions made during the CD interviews were incorporated into the finalized CGI-C and CaGI-C measures. Results The symptoms most frequently reported by clinicians, caregivers and individuals with Duchenne were muscle weakness, fatigue, cardiac difficulties and pain. Regarding physical functioning, all three populations noted that small changes in functional ability were meaningful, particularly when independence was impacted. Caregivers and clinicians reported that changes in speed, endurance and quality of movement were important, as was improvement in the ability of individuals to keep up with their peers. A change in the ability to complete everyday activities was also significant to families. These results were used to create two global impression of change items and instruction documents for use by clinicians (CGI-C) and caregivers (CaGI-C). Overall, both items were well understood by participants. The descriptions and examples developed from the CE interviews were reported to be relevant and appropriate for illustrating different levels of meaningful change in patients with Duchenne. Modifications were made based on caregiver and clinician CD feedback . Conclusions As part of a holistic measurement strategy, such COA can be incorporated into the clinical trial setting to assess global changes in relevant symptoms and functional impacts associated with Duchenne. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01813-w.
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Affiliation(s)
| | | | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | | | - Pat Furlong
- Parent Project Muscular Dystrophy, Hackensack, NJ, USA
| | - Ryan Fischer
- Parent Project Muscular Dystrophy, Hackensack, NJ, USA
| | - Rebecca Hall
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
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16
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Halstead P, Arbuckle R, Marshall C, Zimmerman B, Bolton K, Gelotte C. Development and Content Validity Testing of Patient-Reported Outcome Items for Children to Self-Assess Symptoms of the Common Cold. Patient 2021; 13:235-250. [PMID: 31858430 PMCID: PMC7075834 DOI: 10.1007/s40271-019-00404-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and objective No pediatric patient-reported outcome instruments specific to the common cold are found in the literature. This study involved development and content validity testing of patient-reported outcome items (questions and response options) assessing cold symptoms in children aged 6–11 years. Methods Draft patient-reported outcome instructions, items, response scales, and recall periods were developed based on the literature and existing measures. Qualitative interviews were conducted with children (n = 39) who were currently (n = 31) or had recently (n = 8) experienced a cold and ten parents of a subset of children aged 6–8 years. The interviews were conducted over two rounds and included open-ended concept elicitation questioning, a free-drawing task, a card sorting task, and a task involving circling parts of the body, followed by cognitive debriefing of draft items. Thematic analysis of verbatim transcripts was performed to analyze the qualitative data. The findings were used to support revisions to the draft patient-reported outcome. Results Ten symptom concepts were reported by the children during concept elicitation. The creative tasks helped the children to describe their symptoms, generally using consistent language to do so, irrespective of age. Nineteen patient-reported outcome items were developed and subject to cognitive debriefing. Debriefing with both children and parents informed several small revisions and provided evidence that the majority of children found most patient-reported outcome items easy to understand, and that the items were mainly interpreted consistently and as intended. Conclusions This in-depth qualitative study has supported identification of relevant symptom concepts and the development and refinement of patient-reported outcome items to assess those concepts. The findings support the content validity of the items and suggest that they can be used with confidence in children aged 9 years and older. For children aged 6–8 years, it is recommended the items are administered with initial adult supervision to explain the more difficult concepts or through parent/interviewer administration.
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Affiliation(s)
- Patricia Halstead
- McNeil Consumer Healthcare, a Division of Johnson & Johnson Consumer Inc., Fort Washington, PA, USA
| | - Rob Arbuckle
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK.
| | - Chris Marshall
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - Brenda Zimmerman
- McNeil Consumer Healthcare, a Division of Johnson & Johnson Consumer Inc., Fort Washington, PA, USA
| | - Kate Bolton
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire, SK10 5JB, UK
| | - Cathy Gelotte
- McNeil Consumer Healthcare, a Division of Johnson & Johnson Consumer Inc., Fort Washington, PA, USA
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17
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Duong T, Braid J, Staunton H, Barriere A, Petridis F, Reithinger J, Cruz R, Jarecki J, De Lemus M, Gusset N, Broekgaarden R, Randhawa S, Flynn J, Arbuckle R, Reif S, Yang L, De Martini A, Vuillerot C. Understanding the relationship between the 32-item motor function measure and daily activities from an individual with spinal muscular atrophy and their caregivers' perspective: a two-part study. BMC Neurol 2021; 21:143. [PMID: 33789607 PMCID: PMC8011105 DOI: 10.1186/s12883-021-02166-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/22/2021] [Indexed: 01/23/2023] Open
Abstract
Background The 32-item Motor Function Measure (MFM32) is a clinician-reported outcome measure used to assess the functional abilities of individuals with neuromuscular diseases, including those with spinal muscular atrophy (SMA). This two-part study explored the relationship between the functional abilities assessed in the MFM32 and activities of daily living (ADLs) from the perspective of individuals with Type 2 and Type 3 (non-ambulant and ambulant) SMA and their caregivers through qualitative interviews and a quantitative online survey. Methods In-depth, semi-structured, qualitative interviews were conducted with individuals with SMA and caregivers from the US. Subsequently, a quantitative online survey was completed by individuals with SMA or their caregivers from France, Germany, Italy, Poland, Spain, Canada, the United States (US) and the UK. In both parts of the study, participants were asked to describe the ADLs considered to be related to the functional abilities assessed in the MFM32. Results from the qualitative interviews informed the content of the quantitative online survey. Results Qualitative interviews were conducted with 15 adult participants, and 217 participants completed the quantitative online survey. From the qualitative interviews, all of the functional abilities assessed in the patient-friendly MFM32 were deemed as related to one or more ADL. The specific ADLs that participants considered related to the patient-friendly MFM32 items could be grouped into 10 key ADL domains: dressing, mobility/transferring, self-care, self-feeding, reaching, picking up and holding objects, physical activity, writing and technology use, social contact/engagement, toileting and performing work/school activities. These results were confirmed by the quantitative online survey whereby the ADLs reported to be related to each patient-friendly MFM32 item were consistent and could be grouped into the same 10 ADL domains. Conclusion This study provides in-depth evidence from the patient/caregiver perspective supporting the relevance of the patient-friendly MFM32 items to the ADLs of individuals with Type 2 and Type 3 SMA. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02166-z.
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Affiliation(s)
- Tina Duong
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | | | | | - Aurelie Barriere
- Department of Pediatric Physical Medicine and Rehabilitation, Hôpital Mère Enfant, CHU-Lyon, Lyon University, Lyon, France
| | | | | | | | | | - Mencia De Lemus
- SMA Europe Freiburg, Freiburg, Germany.,FundAME, Madrid, Spain
| | - Nicole Gusset
- SMA Europe Freiburg, Freiburg, Germany.,SMA Schweiz, Swiss Patient Organisation for Spinal Muscular Atrophy, Heimberg, Switzerland
| | - Ria Broekgaarden
- SMA Europe Freiburg, Freiburg, Germany.,SMA Europe and Vereniging Spierziekten Nederland, Baarn, The Netherlands
| | - Sharan Randhawa
- Adelphi Values, Patient-Centered Outcomes, Adelphi Mill, Bollington, Cheshire, UK
| | - Jessica Flynn
- Adelphi Values, Patient-Centered Outcomes, Adelphi Mill, Bollington, Cheshire, UK
| | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Adelphi Mill, Bollington, Cheshire, UK
| | - Sonia Reif
- Charles River Associates Inc, Zurich, Switzerland
| | - Lida Yang
- Charles River Associates Inc, Zurich, Switzerland
| | | | - Carole Vuillerot
- Department of Pediatric Physical Medicine and Rehabilitation, Hôpital Mère Enfant, CHU-Lyon, Lyon University, Lyon, France.,Neuromyogen Institute, CNRS UMR 5310 - INSERM U1217, Université de Lyon, Lyon, France
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18
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Panter C, Berry P, Chauhan D, Fernandes S, Gatsi S, Park J, Wells JR, Arbuckle R. A qualitative exploration of the patient experience of erosive and non-erosive hand osteoarthritis. J Patient Rep Outcomes 2021; 5:18. [PMID: 33537932 PMCID: PMC7859145 DOI: 10.1186/s41687-021-00286-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/07/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many patients with hand osteoarthritis (HOA) experience reduced health-related quality of life. This study sought to better understand the disease and treatment experience of individuals with HOA, explore any differences in experiences between erosive and non-erosive HOA sub-types, and evaluate content validity of the Michigan Hand Outcomes Questionnaire (MHQ) in HOA. METHODS Thirty subjects from the United States (n = 15 erosive HOA; n = 15 non-erosive HOA) participated in semi-structured interviews: concept elicitation explored symptoms/impacts important to patients; cognitive interviews assessed understanding and relevance of the MHQ. A sub-sample participated in real-time data capture (RTDC) activities via a smartphone/tablet app over 7 days. Verbatim transcripts were coded using Atlas.ti software and thematically analyzed. Concept saturation and MHQ content validity were evaluated. RESULTS Most participants reported experiencing pain, swelling and stiffness, symptoms that most commonly had a direct impact on physical functioning. Substantial impacts on activities of daily living, emotional functioning, sleep and work were also reported. RTDC findings corroborated concept elicitation findings. There were no notable differences between erosive and non-erosive HOA, except nodules were reported more frequently in erosive disease. Most participants used analgesic treatments, but effects were short-lived. Pain was the symptom most frequently reported as most bothersome and important to treat. Concept saturation was achieved. MHQ items and instructions were well understood and relevant to most participants; stiffness and swelling were reported as important symptoms not included in the MHQ. CONCLUSIONS This study characterizes key symptoms of HOA which are burdensome for patients and not well controlled by current therapies, highlighting an unmet treatment need. Although the study is limited by a small sample size that may not be representative of the broader erosive and non-erosive HOA population, concept saturation was achieved, and our findings suggest that disease experience is similar for patients with erosive and non-erosive HOA. Evaluation of stiffness and swelling items in conjunction with the MHQ may enhance relevance and improve measurement precision to assess important domains of HQRoL in an HOA population.
