Table 4 Floor and ceiling effects of patient-reported outcome measures in the Sickle Cell Disease Functional Assessment (N = 40)
From: The Sickle Cell Disease Functional Assessment (SCD-FA) tool: a feasibility pilot study
Measure | Mean ± SD | Range of participant scores | Lower and upper limits of measure | % (n) with floor effect* | % (n) with ceiling effect* | Action taken |
|---|---|---|---|---|---|---|
OARS ADL/IADL | 28 ± 1.4 | 20–28 | 0–28 | 0 (0%) | 88% (35)* | Will keep measure since it has low respondent burden and is an important marker of functional dependence in older adults in the general population. Will reassess floor and ceiling effects and validity in a larger sample of adults with SCD |
Physical Functioning Subscale of SF-36 | 77 ± 20 | 25–100 | 0–100 | 0% (0) | 10% (4) | Keep measure |
KPS – patient reported | 89 ± 11 | 60–100 | 0–100 | 0% (0) | 38% (15)* | Remove measure due to ceiling effect and redundancy with other measures in the functional status domain |
KPS – physician reported | 92 ± 9 | 60–100 | 0–100 | 0% (0) | 50% (20)* | Remove measure due to ceiling effect and redundancy with other measures in the functional status domain |
Falls/6 months | 0.2 ± 0.6 | 1–3 | > 0 | 88% (35)* | N/A | Keep measure despite floor effect given low respondent burden. Will need to assess the incidence of falls and validity of the measure in a larger sample of adults with SCD |
MHI-18 | 78 ± 14 | 27–100 | 0–100 | 0% (0) | 3% (1) | Remove due to issues with length and interpretability. Replace with PHQ-9 and GAD-7 for shorter length, familiarity with use in adults with SCD, and better interpretability |
MOS Social Support Survey | 70 ± 21 | 7–93 | 0–100 | 0% (0) | 0% (0) | Keep measure |
BOMC Test | 3.2 ± 3.6 | 0–14 | 0–28 | 40% (16)* | 0% (0) | Remove measure due to floor effect |
MoCA | 26 ± 3 | 19–30 | 0–30 | 0% (0) | 7.5% (3) | Remove measure due to respondent and administrative burden. Replaced with Mini-Cog |