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Minimally Important Difference for the Expanded Prostate Cancer Index Composite Short Form
- Skolarus, Ted A;
- Dunn, Rodney L;
- Sanda, Martin G;
- Chang, Peter;
- Greenfield, Thomas K;
- Litwin, Mark S;
- Wei, John T;
- Consortium, PROSTQA;
- Regan, Meredith;
- Hembroff, Larry;
- Wei, John T;
- Hamstra, Dan;
- Dunn, Rodney;
- Northouse, Laurel;
- Wood, David;
- Klein, Eric A;
- Ciezki, Jay;
- Michalski, Jeff;
- Andriole, Gerald;
- Litwin, Mark;
- Saigal, Chris;
- Greenfield, Thomas;
- Pisters, Louis;
- Kuban, Deborah;
- Sandler, Howard;
- Hu, Jim;
- Kibel, Adam;
- Dahl, Douglas;
- Zietman, Anthony;
- Chang, Peter;
- Wagner, Andrew;
- Kaplan, Irving;
- Sanda, Martin G
- et al.
Published Web Location
https://doi.org/10.1016/j.urology.2014.08.044Abstract
Objective
To establish a score threshold that constitutes a clinically relevant change for each domain of the Expanded Prostate Cancer Index Composite (EPIC) Short Form (EPIC-26). Although its use in clinical practice and clinical trials has increased worldwide, the clinical interpretation of this 26-item disease-specific patient-reported quality of life questionnaire for men with localized prostate cancer would be facilitated by characterization of score thresholds for clinically relevant change (the minimally important differences [MIDs]).Methods
We used distribution- and anchor-based approaches to establish the MID range for each EPIC-26 domain (urinary, sexual, bowel, and vitality/hormonal) based on a prospective multi-institutional cohort of 1201 men treated for prostate cancer between 2003 and 2006 and followed up for 3 years after treatment. For the anchor-based approach, we compared within-subject and between-subject score changes for each domain to an external "anchor" measure of overall cancer treatment satisfaction.Results
We found the bowel and vitality/hormonal domains to have the lowest MID range (a 4-6 point change should be considered clinically relevant), whereas the sexual domain had the greatest MID values (10-12). Urinary incontinence appeared to have a greater MID range (6-9) than the urinary irritation/obstruction domain (5-7).Conclusion
Using 2 independent approaches, we established the MIDs for each EPIC-26 domain. A definition of these MID values is essential for the researcher or clinician to understand when changes in symptom burden among prostate cancer survivors are clinically relevant.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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