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Mode and Order Effects on HRQOL Scores: Practical Considerations in Clinical Outcomes Study

This study by Ron D. Hays et al. examines the impact of mode and order of administration on generic HRQOL scores using various measures like SF-36v2TM, QWB, EQ-5D, and HUI in patients undergoing health measurements over a span of 6 months. Analysis of survey dates, patient demographics, and HRQOL results reveals significant differences based on the mode and order of administration. The findings suggest that phone administration following mail tends to yield more positive HRQOL reports compared to the reverse sequence. The study emphasizes caution in interpreting HRQOL estimates when the mode or order of administration varies, as even small changes can have noticeable effects.

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Mode and Order Effects on HRQOL Scores: Practical Considerations in Clinical Outcomes Study

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  1. Effects of Mode and Order of Administration on Generic HRQOL Scores? Ron D. Hays, Seong Eun Kim, Karen Spritzer, and Honghu Liu UCLA 1:00-2:00 pm

  2. Health Measurement in Patients Tracking Clinical Outcomes Study • Self-administration (mail) of HRQOL measures at baseline, 1 month, 3 months, and 6 months post-baseline. • SF-36v2TM, QWB, EQ-5D, HUI • Telephone interview at 6 months post-baseline • Participants randomized to order of mail/phone administration at 6 months

  3. Analysis • Differences in days between survey dates • -133 to 54 days (mail – phone) • 57% were within 3 weeks • 318 patients at 6 months: • 92 heart failure • 226 cataract surgery • Random intercept model (PROC Mixed), controlling for gender, age, race, education, and site (UCSD, UCLA, Wisconsin by heart failure and cataract).

  4. Means by Mode and Order

  5. Project 1 Later order of administration in telephone interview is significantly related to: - More positive HRQOL reports for EQ-5D (VA and U.S. preference score) and SF-36 (6D, PCS, MCS) - More negative for QWB-SA

  6. Max. Differences by HRQOL Measure

  7. Test-Retest Reliability Estimates

  8. Correlations among HRQOL Measures

  9. Results • The most positive generic HRQOL scores tend to be obtained when the measures are administered by phone after a mail administration whereas the least positive scores occur by mail after a phone administration. • Effect sizes range from small to moderate

  10. Conclusions • No doubt that these are differences that are beyond minimally important • Caution is needed when comparing HRQOL estimates if mode or order of administration varies

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