Table 2:
Areas Identified for Future Research
| For all applications: |
| • To investigate approaches to address the inherent confusion associated with inconsistency in directionality across instruments. |
| • To explore whether the evidence supporting better interpretation accuracy and clarity associated with the “better” directionality may be informative for future measure development and application. Specifically, to investigate whether, when PROs are used and developed in the future, preference should be given to measures where higher scores always indicate better outcomes. |
| • To identify the specific score ranges associated with the descriptive y-axis labels (particularly those in the middle [e.g., mild, moderate]) for PRO instruments – and the best methods for identifying these score ranges. Specifically, while the extreme categories (e.g., none, severe) can generally be placed at the lowest and highest scores, for many PRO measures, the score ranges that would be considered mild or moderate, for example, may not have been established. Research is needed to identify the point ranges representing the middle categories (e.g., mild or moderate) for different PRO measures – and to identify methods for making these determinations. |
| For individual-level data |
| • To determine if indicating changes greater than the established minimally important difference for the instrument would be clinically valued in practice. |
| • To determine whether the proportionality of time on the x-axis is an important issue, and if it is, how to address it. |
| For research data presented to patients: |
| • To consider how the data indicating challenges with accurately interpreting normed scores may be important for clinical implementation. Specifically, given the evidence demonstrating challenges accurately interpreting normed scores for presentation to patients, further research is needed to investigate how to handle normed scores for this application of PRO data. |
| For research data presented to patients and to clinicians/researchers |
| • To identify effective approaches for indicating clinically important differences. |