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Affiliation(s)
- Charlotte Panter
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Pamela Berry
- GSK, Collegeville, PA, USA
- Present Address: Janssen Global Services LLC, Horsham, PA, USA
| | - Deven Chauhan
- Value Evidence and Outcomes, Stockley Park West, 1-3 Ironbridge Road, GSK, Uxbridge, Middlesex, UB11 1BT, UK.
| | | | | | | | - Jane R Wells
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Bollington, Cheshire, UK
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19
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Arbuckle R, Halstead P, Marshall C, Zimmerman B, Bolton K, Regnault A, Gelotte C. Testing and Psychometric Validation of a Pediatric Instrument to Self-Assess Symptoms of the Common Cold. Patient 2021; 14:101-117. [PMID: 33174079 PMCID: PMC7794207 DOI: 10.1007/s40271-020-00462-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Given the lack of validated patient-reported outcomes (PRO) instruments assessing cold symptoms, a new pediatric PRO instrument was developed to assess multiple cold symptoms: the Child Cold Symptom Questionnaire (CCSQ). The objective of this research was to evaluate the measurement properties of the CCSQ. METHODS This observational study involved daily completion of the self-report CCSQ by children aged 6-11 years in their home for 7 days. These data were used to develop a scoring algorithm and item-scale structure and evaluate the psychometric properties of the resulting scores. Analyses included evaluation of item and dimensionality performance (item response distributions and confirmatory factor analysis) and assessment of test-retest reliability in stable patients, construct validity (convergent and known groups validity), and preliminary responsiveness. Qualitative exit interviews in a subgroup of the children with colds and their parents were conducted. RESULTS More than 90% of children had no missing data during the testing period, reflecting an excellent completion rate. For most items, responses were distributed across the options, with approximately normal distributions. Test-retest reliability was adequate, with intra-class correlation coefficients ranging from 0.63 to 0.83. A logical pattern of correlations with the validated Strep-PRO instrument provided evidence supporting convergent validity. Single- and multi-item symptom scores distinguished between children who differed in their cold severity based on global ratings, providing evidence of known groups validity. Preliminary evidence indicates the CCSQ is responsive to changes over time. CONCLUSIONS The findings demonstrate that the CCSQ items and multi-item scores provide valid and reliable patient-reported measures of cold symptoms in children aged 6-11 years. They provide strong evidence supporting the validity of these items and multi-item scores for inclusion as endpoints in clinical trials to evaluate the efficacy of cold medicines.
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Affiliation(s)
- Rob Arbuckle
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, SK10 5JB CH UK
| | - Patricia Halstead
- McNeil Consumer Healthcare, a Division of Johnson and Johnson Consumer Inc., 7050 Camp Hill Rd, Fort, Washington, PA 19034 USA
| | - Chris Marshall
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, SK10 5JB CH UK
| | - Brenda Zimmerman
- McNeil Consumer Healthcare, a Division of Johnson and Johnson Consumer Inc., 7050 Camp Hill Rd, Fort, Washington, PA 19034 USA
| | - Kate Bolton
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, SK10 5JB CH UK
| | | | - Cathy Gelotte
- McNeil Consumer Healthcare, a Division of Johnson and Johnson Consumer Inc., 7050 Camp Hill Rd, Fort, Washington, PA 19034 USA
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Chaplin JE, Muehlan H, Arbuckle R. Registered reports and paediatric research. Qual Life Res 2020; 29:3189-3190. [PMID: 33201391 DOI: 10.1007/s11136-020-02702-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
- John Eric Chaplin
- Institute for Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
| | - Holger Muehlan
- Department of Health and Prevention, University of Greifswald, Greifswald, Germany
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21
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Wolffsohn JS, Leteneux-Pantais C, Chiva-Razavi S, Bentley S, Johnson C, Findley A, Tolley C, Arbuckle R, Kommineni J, Tyagi N. Social Media Listening to Understand the Lived Experience of Presbyopia: Systematic Search and Content Analysis Study. J Med Internet Res 2020; 22:e18306. [PMID: 32955443 PMCID: PMC7536603 DOI: 10.2196/18306] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/05/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Presbyopia is defined as the age-related deterioration of near vision over time which is experienced in over 80% of people aged 40 years or older. Individuals with presbyopia have difficulty with tasks that rely on near vision. It is not currently possible to stop or reverse the aging process that causes presbyopia; generally, it is corrected with glasses, contact lenses, surgery, or the use of a magnifying glass. OBJECTIVE This study aimed to explore how individuals used social media to describe their experience of presbyopia with regard to the symptoms experienced and the impacts of presbyopia on their quality of life. METHODS Social media sources including Twitter, forums, blogs, and news outlets were searched using a predefined search string relating to symptoms and impacts of presbyopia. The data that were downloaded, based on the keywords, underwent manual review to identify relevant data points. Relevant posts were further manually analyzed through a process of data tagging, categorization, and clustering. Key themes relating to symptoms, impacts, treatment, and lived experiences were identified. RESULTS A total of 4456 social media posts related to presbyopia were identified between May 2017 and August 2017. Using a random sampling methodology, we selected 2229 (50.0%) posts for manual review, with 1470 (65.9%) of these 2229 posts identified as relevant to the study objectives. Twitter was the most commonly used channel for discussions on presbyopia compared to forums and blogs. The majority of relevant posts originated in Spain (559/1470, 38.0%) and the United States (426/1470, 29.0%). Of the relevant posts, 270/1470 (18.4%) were categorized as posts written by individuals who have presbyopia, of which 37 of the 270 posts (13.7%) discussed symptoms. On social media, individuals with presbyopia most frequently reported experiencing difficulty reading small print (24/37, 64.9%), difficulty focusing on near objects (15/37, 40.5%), eye strain (12/37, 32.4%), headaches (9/37, 24.3%), and blurred vision (8/37, 21.6%). 81 of the 270 posts (30.0%) discussed impacts of presbyopia-emotional burden (57/81, 70.4%), functional or daily living impacts (46/81, 56.8%), such as difficulty reading (46/81, 56.8%) and using electronic devices (21/81, 25.9%), and impacts on work (3/81, 3.7%). CONCLUSIONS Findings from this social media listening study provided insight into how people with presbyopia discuss their condition online and highlight the impact of presbyopia on individuals' quality of life. The social media listening methodology can be used to generate insights into the lived experience of a condition, but it is recommended that this research be combined with prospective qualitative research for added rigor and for confirmation of the relevance of the findings.
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Affiliation(s)
- James S Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | | | | | - Sarah Bentley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Chloe Johnson
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Amy Findley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Chloe Tolley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Jyothi Kommineni
- Novartis Business Services, Product Lifecycle Services, Hyderabad, India
| | - Nishith Tyagi
- Novartis Business Services, Product Lifecycle Services, Hyderabad, India
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22
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Cairns I, Lindsay K, Dalbeth N, Díaz-Torné C, Antònia Pou M, Rodríguez Diez B, Pujol-Ribera E, Panter C, Arbuckle R, Tatlock S, Taylor WJ. The impact of gout as described by patients, using the lens of The International Classification of Functioning, Disability and Health (ICF): a qualitative study. BMC Rheumatol 2020; 4:50. [PMID: 32832854 PMCID: PMC7422533 DOI: 10.1186/s41927-020-00147-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 06/19/2020] [Indexed: 11/14/2022] Open
Abstract
Background The International Classification of Functioning, Disability and Health (ICF) aims to comprehensively describe the ways in which a person’s health condition affects their life. This study aimed to contribute to the development of an ICF core set for gout through patient opinion derived from focus groups and interviews. Methods We conducted a secondary qualitative analysis of data from three studies investigating the patient experience of gout. In total there were 30 individual interviews and 2 focus groups (N = 17) comprising 47 participants. We conducted thematic analysis of the textual data to extract meaning units, which were then linked to the ICF. Results A large number of ICF categories were relevant to patients with gout. Participants mentioned 93 third level categories, 17 of which were mentioned by more than 50% of patients. The most references for a single category was for b280, Sensation of pain, followed by personal factors (not yet categorised by the ICF). The most participants mentioned the environmental factor e355, Health professional support, followed by b280, Sensation of pain. Conclusion The categories identified in this study as relevant to patients with gout highlight the severe pain associated with this disease, the impact on mobility and corresponding life areas. The roles of health professional support, medication, and personal attitudes to disease management are also reflected in the data. These results will contribute to the development of the ICF core set for gout.
