Canada Research Chair in Medical AI @ uOttawa / CHEO RI & Scholar-in-Residence at the Office of the Information and Privacy Commissioner of Ontario
This latest publication based on our work with the medical oncology team at the Ottawa Hospital examines the measurement of the severity of hot flashes in women undergoing treatment for breast cancer. Hot flashes can reduce the quality of life and are related with treatment discontinuation. One of the key points in this work was the measurement of change. Usually the minimal clinically important difference (MCID) is used to determine if a change is big enough. For example, when evaluating interventions that can help with hot flashes, a change of two points on a standardized hot-flashes-severity scale is considered clinically meaningful. However, we know from the measurement of pain that whether a change is meaningful for a patient depends on the baseline (for example, whether the baseline pain was low or high). We therefore developed a scoring scheme for a standardized hot flashes measure examining the impact of the baseline on the meaningfulness of a change from the patient's perspective. It turns out that change is most meaningful at high baselines (i.e., when the severity of hot flashes is already high at baseline). So at high severity baselines an improvement or deterioration has a larger impact on the patients' perceptions. When the severity baseline is low the patients do not perceive changes (up or down) as being very meaningful. This means that future studies evaluating interventions they should focus on recruiting patients with high severity at baseline rather than try to cover the full distribution of hot flashes severity. The study then used that change score to evaluate a number of different interventions in a cohort study.
Director, Clinical Practice Research Datalink (CPRD)
9moVery interesting- thanks for sharing!