Meaningful differences in patient-reported outcome measurement scores in liver disease.

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2025-05-29 eCollection Date: 2025-06-01 DOI:10.1097/HC9.0000000000000727
Archita P Desai, Eric S Orman, Tarek G Aridi, Timothy Stump, Lauren Nephew, Marwan S Ghabril, Michael Fallon, Naga Chalasani, Patrick Monahan
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引用次数: 0

Abstract

Background: Patient-reported outcome measures (PROMs) are being used more often in chronic liver disease (CLD) clinical care and research. Their interpretability can be greatly enhanced by establishing the smallest meaningful score difference (MSD). We report scores of commonly used PROMs and their MSDs in patients at different stages of liver disease.

Methods: Patient-Reported Outcomes Measurement Information System (PROMIS)-29 Profile, Chronic Liver Disease Questionnaire (CLDQ), and Short Form-36 (SF-36) v1.0 scores were aggregated from 2442 adults with CLD at 4 different stages: inpatients with decompensated cirrhosis (n=1146) and outpatients with cirrhosis (n=677) or CLD (n=128) or recipients of liver transplant (LT, n=490) between June 2014 and April 2023 from 3 academic centers. MSDs were estimated using distribution and anchor-based methods.

Results: The study sample's median age was 60.0 (IQR: 51.0-66.0); 55% were male, 17% Hispanic, 84% White, and 49% college educated. The etiology of CLD was alcohol in 36%, metabolic dysfunction-associated steatohepatitis (MASH) in 31%, and viral hepatitis B/C in 26%. Median PROMIS domain scores were generally lowest in inpatients and highest after transplant. For PROMIS, distribution-based and anchor-based MSDs ranged from 3 to 4 for individual domains and 4 to 6 for summary scores. Distribution-based MSDs were 1 for CLDQ and ranged from 7 to 11 for individual SF-36 domains, except role limitations domains, which ranged from 15 to 18, and component scores, which were 3. When compared across stages of liver disease, PROMIS MSDs were generally similar, although they tended to be 0.5-1.0 points smaller in the decompensated population compared to the stable populations.

Conclusions: This study provides data-driven recommendations for MSDs, enhancing the interpretability of commonly used PROMs in liver disease and facilitating the integration of PROMs in various clinical and research settings.

肝病患者报告的结局测量评分有意义的差异
背景:患者报告结果测量(PROMs)在慢性肝病(CLD)临床护理和研究中越来越常用。通过建立最小的有意义分数差异(MSD),可以大大提高其可解释性。我们报告了不同阶段肝病患者常用PROMs及其MSDs的评分。方法:从2014年6月至2023年4月来自3个学术中心的2442名CLD成人患者中收集患者报告结局测量信息系统(PROMIS)-29概况、慢性肝病问卷(CLDQ)和短表格36 (SF-36) v1.0评分,分为4个不同阶段:住院失代偿性肝硬化患者(n=1146)和门诊肝硬化患者(n=677)或CLD患者(n=128)或肝移植患者(n= 490)。使用分布和基于锚点的方法估计msd。结果:研究样本的中位年龄为60.0岁(IQR: 51.0 ~ 66.0);55%为男性,17%为西班牙裔,84%为白人,49%为大学学历。CLD的病因为酒精(36%)、代谢功能障碍相关脂肪性肝炎(MASH)(31%)和病毒性乙型/丙型肝炎(26%)。一般而言,住院患者的PROMIS结构域评分中位数最低,移植后评分最高。对于PROMIS,基于分布和基于锚点的msd在单个域的范围从3到4,在总结得分的范围从4到6。CLDQ的基于分布的msd为1,SF-36域的msd范围为7到11,角色限制域的msd范围为15到18,组件得分为3。当比较肝脏疾病的各个阶段时,PROMIS MSDs总体上是相似的,尽管失代偿人群的MSDs往往比稳定人群小0.5-1.0点。结论:本研究为msd提供了数据驱动的建议,增强了肝脏疾病中常用PROMs的可解释性,促进了PROMs在各种临床和研究环境中的整合。
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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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