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Affiliation(s)
- Isobel Cairns
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, PO Box 7343, Wellington, New Zealand
| | - Karen Lindsay
- Department of Rheumatology, Auckland City Hospital, Auckland, New Zealand
| | - Nicola Dalbeth
- Department of Rheumatology, Auckland City Hospital, Auckland, New Zealand.,Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Cesar Díaz-Torné
- Universitat Autònoma de Barcelona. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | | | - Rob Arbuckle
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB UK
| | - Sophi Tatlock
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB UK
| | - William J Taylor
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, PO Box 7343, Wellington, New Zealand
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Bonner N, Bozzi S, Morgan L, Mason B, Peterschmitt MJ, Fischer TZ, Arbuckle R, Reaney M. Patients' experiences of Parkinson's disease: a qualitative study in glucocerebrosidase and idiopathic Parkinson's disease. J Patient Rep Outcomes 2020; 4:65. [PMID: 32757092 PMCID: PMC7406609 DOI: 10.1186/s41687-020-00230-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/12/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Approximately 7-10% of Parkinson's disease (PD) patients carry a GBA (Glucocerebrosidase) mutation (GBA-PD patients), which may influence the disease's clinical course. OBJECTIVES This study aimed to explore the patient experience of GBA-PD and identify the most important symptoms and impacts to inform clinical trial measurement strategies. METHODS Twenty PD patients (n = 15 GBA-PD; n = 5 idiopathic-PD) participated in qualitative interviews which explored concepts spontaneously reported or identified through a literature review. Telephone interviews with five expert clinicians included discussion of a preliminary conceptual model derived from literature. Verbatim transcripts were thematically analysed. RESULTS Thirty symptoms reported by patients were categorized as motor, non-motor, and cognitive/psychiatric. Tremor (n = 13), memory loss (n = 13), rigidity/stiffness (n = 11), and speech problems (n = 11) were considered the most important and impactful symptoms by GBA-PD patients, although other symptoms were also relevant to the majority of patients. Key impacts included: sleep disturbances (n = 13), handwriting changes (n = 13), reduced social interaction (n = 12), dyskinesia (n = 10), depressed mood (n = 9), and fear of falling (n = 8). Key symptoms and impacts reported by GBA-PD patients were consistent with those reported by idiopathic-PD patients. Clinician interview results supported the patient findings, although some clinicians indicated that cognitive/psychiatric symptoms may present earlier in GBA-PD patients. The concepts emerging from the research informed updates to a conceptual model of GBA-PD patients' disease experience. CONCLUSIONS The findings provide in-depth understanding of the patient experience of GBA-PD. The findings confirm that the concepts relevant to assess in GBA-PD are consistent with those relevant to assess in idiopathic-PD; however, greater consideration of cognitive/psychiatric symptoms may be warranted in GBA-PD populations.
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Affiliation(s)
| | | | | | - B Mason
- Adelphi Values, Manchester, UK
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24
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Sharma G, Chiva-Razavi S, Viriato D, Naujoks C, Patalano F, Bentley S, Findley A, Johnson C, Arbuckle R, Wolffsohn J. Patient-reported outcome measures in presbyopia: a literature review. BMJ Open Ophthalmol 2020; 5:e000453. [PMID: 32685693 PMCID: PMC7359053 DOI: 10.1136/bmjophth-2020-000453] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/18/2020] [Accepted: 06/12/2020] [Indexed: 12/02/2022] Open
Abstract
Presbyopia is the age-related loss of near-distance focusing ability. The aim of this study was to identify patient-reported outcome measures (PROMs) used in clinical trials and quality-of-life studies conducted in individuals with presbyopia and to assess their suitability for use in individuals with phakic presbyopia. Literature searches were performed in Medline and Embase up until October 2017. Specific search terms were used to identify presbyopia studies that included a PROM. All clinical trials with PROM-supported endpoints in presbyopia were identified on ClinicalTrials.gov. Further searches were conducted to retrieve articles documenting the development and psychometric evaluation of the PROMs identified. A total of 703 records were identified; 120 were selected for full-text review. Twenty-one clinical trials employed PROMs to support a primary or secondary endpoint. In total, 13 PROMs were identified; a further 23 publications pertaining to the development and validation of these measures were retrieved. Most PROMs were developed prior to release of the Food and Drug Administration (FDA) 2009 patient-reported outcome guidance and did not satisfy regulatory standards. The Near Activity Visual Questionnaire (NAVQ) was identified as the most appropriate for assessing near-vision functioning in presbyopia. While the NAVQ was developed in line with the FDA guidance, the items do not reflect changes in technology that have occurred since the questionnaire was developed in 2008 (eg, the increase in smartphone use), and the measure was not validated in a purely phakic presbyopia sample. Further research is ongoing to refine the NAVQ to support trial endpoints related to changes in near-vision functioning associated with phakic presbyopia.
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Affiliation(s)
| | | | | | | | | | - Sarah Bentley
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Amy Findley
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Chloe Johnson
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Rob Arbuckle
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
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25
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Green J, Tolley C, Bentley S, Arbuckle R, Burstedt M, Whelan J, Holopigian K, Stasi K, Sloesen B, Spera C, Deslandes JY, Mullins A. Qualitative Interviews to Better Understand the Patient Experience and Evaluate Patient-Reported Outcomes (PRO) in RLBP1 Retinitis Pigmentosa (RLBP1 RP). Adv Ther 2020; 37:2884-2901. [PMID: 32372289 PMCID: PMC7467452 DOI: 10.1007/s12325-020-01275-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Indexed: 10/31/2022]
Abstract
INTRODUCTION RLBP1 RP is an autosomal recessive form of retinitis pigmentosa (RP), characterized by night blindness, prolonged dark adaptation, constricted visual fields and impaired macular function. This study aimed to better understand the patient experience of RLBP1 RP and evaluate the content validity of existing patient reported outcome (PRO) instruments in this condition. METHODS Semi-structured concept elicitation and cognitive debriefing interviews were conducted with RLBP1 RP patients in Canada and Sweden. Interviews started with open-ended concept elicitation questioning, and then patients were cognitively debriefed on The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), the Low Luminance Questionnaire (LLQ) and four light/dark adaptation items of the Visual Activities Questionnaire (VAQ). Qualitative interviews were also conducted with three expert clinicians. Anonymized, verbatim transcripts were analyzed using thematic analysis. RESULTS Twenty-one patients were interviewed (Canada n = 10; Sweden n = 11). Symptoms reported included night blindness (n = 21), difficulty adapting to changes in lighting (n = 21) and difficulties seeing in bright lighting (n = 18). Patients experienced substantial impacts on daily activities (n = 21) and physical functioning (n = 17). Patients had difficulty interpreting and selecting a response for some items in the NEI VFQ-25 and LLQ. Some items were not relevant to patients' disease experience. There were both gaps and overlaps in the conceptual coverage of the instruments. CONCLUSIONS Visual impairment due to RLBP1 RP has a substantial impact on physical functioning and daily activities. To adequately assess all important symptoms and associated functional impacts in RLBP1 RP, it is recommended to either modify one or more existing instruments or to develop a new non-syndromic RP specific instrument.
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Becker B, Eliason L, Culver KW, Arbuckle R, Francis A, Pokras S. Qualitative patient interviews on symptoms and impacts in metastatic synovial sarcoma (mSS). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e23576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23576 Background: Synovial sarcoma (SS), a soft tissue sarcoma, is a rare and aggressive malignancy, with significant morbidity and mortality associated with mSS. There are currently no patient-reported outcome (PRO) instruments specific to mSS patients and little qualitative research to understand impacts on mSS patients’ health-related quality of life (QoL). The objective of this study was to characterize the symptoms and impacts experienced by mSS patients to inform the selection of content-valid PRO instruments for use in investigational trials in mSS patients. Methods: This was a non-interventional, qualitative interview study of adult participants in the United States (US) with physician-confirmed mSS. Participants were consented from a large private practice in the US. Six semistructured concept elicitation interviews (60–90m by telephone) were conducted by trained interviewers. Participants were asked to describe their mSS symptoms and their impact on functioning in an open-ended fashion with follow-up probes. Verbatim transcripts were analyzed using thematic analysis methods and Atlas.Ti software. Socio-demographics and clinical characteristics were collected by the site. The study received Institutional Review Board (IRB) approval from Western IRB. Results: Among the 6 participants, average age was 45y (range 21–61y) and 2 were female. All 6 participants had pulmonary metastasis, 1 participant had a liver metastasis, and 1 participant had a mediastinal mass. The most common symptoms participants spontaneously identified were pain (n = 6), fatigue (n = 6), coughing (n = 5, with 2 upon probing), shortness of breath (n = 4), phlegm/mucus in the lungs (n = 3), coughing up blood (n = 2), and gastrointestinal complications (n = 2). Nerve/shooting/burning pain (n = 5) was mentioned upon probing. Participants also reported impacts of their disease on sleep (quantity and quality) (n = 6), physical activity (n = 6), social life (n = 6), daily activities (n = 5), emotions (n = 5), loss of appetite (n = 3), and finances (n = 1). Although not spontaneously reported, global ratings of overall health and QoL were considered relevant by all participants. Conclusions: This is the first study to identify patient-relevant symptoms and impacts associated with mSS. Further interviews with additional participants are ongoing, and we will analyze these data to identify appropriate PRO instruments for use in investigational trials in mSS patients. Funding: GlaxoSmithKline (209386).
