Making results of patient-reported outcomes interpretable

Article type
Authors
Guyatt GH1, Patrick D2
1McMaster University, Canada
2University of Washington, USA
Abstract
Background: Patient-reported outcomes include reports of symptoms, health-related quality of life, and patient satisfaction. In some areas, patient-reported outcomes are typically primary outcomes; in others, they complement measures of morbidity and mortality. Patient-reported outcomes often present unique challenges in interpretation faced to a considerably lesser extent by other outcomes. Many of those who use Cochrane Reviews will be unfamiliar with the instruments used to measure patient experience, and they will find the significance of the differences expressed in natural units (the pooled differences between intervention and control was five units on instrument x) obscure. The challenge is compounded when several instruments using different units measure the same construct requiring standardized units for aggregation across studies.

Objectives: The presentation will describe the tools to make patient-reported outcomes interpretable to the audiences of their Cochrane Reviews. This presentation will address the methods available for making patient-reported outcomes readily understandable to the audience of Cochrane Reviews. Concepts that will be introduced include the minimal important difference (the smallest difference that would motivate a patient to use an intervention), the dichotomization of outcomes (e.g. proportion of patients who achieve a minimal important difference), and alternatives to the standardized mean difference as an approach to aggregating across different instruments measuring the same construct.