Patients' ratings of global perceived change during 2 years were strongly influenced by the current health status

Abstract

Objectives: To investigate the longitudinal validity of patients' ratings of global perceived change (GPC) and to assess the implications of using the GPC as the anchor to determine the minimal important change (MIC).

Study design and setting: Secondary analysis of data from a multicenter study including 380 patients with disc-related sciatica with follow-ups at 3, 6, 12, and 24 months. The GPC scale ranged from much worse to completely gone. Five patient-reported outcome measures were used. An MIC was defined as the mean change score in the actual outcome measure for patients reporting being better. The influence of patients' current state and baseline scores on the GPC was analyzed by multivariate linear regression. Differences in the magnitude of the MIC between the 3- and 24-month recall periods were analyzed by hierarchical linear models.

Results: Across all recall periods and outcome measures, the GPC was strongly influenced by the patient's state at the time of asking. In four of five outcome measures, the magnitude of the MIC increased when recall increased from 3 to 24 months.

Conclusion: Caution is needed when using the GPC to determine the MIC of patient-reported outcome measures in patients with chronic conditions.

Keywords: Global perceived change; Minimal clinically important difference; Minimal important change; Outcome assessment; Recall bias; Transition rating.