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Affiliation(s)
- Brandon Becker
- Value Evidence & Outcomes, GlaxoSmithKline, Collegeville, PA
| | | | | | - Rob Arbuckle
- Adelphi Values Patient-Centered Outcomes, Macclesfield, United Kingdom
| | - Anya Francis
- Adelphi Values Patient-Centered Outcomes, Macclesfield, United Kingdom
| | - Shibani Pokras
- Value Evidence & Outcomes, GlaxoSmithKline, Collegeville, PA
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27
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Grant L, Seiding Larsen L, Burrows K, Belsito DV, Weisshaar E, Diepgen T, Hahn-Pedersen J, Sørensen OE, Arbuckle R. Development of a Conceptual Model of Chronic Hand Eczema (CHE) Based on Qualitative Interviews with Patients and Expert Dermatologists. Adv Ther 2020; 37:692-706. [PMID: 31956966 PMCID: PMC7004418 DOI: 10.1007/s12325-019-01164-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Chronic hand eczema (CHE) is a relapsing inflammatory dermatologic disease. Signs and symptoms can have a significant impact on patients' health-related quality of life (HRQoL). The aim of this study is to characterize the core signs, symptoms and impacts of CHE to develop a conceptual model. METHODS A structured literature search and qualitative interviews with 20 adult CHE patients in the US and 5 expert dermatologists were conducted to explore the patient experience of CHE signs, symptoms and impacts. Findings were used to support the development of a conceptual model. RESULTS There was a paucity of CHE qualitative research in the literature, supporting the need for the prospective qualitative research. The primary signs and symptoms identified from the literature review and interviews included itch, dryness, cracking, pain, thickened skin and bleeding. The most salient impacts included embarrassment and appearance concerns, frustration, impacts on work and sleep disturbance. Saturation was achieved for all signs, symptoms and impact concepts. CONCLUSIONS Findings from this literature review and in-depth qualitative interviews supported the development of a comprehensive conceptual model documenting the signs, symptoms and impacts relevant to CHE patients. Such a model is of considerable value given the lack of existing studies in the literature focused on the qualitative exploration of the CHE patient experience. Limitations included the patient sample being only from the US and not including some CHE subtypes.
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Affiliation(s)
- Laura Grant
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire UK
| | | | - Kate Burrows
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire UK
| | - Donald V. Belsito
- Columbia University Medical Center, 16th St & Broadway, New York, NY 10027 USA
| | - Elke Weisshaar
- University Hospital Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Thomas Diepgen
- University Hospital Heidelberg, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | | | | | - Rob Arbuckle
- Adelphi Values, Adelphi Mill, Grimshaw Lane, Bollington, Cheshire UK
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Staunton H, Willgoss T, Nelsen L, Burbridge C, Sully K, Rofail D, Arbuckle R. An overview of using qualitative techniques to explore and define estimates of clinically important change on clinical outcome assessments. J Patient Rep Outcomes 2019; 3:16. [PMID: 30830492 PMCID: PMC6399361 DOI: 10.1186/s41687-019-0100-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/21/2019] [Indexed: 02/08/2023] Open
Abstract
Establishing meaningful change thresholds for Clinical Outcome Assessments (COA) is critical for score interpretation. While anchor- and distribution-based statistical methods are well-established, qualitative approaches are less frequently used. This commentary summarizes and expands on a symposium presented at the International Society for Quality of Life Research (ISOQOL) 2017 annual conference, which provided an overview of qualitative methods that can be used to support understanding of meaningful change thresholds on COAs. Further published literature and additional examples from multiple disease areas which have also qualitatively explored the concept of meaningful change are presented.Semi-structured interviews conducted independently from a clinical trial, exit interviews conducted in the context of a clinical trial, focus groups, vignettes and the Delphi panel method can be used to obtain data regarding meaningful change thresholds, with advantages and disadvantages to each method. Semi-structured interviews using concept elicitation (CE) or cognitive debriefing (CD) methods conducted independently from a clinical trial can be an efficient way to gain in-depth patient/caregiver insights. However, there can be challenges with reconciling heterogeneous data across diverse samples and in interpreting the qualitative insights in the context of quantitative score changes. Semi-structured qualitative interviews using CE/CD methods embedded as exit interviews in a clinical trial context with patients/caregivers can provide insights which can augment quantitative findings based on analysis of clinical trial data. However, there are logistical challenges relating to embedding the interviews in a clinical trial.Focus groups and the Delphi panel method can be valuable for reaching consensus regarding meaningful change thresholds; however, for face-to-face interactions, social desirability bias can affect responses. Finally, using vignettes and taking a mixed methods approach can aid in achieving consensus on the minimum score change endorsed by respondents as a meaningful improvement/decrement. However, the approach can be cognitively challenging for participants and reaching a consensus is not guaranteed.Anchor- and distribution- based methods remain critical in establishing responder definitions. Nonetheless, qualitative data has the potential to provide complementary support that a certain level of change on the target COA, which has been statistically supported, is truly important and meaningful for the target population.
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Affiliation(s)
- Hannah Staunton
- Roche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW UK
| | - Tom Willgoss
- Roche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW UK
| | | | | | - Kate Sully
- Adelphi Values, Patient-Centered Outcomes, Macclesfield, Cheshire UK
| | - Diana Rofail
- Roche Products Limited, Hexagon Place, 6 Falcon Way, Shire Park, Welwyn Garden City, AL7 1TW UK
| | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Macclesfield, Cheshire UK
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Arbuckle R, Staunton H, Sully K, Tomkins S, Khindri S, Svedsater H, Nelsen L. Use of Both Qualitative and Quantitative Methods to Estimate Meaningful Change Thresholds for Key Endpoints in Pediatric Asthma Trials. Value Health 2019; 22:340-347. [PMID: 30832972 DOI: 10.1016/j.jval.2018.09.2845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/03/2018] [Accepted: 09/26/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Diary-derived symptom score and rescue medication use endpoints, such as symptom-free days (SFDs) and rescue medication-free days (RFD), are frequently used as clinical trial endpoints. Estimates of meaningful change for SFDs and RFDs have not been generated in pediatric populations. This research aimed to generate evidence supporting estimates of the individual within-patient changes that constitute an important or meaningful change in SFDs, RFDs, and updated estimates on the Childhood Asthma Control Test (C-ACT) in pediatric asthma populations aged 5-11 years. METHODS Semistructured, qualitative interviews were conducted with children (ages 8-11 years) who had asthma and parents/caregivers of children (4-11 years) with asthma. Before the interview (4-9 days) participants were asked to complete a morning and evening diary. RESULTS On average, parent/caregiver estimates of the difference in SFDs between a "very bad" and a "little bad" week for their children's asthma were largely concordant with the values reported by their children (differences of 1.8 and 1.4 SFDs, respectively). Both parents/caregivers and children were able to articulate what a meaningful level of change would be on the C-ACT at the item level. This qualitative study generated C-ACT item-level meaningful change estimates in the region of 1-3 category change, which potentially suggests that, if scaled up to represent C-ACT total score, this would lead to change estimates of 7-15 points. CONCLUSIONS Our findings suggest that both children with asthma and parents/caregivers can quantitatively estimate and to some extent qualitatively articulate meaningful change in SFDs and RFDs.
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Affiliation(s)
| | | | - Kate Sully
- Adelphi Values, Macclesfield, Cheshire, UK
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30
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Johnson CD, Williamson N, Janssen-van Solingen G, Arbuckle R, Johnson C, Simpson S, Staab D, Dominguez-Munoz E, Levy P, Connett G, Lerch MM. Psychometric evaluation of a patient-reported outcome measure in pancreatic exocrine insufficiency (PEI). Pancreatology 2019; 19:182-190. [PMID: 30528109 DOI: 10.1016/j.pan.2018.11.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/20/2018] [Accepted: 11/27/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Pancreatic exocrine insufficiency (PEI) is commonly caused by chronic pancreatitis (CP) or cystic fibrosis (CF). There are no PEI-specific patient-reported assessments of symptoms and impacts. The PEI Questionnaire (PEI-Q) was developed through qualitative research with PEI patients and expert clinical input. This study evaluated the psychometric properties of the PEI-Q. METHODS 162 PEI patients (CF = 71 and CP = 91), 62 diarrhoea-specific irritable bowel syndrome (IBS-D) patients and 60 healthy controls completed the 26-item PEI-Q and the Gastrointestinal Quality of Life Index (GIQLI) at baseline. PEI patients completed the measures again two weeks later to assess the test-retest reliability of the PEI-Q. Analyses supported item reduction and scoring algorithm development, followed by psychometric evaluation. RESULTS Over 90% of PEI patients completed at least 23 of the 26 items at baseline. Item responses and clinical relevance supported retention of 18 items. Factor analysis supported a three-factor solution (abdominal symptoms, bowel movements, impacts) with adequate model fit. PEI-Q scores had good internal consistency (Cronbach's alpha: 0.77-0.82) and test-retest reliability (ICC: 0.73-0.87). Correlations between PEI-Q and GIQLI supported convergent validity. Known-groups and receiver operating characteristic analyses demonstrated that PEI-Q scores discriminated (p < 0.001) between differing PEI severities, and PEI patients and controls. CONCLUSIONS The PEI-Q has good validity and reliability. Results indicate that the PEI-Q could be used to aid identification and diagnosis of PEI, assist in the management of patients already diagnosed with PEI, ensuring correct and optimum treatment as well as enhance patient-clinician communication.
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Affiliation(s)
- Colin D Johnson
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | | | - Rob Arbuckle
- Adelphi Values, Cheshire, England, United Kingdom
| | | | | | - Doris Staab
- Charité University Hospital, Berlin, Germany
| | | | - Phillippe Levy
- Université Denis Diderot-Paris VII Hôpital Beaujon, Clichy Cedex, France
| | - Gary Connett
- Southampton Children's Hospital, Hampshire, England, United Kingdom
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Tatlock S, Abraham L, Bushmakin A, Moffatt M, Williamson N, Coon C, Arbuckle R. Psychometric evaluation of electronic diaries assessing side-effects of hormone therapy. Climacteric 2018; 21:594-600. [PMID: 30372631 DOI: 10.1080/13697137.2018.1517738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Postmenopausal women (PMW) can experience side-effects (breast pain/tenderness and vaginal spotting/bleeding) associated with estrogen plus progestin therapies (EPTs). To assess these outcomes, the Breast Pain and Tenderness Daily Diary (BPT-DD) and the Vaginal Bleeding and Spotting Daily Diary (VBS-DD) were developed for electronic completion (eDiaries). This study evaluated the psychometric properties of the eDiaries. METHODS The eDiaries were completed daily for 28 days by 202 PMW experiencing breast pain/tenderness and/or vaginal spotting/bleeding while on EPTs. Confirmatory factor analysis (CFA) investigated the BPT-DD structure. Response distributions, test-retest reliability (intraclass correlation coefficient [ICC]), internal consistency (BPT-DD only), and construct validity (via known groups and convergent validity analyses) were assessed. RESULTS Completion rates were high: over 90% of women missed <3 daily entries. CFA supported the BPT-DD unidimensional structure (Bentler's Comparative Fit Index >0.98). BPT-DD inter-item correlations (r = 0.77-0.89) and internal consistency (Cronbach's alpha = 0.95-0.97) were high and good test-retest reliability was demonstrated (ICC ≥ 0.70). The eDiaries correlated moderately (>0.40), in a logical pattern with other instruments, supporting convergent validity. Known-groups analyses indicated both measures demonstrated significant differences between patients of differing severity (p < 0.001). CONCLUSION The study provides evidence of strong psychometric properties for the BPT-DD and VBS-DD to assess breast pain/tenderness and spotting/bleeding in PMW.
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Affiliation(s)
- S Tatlock
- a Adelphi Mill , Adelphi Values , Bollington , Cheshire , UK
| | - L Abraham
- b Pfizer Ltd , Tadworth , Surrey , UK
| | | | - M Moffatt
- b Pfizer Ltd , Tadworth , Surrey , UK
| | - N Williamson
- a Adelphi Mill , Adelphi Values , Bollington , Cheshire , UK
| | - C Coon
- d Outcometrix , Essex , MA , USA
| | - R Arbuckle
- a Adelphi Mill , Adelphi Values , Bollington , Cheshire , UK
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Coon C, Bushmakin A, Tatlock S, Williamson N, Moffatt M, Arbuckle R, Abraham L. Evaluation of a crosswalk between the European Quality of Life Five Dimension Five Level and the Menopause-Specific Quality of Life questionnaire. Climacteric 2018; 21:566-573. [DOI: 10.1080/13697137.2018.1481381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C. Coon
- Outcometrix, Ipswich, MA, USA
| | | | - S. Tatlock
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
| | - N. Williamson
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
| | | | - R. Arbuckle
- Patient-Centered Outcomes, Adelphi Values, Bollington, Cheshire, UK
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Theodore-Oklota C, Bonner N, Spencer H, Arbuckle R, Chen CY, Skrinar A. Qualitative Research to Explore the Patient Experience of X-Linked Hypophosphatemia and Evaluate the Suitability of the BPI-SF and WOMAC® as Clinical Trial End Points. Value Health 2018; 21:973-983. [PMID: 30098676 DOI: 10.1016/j.jval.2018.01.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/14/2017] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND X-linked hypophosphatemia (XLH) is a rare genetic disorder characterized by renal phosphate wasting and defective bone mineralization. Symptoms include bone pain, joint pain, stiffness, and fatigue. Published evidence regarding the patient experience of XLH is sparse and no XLH-specific outcome measures have been validated. OBJECTIVES To understand the symptoms, impacts, and patient experience of XLH and to evaluate the face and content validity of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC®) and the Brief Pain Inventory Short Form (BPI-SF) for use as end points in XLH clinical trials. METHODS Face-to-face, qualitative, semistructured interviews were conducted with 18 adults with XLH in the United States using concept elicitation and cognitive debriefing techniques. Open-ended questioning elicited spontaneous concepts focusing on XLH-associated symptoms and functional limitations. Cognitive debriefing of the WOMAC® and BPI-SF assessed the relevance and patient understanding of item wording, recall period, and response options. RESULTS Various distinct symptom concepts were elicited including pain symptoms, dental symptoms, sensory symptoms, tiredness/fatigue symptoms, and musculoskeletal symptoms. Participants reported experiencing significant bone and joint pain, stiffness, mobility limitations, and an impact on their ability to work. Cognitive interviewing found both instruments to be relevant and well understood by most patients. CONCLUSIONS The interviews generated rich, qualitative insights into the patient experience of XLH. Cognitive debriefing of the BPI-SF and WOMAC® supported their value as XLH clinical trial end points. Future research will assess the psychometric properties of these instruments for use in the XLH population.
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Tatlock S, Rüdell K, Panter C, Arbuckle R, Harrold LR, Taylor WJ, Symonds T. What Outcomes are Important for Gout Patients? In-Depth Qualitative Research into the Gout Patient Experience to Determine Optimal Endpoints for Evaluating Therapeutic Interventions. Patient 2017; 10:65-79. [PMID: 27384670 PMCID: PMC5250642 DOI: 10.1007/s40271-016-0184-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background and Objectives Characterized by sudden onset of severe joint pain, swelling, redness, and tenderness to touch, gout ‘flare ups’ have a substantial impact on quality of life (QoL). This research employed a patient-centered approach to explore the symptoms and impacts of gout, and assess the content validity of existing patient-reported outcomes (PROs). Methods Qualitative interviews were conducted with 30 US gout patients (non-tophaceous: n = 20, tophaceous: n = 10) and five expert rheumatologists. Each interview included both concept elicitation (CE) questioning to learn about the patient experience and cognitive debriefing to assess the content validity of three PRO instruments (HAQ-DI, GAQ, and TIQ-20). Nine of the patients provided further real-time qualitative data through a smart phone application. All qualitative data were subject to thematic analysis using Atlas.ti. Two patient advisors and three expert clinicians were engaged as advisors at key stages throughout the research. Results Interview and real-time data identified the same core symptoms and proximal impact concepts. Severe pain (typically in joints of extremities) was described as the cardinal symptom, often accompanied by swelling, redness, heat, sensitivity to touch, and stiffness. Domains of QoL impacted included physical functioning, sleep, daily activities, and work. The PRO instruments were generally well-understood by patients, but each included items with questionable relevance to at least some of the sample, dependent on the specific joints affected. Conclusions Gout patients experience severe pain in affected joints, resulting in substantial limitations in physical functioning. Both the HAQ-DI and the TIQ-20 are useful for specific research purposes in the gout population, although modifications are recommended. Electronic supplementary material The online version of this article (doi:10.1007/s40271-016-0184-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sophi Tatlock
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK.
| | - Katja Rüdell
- AstraZeneca, Da Vinci Building, Melbourn Science Park, Royston, Cambridgeshire, SG86EE, UK
| | - Charlotte Panter
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK
| | - Rob Arbuckle
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK
| | - Leslie R Harrold
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - William J Taylor
- Rehabilitation Teaching and Research Unit, University of Otago Wellington, PO Box 7343, Wellington, New Zealand
| | - Tara Symonds
- Clinical Outcomes Solutions Ltd, Shearway Road, Folkestone, CT194RH, UK
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Mayhew J, Bonner N, Arbuckle R, Turnbull A, Bowden A, Skrinar A. Development and preliminary evidence of the psychometric properties of the GNE myopathy functional activity scale. J Comp Eff Res 2017; 7:381-395. [PMID: 29139300 DOI: 10.2217/cer-2017-0062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM GNE myopathy, a rare, severe, progressive myopathy, presents with lower extremity distal muscle weakness. The GNE myopathy functional activity scale (GNEM-FAS) evaluates the impact of GNE myopathy on functioning in adults. This paper presents the psychometric validation of the GNEM-FAS. PATIENTS & METHODS Validation of the GNEM-FAS was performed using data from a randomized, double-blind, placebo-controlled Phase-II study (n = 46). RESULTS Domain score distributions were acceptable. Moderate inter-item correlations (typical range, 0.40-0.70), strong item convergent and discriminant validity and high internal consistency reliability (α = 0.88-0.92) supported the instrument structure. Test-retest reliability was strong (ICC range: 0.87-0.95). Scale scores distinguished among subjects with differing disease severity (p < 0.05). CONCLUSION This study provides preliminary evidence of the GNEM-FAS as a valid, reliable assessment.
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Affiliation(s)
- Jill Mayhew
- Ultragenyx Pharmaceutical, 60 Leveroni Court, Novato, CA 94949, USA
| | | | - Rob Arbuckle
- Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK
| | | | - Alexandra Bowden
- Ultragenyx Pharmaceutical, 60 Leveroni Court, Novato, CA 94949, USA
| | - Alison Skrinar
- Ultragenyx Pharmaceutical, 60 Leveroni Court, Novato, CA 94949, USA
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Graham J, Spiliopoulou P, Arbuckle R, Bridge JA, Cassidy J. A pilot study of subjective well-being in colorectal cancer patients and their caregivers. Patient Relat Outcome Meas 2017; 8:111-119. [PMID: 29089790 PMCID: PMC5656346 DOI: 10.2147/prom.s141815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Traditional endpoints in oncology are based on measuring the tumor size and combining this with a time factor. Current studies with immunotherapy show that even when median survival is unaltered, a significant proportion of patients can achieve prolonged survival. Objective tumor response does not always mean “overall” improvement, especially if toxicity is harsh. Novel agents are significantly expensive, and it is therefore crucial to measure the impact on “quality” of life, in addition to “quantity”. Materials and methods We studied the preferences and experiences of cancer patients and their caregivers, measuring subjective well-being (SWB) ratings, EQ5D descriptions and time trade-off preferences. Results We studied 99 patients and 88 caregivers. Life satisfaction ratings were similar between the two groups, but daily mood was significantly lower in caregivers (P<0.1). Anxiety/depression affected SWB, while pain and mobility did not. Positive thoughts about health were associated with better daily moods in both groups, and stage IV cancer was associated with lower life satisfaction. Cancer in remission was associated with better daily moods, but, interestingly, not with patient life satisfaction. Patients with better daily mood and positive thoughts about family were less willing to “trade-off ” life years. Conclusion Caregivers are as anxious or depressed as patients, and report similar levels of life satisfaction but lower daily mood. A focus on SWB could provide a valid assessment of treatment benefit. Given the interesting results of this pilot study, we suggest a larger study should be conducted, measuring SWB over time.
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Affiliation(s)
- Janet Graham
- Department of Medical Oncology, Beatson, West of Scotland Cancer Center, Glasgow, UK
| | - Pavlina Spiliopoulou
- Department of Medical Oncology, Beatson, West of Scotland Cancer Center, Glasgow, UK
| | - Rob Arbuckle
- Adelphi Values, Adelphi Mill Macclesfield, Cheshire, UK
| | | | - James Cassidy
- Department of Medical Oncology, Beatson, West of Scotland Cancer Center, Glasgow, UK
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Tatlock S, Gober M, Williamson N, Arbuckle R. Development and preliminary psychometric evaluation of an owner-completed measure of feline quality of life. Vet J 2017; 228:22-32. [DOI: 10.1016/j.tvjl.2017.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 06/15/2017] [Accepted: 10/11/2017] [Indexed: 11/26/2022]
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Delgado-Herrera L, Lasch K, Zeiher B, Lembo AJ, Drossman DA, Banderas B, Rosa K, Lademacher C, Arbuckle R. Evaluation and performance of a newly developed patient-reported outcome instrument for diarrhea-predominant irritable bowel syndrome in a clinical study population. Therap Adv Gastroenterol 2017; 10:673-687. [PMID: 28932269 PMCID: PMC5598814 DOI: 10.1177/1756283x17726018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 07/05/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To evaluate the psychometric properties of the newly developed seven-item Irritable Bowel Syndrome - Diarrhea predominant (IBS-D) Daily Symptom Diary and four-item Event Log using phase II clinical trial safety and efficacy data in patients with IBS-D. This instrument measures diarrhea (stool frequency and stool consistency), abdominal pain related to IBS-D (stomach pain, abdominal pain, abdominal cramps), immediate need to have a bowel movement (immediate need and accident occurrence), bloating, pressure, gas, and incomplete evacuation. METHODS Psychometric properties and responsiveness of the instrument were evaluated in a clinical trial population [ClinicalTrials.gov identifier: NCT01494233]. RESULTS A total of 434 patients were included in the analyses. Significant differences were found among severity groups (p < 0.01) defined by IBS Patient Global Impression of Severity (PGI-S) and IBS Patient Global Impression of Change (PGI-C). Severity scores for each Diary and Event Log item score and five-item, four-item, and three-item summary scores were calculated. Between-group differences in changes over time were significant for all summary scores in groups stratified by changes in PGI-S (p < 0.05), two of six Diary items, and three of four Event Log items; a one-grade change in PGI-S was considered a meaningful difference with mean change scores on all Diary items -0.13 to -0.86 [standard deviation (SD) 0.79-1.39]. Similarly, for patients who reported being 'slightly improved' (considered a clinically meaningful difference) on the PGI-C, mean change scores on Diary items ranged from -0.45 to -1.55 (SD 0.69-1.39). All estimates of clinically important change for each item and all summary scores were small and should be considered preliminary. These results are aligned with the previous standalone psychometric study regarding reliability and validity tests. CONCLUSIONS These analyses provide evidence of the psychometric properties of the IBS-D Daily Symptom Diary and Event Log in a clinical trial population.
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Affiliation(s)
| | | | | | | | - Douglas A. Drossman
- Drossman Center for the Education and Practice of Biopsychosocial Care, UNC Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, and Drossman Gastroenterology PLLC, Chapel Hill, NC, USA
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Nguyen AM, Arbuckle R, Korver T, Chen F, Taylor B, Turnbull A, Norquist JM. Psychometric validation of the dysmenorrhea daily diary (DysDD): a patient-reported outcome for dysmenorrhea. Qual Life Res 2017; 26:2041-2055. [PMID: 28405780 DOI: 10.1007/s11136-017-1562-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2017] [Indexed: 01/17/2023]
Abstract
PURPOSE The objective of this study was to evaluate the psychometric properties of the Dysmenorrhea Daily Diary (DysDD), an electronic patient-reported outcome, in a sample of 355 women with primary dysmenorrhea enrolled in a phase IIb, multicenter, randomized, partially blinded, placebo-controlled trial for treatment of dysmenorrhea. METHODS Subjects completed the DysDD over three menstrual cycles, one pre-treatment baseline cycle and two treatment cycles. The DysDD was administered alongside the Menstrual Distress Questionnaire (MDQ), the Short-Form 36 Version 2.0 (SF-36v2), and a Global Assessment of Change (GAC). Item response distributions, test-retest reliability, concurrent and known groups validity, responsiveness, and minimally important difference (MID) were evaluated for the DysDD. RESULTS As expected, item response distributions varied throughout the menstrual period for all items, with the response scales fully utilized. Within-cycle test-retest reliability was adequate (weighted kappa: 0.5-0.7), although between-cycle test-retest was poor (weighted kappa: 0.1-0.5), most likely due to the highly variable nature of dysmenorrhea between cycles rather than limitations of the measure. Correlations with the MDQ and SF-36v2 were low-moderate, but in the predicted direction, supporting concurrent validity. There were significant differences in DysDD scores across severity groups based on pain medication use. The DysDD was responsive to changes in patients' dysmenorrhea with significantly different changes in scores between change groups (p < 0.0001). MID analyses suggest changes on the DysDD 0-10 pelvic pain score of three points can be considered clinically meaningful. CONCLUSIONS Overall, findings indicate that the DysDD has acceptable reliability and is a valid and responsive instrument for assessing dysmenorrhea.
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Affiliation(s)
- Allison M Nguyen
- Merck Sharp & Dohme Corp., 351 N. Sumneytown Pike, UG1D-60, North Wales, PA, 19454, USA.
| | | | - Tjeerd Korver
- Reprovision Consultancy in Clinical Development, Oss, The Netherlands
| | - Fang Chen
- Merck Sharp & Dohme Corp., 351 N. Sumneytown Pike, UG1D-60, North Wales, PA, 19454, USA
| | | | | | - Josephine M Norquist
- Merck Sharp & Dohme Corp., 351 N. Sumneytown Pike, UG1D-60, North Wales, PA, 19454, USA
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Tatlock S, Arbuckle R, Sanchez R, Grant L, Khan I, Manvelian G, Spertus JA. Psychometric Evaluation of a Treatment Acceptance Measure for Use in Patients Receiving Treatment via Subcutaneous Injection. Value Health 2017; 20:430-440. [PMID: 28292488 DOI: 10.1016/j.jval.2016.09.2410] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 08/15/2016] [Accepted: 09/28/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, significantly reduces low-density lipoprotein cholesterol, but requires subcutaneous injections rather than oral pills. To measure patients' acceptance of this treatment modality, a new patient-reported outcome, the Injection-Treatment Acceptance Questionnaire (I-TAQ), was developed. OBJECTIVES To psychometrically evaluate the I-TAQ with patients at high risk of cardiovascular events receiving alirocumab. METHODS The 22-item, 5-domain I-TAQ was administered cross-sectionally to 151 patients enrolled in alirocumab clinical trials. Item response distributions, factor and multitrait analyses, interitem correlations, correlations with an existing measure of acceptance (convergent validity), and comparison of known-groups were performed to assess the I-TAQ's psychometric properties. RESULTS Completion rates were high, with no patients missing more than two items and 91.4% missing no data. All items displayed high ceiling effects (>30%) because of high treatment acceptance. Factor analysis supported the a priori hypothesized item-domain structure with good fit indices (root mean square error approximation = 0.070; comparative fit index = 0.988) and high factor loadings. All items demonstrated item convergent validity (item-scale correlation ≥0.40), except for the side effects domain, which was limited by small numbers (n = 46). Almost all items correlated most highly with the domain to which they were assigned (item discriminant validity). Internal reliability was acceptable for all domains (Cronbach α range 0.72-0.88) and convergent validity was supported by a logical pattern of correlations with the Chronic Treatment Acceptance Questionnaire. CONCLUSIONS These findings provide initial evidence of validity and reliability for the I-TAQ in patients treated with subcutaneous alirocumab. The I-TAQ could prove to be a valuable patient-reported outcome for therapies requiring subcutaneous injection.
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Affiliation(s)
| | | | | | - Laura Grant
- Adelphi Values Ltd., Bollington, Cheshire, UK
| | | | | | - John A Spertus
- Mid America Heart Institute of Saint Luke's Hospital and the University of Missouri-Kansas City, Kansas City, MO, USA
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Rosa K, Delgado-Herrera L, Zeiher B, Banderas B, Arbuckle R, Spears G, Hudgens S. Psychometric assessment of the IBS-D Daily Symptom Diary and Symptom Event Log. Qual Life Res 2016; 25:3197-3208. [PMID: 27342236 PMCID: PMC5102981 DOI: 10.1007/s11136-016-1335-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 12/17/2022]
Abstract
Purpose Diarrhea-predominant irritable bowel syndrome (IBS-D) can considerably impact patients’ lives. Patient-reported symptoms are crucial in understanding the diagnosis and progression of IBS-D. This study psychometrically evaluates the newly developed IBS-D Daily Symptom Diary and Symptom Event Log (hereafter, “Event Log”) according to US regulatory recommendations. Methods A US-based observational field study was conducted to understand cross-sectional psychometric properties of the IBS-D Daily Symptom Diary and Event Log. Analyses included item descriptive statistics, item-to-item correlations, reliability, and construct validity. Results The IBS-D Daily Symptom Diary and Event Log had no items with excessive missing data. With the exception of two items (“frequency of gas” and “accidents”), moderate to high inter-item correlations were observed among all items of the IBS-D Daily Symptom Diary and Event Log (day 1 range 0.67–0.90). Item scores demonstrated reliability, with the exception of the “frequency of gas” and “accidents” items of the Diary and “incomplete evacuation” item of the Event Log. The pattern of correlations of the IBS-D Daily Symptom Diary and Event Log item scores with generic and disease-specific measures was as expected, moderate for similar constructs and low for dissimilar constructs, supporting construct validity. Known-groups methods showed statistically significant differences and monotonic trends in each of the IBS-D Daily Symptom Diary item scores among groups defined by patients’ IBS-D severity ratings (“none”/“mild,” “moderate,” or “severe”/“very severe”), supporting construct validity. Conclusions Initial psychometric results support the reliability and validity of the items of the IBS-D Daily Symptom Diary and Event Log.
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Affiliation(s)
| | | | - Bernie Zeiher
- Astellas Pharma Global Development, Inc., 1 Astellas Way, Northbrook, IL, 60062, USA
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Delgado-Herrera L, Lasch K, Popielnicki A, Nishida A, Arbuckle R, Banderas B, Zentner S, Gagainis I, Zeiher B. Cultural adaptation: translatability assessment and linguistic validation of the patient-reported outcome instrument for irritable bowel syndrome with diarrhea. Patient Relat Outcome Meas 2016; 7:81-92. [PMID: 27382346 PMCID: PMC4922818 DOI: 10.2147/prom.s102647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Following a 2009 US Food and Drug Administration guidance, a new patient-reported outcome (PRO) instrument was developed to support end points in multinational clinical trials assessing irritable bowel syndrome with diarrhea (IBS-D) symptom severity. Our objective was to assess the translatability of the IBS-D PRO instrument into ten languages, and subsequently perform a cultural adaptation/linguistic validation of the questionnaire into Japanese and US Spanish. MATERIALS AND METHODS Translatability assessments of the US English version of the IBS-D PRO were performed by experienced PRO translators who were native speakers of each target language and currently residing in target-language countries. Languages were Chinese (People's Republic of China), Dutch (the Netherlands), French (Belgium), German (Germany), Japanese (Japan), Polish (Poland), Portuguese (Brazil), Russian (Russia), Spanish (Mexico), and Spanish (US). The project team assessed the instrument to identify potential linguistic and/or cultural adaptation issues. After the issues identified were resolved, the instrument was translated into Spanish (US) and Japanese through a process of two forward translations, one reconciled translation, and one backward translation. The project team reviewed the translated versions before the instruments were evaluated by cognitive debriefing interviews with samples of five Spanish (US) and five Japanese IBS-D patients. RESULTS Linguistic and cultural adaptation concerns identified during the translatability assessment required minor revisions, mainly the presentation of dates/times and word structure. During the cognitive debriefing interviews, two of five Spanish respondents misunderstood the term "bowel movement" to mean only diarrhea in the Spanish version. Consequently, the term was changed from "movimiento intestinal" to "evacuaciones". None of the Japanese respondents identified issues with the Japanese version. CONCLUSION The translatability of the IBS-D PRO instrument into ten target languages was confirmed, with only minor changes made to the translations of the instrument. The translation and linguistic validation into Spanish (US) and Japanese provide evidence that this instrument can be used in multinational trials and clinical settings.
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Affiliation(s)
| | | | | | - Akito Nishida
- Development Project Management, Astellas Pharma Inc, Tokyo, Japan
| | - Rob Arbuckle
- Patient-Centered Outcomes Adelphi Values, Bollington, UK
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Tatlock S, Grant L, Spertus JA, Khan I, Arbuckle R, Manvelian G, Sanchez RJ. Development and Content Validity Testing of a Patient-Reported Treatment Acceptance Measure for Use in Patients Receiving Treatment via Subcutaneous Injection. Value Health 2015; 18:1000-1007. [PMID: 26686784 DOI: 10.1016/j.jval.2015.09.2937] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/07/2015] [Accepted: 09/08/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND New therapies in development for lowering low-density lipoprotein cholesterol, such as alirocumab, require administration by subcutaneous injections. There is a need to assess the acceptance of such treatments and their mode of administration. OBJECTIVES To develop a novel patient-reported outcome measure, the Injection-Treatment Acceptance Questionnaire (I-TAQ), and assess its content validity using qualitative methods. METHODS Concepts generated from a literature and instrument review informed the initial drafting of 17 items in the I-TAQ, with item wording adapted from three existing instruments. Three rounds of qualitative interviews were conducted with 29 US-English speaking patients at high cardiovascular risk. Concept elicitation questioning was used to explore patients' treatment experiences followed by cognitive debriefing of the I-TAQ using "think-aloud" methods. Verbatim transcripts were analyzed using thematic analysis. RESULTS Qualitative analysis of concept elicitation data identified the following relevant concepts: perceived efficacy, side effects, self-efficacy, convenience, and overall acceptance. Seven (24%) patients discussed an initial fear of needles, but described this as subsiding with no impact on adherence. Five items were added after round one interviews, three of which were retained after round two testing in which two further items were added, forming the conceptually comprehensive 22-item I-TAQ. Patients demonstrated good understanding of item wording, instructions, response scales, and recall period. CONCLUSIONS Successive rounds of in-depth interviews resulted in a treatment acceptance measure with strong content validity. Pending demonstration of its psychometric properties, the I-TAQ may prove to be a valuable measure of patients' perspectives toward being treated with low-density lipoprotein cholesterol-lowering therapies requiring subcutaneous injections.
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Affiliation(s)
- Sophi Tatlock
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK.
| | - Laura Grant
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK
| | - John A Spertus
- Mid America Heart Institute of Saint Luke's Hospital and the University of Missouri - Kansas City, Kansas City, MO, USA
| | | | - Rob Arbuckle
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, UK
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Scott J, Gilles L, Fu M, Brohan E, Panter C, Arbuckle R, Jessner W, Beumont M. Simeprevir added to peginterferon and ribavirin lessens time with fatigue, depressive symptoms and functional limitations in patients with chronic hepatitis C compared with peginterferon and ribavirin: results from 1161 patients in the QUEST-1, QUEST-2 and PROMISE studies. J Viral Hepat 2015; 22:639-50. [PMID: 25487355 DOI: 10.1111/jvh.12365] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 10/06/2014] [Indexed: 02/06/2023]
Abstract
The value of adding simeprevir (SMV) vs placebo (PBO) to peginterferon and ribavirin (PR) for treatment of chronic hepatitis C virus infection was examined using patient-reported outcomes (PROs); further, concordance of PROs with virology endpoints and adverse events (AEs) was explored. Patients (n = 768 SMV/PR, n = 393 PBO/PR) rated fatigue (FSS), depressive symptoms (CES-D) and functional impairment (WPAI: Hepatitis C Productivity, Daily Activity and Absenteeism) at baseline and throughout treatment in three randomised, double-blind trials comparing the addition of SMV or PBO during initial 12 weeks of PR. PR was administered for 48 weeks (PBO group) and 24/48 weeks (SMV group) using a response-guided therapy (RGT) approach. Mean PRO scores (except Absenteeism) worsened from baseline to Week 4 to the same extent in both groups but reverted after Week 24 for SMV/PR and only after Week 48 for PBO/PR. Accordingly, there was a significantly lower area under the curve (baseline-Week 60, AUC60 ) and fewer weeks with clinically important worsening of scores in the SMV/PR group at any time point. Incidences of patients with fatigue and anaemia AEs were similar in both groups, but FSS scores showed that clinically important increases in fatigue lasted a mean of 6.9 weeks longer with PBO/PR (P < 0.001). PRO score subgroup analysis indicated better outcomes for patients who met the criteria for RGT or achieved sustained virological response 12 weeks post-treatment (SVR12); differences in mean PRO scores associated with fibrosis level were only observed with PBO/PR. Greater efficacy of SMV/PR enabled reduced treatment duration and reduced time with PR-related AEs without adding to AE severity.
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Affiliation(s)
- J Scott
- Janssen Global Services, LLC, High Wycombe, UK
| | - L Gilles
- Janssen Research and Development, Beerse, Belgium
| | - M Fu
- Janssen Research and Development, Raritan, NJ, USA
| | | | | | | | - W Jessner
- Janssen Research and Development, Beerse, Belgium
| | - M Beumont
- Janssen Research and Development, Beerse, Belgium
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Chassany O, Tugaut B, Marrel A, Guyonnet D, Arbuckle R, Duracinsky M, Whorwell PJ, Azpiroz F. The Intestinal Gas Questionnaire: development of a new instrument for measuring gas-related symptoms and their impact on daily life. Neurogastroenterol Motil 2015; 27:885-98. [PMID: 25846412 DOI: 10.1111/nmo.12565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/11/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND Although gas-related symptoms (GRS) are common and intrusive, there are no questionnaires to quantitate this problem. This study aimed to develop an instrument to rectify this gap in our knowledge. METHODS Concepts were initially identified from the literature and interviews with gastroenterologists. Exploratory one-to-one interviews and focus groups with irritable bowel syndrome (IBS) patients (n = 28) and non-IBS subjects (n = 27) with GRS were conducted in UK, France, and Spain leading to a conceptual framework for the questionnaire. Last, iterative rounds of cognitive debriefing were performed with IBS (n = 16) and non-IBS subjects (n = 14). KEY RESULTS From the first three steps, nine GRS (bloating, distension, flatulence, odorous flatulence, difficult gas evacuation, stomach rumbling, belching, bad breath, and abdominal movement) were identified although abdominal movement was subsequently excluded. Twelve quality of life domains affected by these symptoms were identified as: Clothing, emotional, physical appearance, diet, daily living, work, social life, physical activity, relationships, sex life, sleep, and cognitive function. A 24-h recall for symptoms and a 7-day recall for impact assessment were supported by the qualitative findings. Cognitive debriefing confirmed the understanding of the instrument. Across the three languages, the instrument was conceptually and linguistically consistent. CONCLUSIONS & INFERENCES The International Gas Questionnaire is a 2-part instrument, developed rigorously and simultaneously in three languages assessing seven symptoms (17 items) and their impact on 12 domains (26 items) in IBS and general population. It is now undergoing psychometric validation and should provide a unique tool for epidemiological surveys and clinical trials for developing new treatments for these symptoms.
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Affiliation(s)
- O Chassany
- Patient-Centered Outcomes Research, EA 7334, University Paris-Diderot, Paris, France.,Health Economics Clinical Research Unit, Hotel-Dieu hospital, AP-HP, Paris, France
| | - B Tugaut
- HEOR & Strategic Market Access, Mapi, Lyon, France
| | - A Marrel
- HEOR & Strategic Market Access, Mapi, Lyon, France
| | - D Guyonnet
- Danone Nutricia Research, Palaiseau, France
| | - R Arbuckle
- Endpoint Development and Outcomes Assessment, Adelphi Values, Manchester, UK
| | - M Duracinsky
- Patient-Centered Outcomes Research, EA 7334, University Paris-Diderot, Paris, France.,Internal Medicine & Clinical Immunology Department, Bicêtre Hospital, AP-HP, Kremlin-Bicêtre, France
| | | | - F Azpiroz
- Digestive System Research Unit, University Hospital Vall d'Hebron, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Spain.,Department of Medicine, Universitat Autónoma de Barcelona, Spain
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Abraham L, Humphrey L, Arbuckle R, Dennerstein L, Simon JA, Mirkin S, Bonner N, Walmsley S, Tatlock S, Symonds T. Qualitative cross-cultural exploration of breast symptoms and impacts associated with hormonal treatments for menopausal symptoms to inform the development of new patient-reported measurement tools. Maturitas 2014; 80:273-81. [PMID: 25542407 DOI: 10.1016/j.maturitas.2014.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/25/2014] [Accepted: 11/26/2014] [Indexed: 11/30/2022]
Abstract
To explore cross-cultural experiences of women taking estrogen plus progestin therapies (EPT) and develop a symptom-based electronic diary and impact questionnaire for EPT-related breast symptoms. (1) Concept elicitation interviews were conducted with women in the US (n=14), Italy (n=15), Mexico (n=15) and China (n=15) to explore breast symptoms associated with EPT. Patients completed the Breast Sensitivity Questionnaire (BSQ) to evaluate understanding and comprehensiveness. (2) Based on concept elicitation, a 6-item eDiary (Breast Pain/Tenderness Daily Diary - BPT-DD) was generated and the BSQ modified forming the 18-item Breast Sensations Impact Questionnaire (BSIQ). (3) The measures were pilot-tested and then cognitively debriefed with US women receiving EPT. All qualitative data was subject to thematic analysis. Concept elicitation identified breast pain/tenderness, swollen breasts and sensitivity to contact as important symptoms, impacting women's emotional well-being, relationships with family/friends, social life, sleep, ability to move freely, contact, clothing and sexual activity. Experiences were relatively consistent across the country samples. Based on pilot testing and cognitive debriefing, the BPT-DD was reduced to 4 items (and renamed the Breast Pain Daily Diary - BP-DD) and the BSIQ was reduced to 13 items due to conceptual redundancy. Women taking EPT in the US, China, Mexico and Italy reported breast sensations that have a detrimental impact on quality of life. Two new measures were developed to assess the severity and impact of breast pain specific to EPT. This work highlights that EPT-related symptoms should be part of treatment decision-making, and treatments with less burdensome side effects are needed.
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Affiliation(s)
- Lucy Abraham
- Pfizer Ltd., Dorking Road, Tadworth, Kent KT20 7NS, UK.
| | - Louise Humphrey
- Adelphi Values, Adelphi Mill, Bollington, Cheshire SK10 5JB, UK.
| | - Rob Arbuckle
- Adelphi Values, Adelphi Mill, Bollington, Cheshire SK10 5JB, UK.
| | | | | | | | - Nicola Bonner
- Adelphi Values, Adelphi Mill, Bollington, Cheshire SK10 5JB, UK.
| | - Steven Walmsley
- Adelphi Values, Adelphi Mill, Bollington, Cheshire SK10 5JB, UK.
| | - Sophi Tatlock
- Adelphi Values, Adelphi Mill, Bollington, Cheshire SK10 5JB, UK.
| | - Tara Symonds
- Pfizer Ltd., Dorking Road, Tadworth, Kent KT20 7NS, UK.
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Rudell K, Tatlock S, Panter C, Arbuckle R, Symonds T. Assessing the Methodological Value of Digital Real-Time Collection of Qualitative Content in Supporting In-Depth Qualitative Interviews Exploring the Symptoms and Impacts of Gout on Health-Related Quality of Life. Value Health 2014; 17:A572. [PMID: 27201913 DOI: 10.1016/j.jval.2014.08.1914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - C Panter
- Adelphi Values Ltd, Bollington, UK
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Tatlock S, Grant L, Arbuckle R, Khan I, Manvelian G, Sanchez R. Development And Content Validity Testing Of A Treatment Acceptance Measure For Use In Hypercholesterolemia Patients Receiving Treatment Via Subcutaneous Injection. Value Health 2014; 17:A569. [PMID: 27201898 DOI: 10.1016/j.jval.2014.08.1898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - L Grant
- Adelphi Values Ltd, Bollington, UK
| | | | - I Khan
- Sanofi, Bridgewater, NJ, USA
| | - G Manvelian
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - R Sanchez
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
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Medin J, Arbuckle R, Abetz L, Halling K, Kulich K, Edvardsson N, Coyne KS. Development and validation of the AFSymp™: an atrial fibrillation-specific measure of patient-reported symptoms. Patient 2014; 7:319-27. [PMID: 24733480 DOI: 10.1007/s40271-014-0058-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patients with atrial fibrillation (AF) can be severely incapacitated by symptoms, but validated symptom measures are lacking. The aim of this study was to develop an AF-specific symptom questionnaire (AFSymp™). METHODS Following a literature review, qualitative interviews with 91 patients (United States [US], n = 30; United Kingdom [UK], n = 16; France, n = 15; Germany, n = 15; Japan, n = 15) with paroxysmal, persistent, and permanent AF were conducted to identify emergent concepts and to develop the items and response options for the AFSymp™. Clinical experts (n = 21) in the US, the UK, France, Germany, and Japan provided feedback on the most clinically relevant symptoms via an email survey. Cognitive interviews with 30 patients were conducted to evaluate content validity. A prospective, observational, psychometric evaluation study (n = 313) consisting of two study visits was performed at 32 sites across the US. RESULTS After item reduction, the AFSymp™ consisted of 11 items with a 1-week recall period. Exploratory and confirmatory factor analysis resulted in three subscales (heart symptoms, tiredness, chest discomfort) and two items: dizziness and shortness of breath. Internal consistency was strong across subscales (Cronbach's α 0.82-0.91). The test-retest reliability of items and subscales was acceptable (intra-class correlation [ICC] 0.58-0.78). The reproducibility of the single global score was strong (ICC 0.78). The construct and known-groups validity was acceptable. CONCLUSION The AFSymp™ demonstrates evidence of reliability and validity as a comprehensive measure of AF symptoms that can be used to assess patient outcomes in clinical and research settings. More research is needed to evaluate the instrument's responsiveness.
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Arbuckle R, Abetz-Webb L. “Not Just Little Adults”: Qualitative Methods to Support the Development of Pediatric Patient-Reported Outcomes. Patient 2013; 6:143-59. [DOI: 10.1007/s40271-013-0022-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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