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Development and Validation of the Endometriosis Daily Pain Impact Diary Items to Assess Dysmenorrhea and Nonmenstrual Pelvic Pain

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Abstract

Daily diary-based dysmenorrhea and nonmenstrual pelvic pain impact items were developed and validated to measure efficacy in endometriosis clinical trial settings. Items were developed across 3 stages of qualitative research, and their psychometric properties were explored in a phase II randomized controlled trial. Eight focus groups, 20 semistructured telephone interviews, and 15 face-to-face concept elicitation and cognitive debriefing interviews constituted the qualitative phase of the research. Psychometric properties of reliability, convergent validity, and responsiveness of the dysmenorrhea and nonmenstrual pelvic pain daily items were examined quantitatively in a phase II clinical trial of an investigational endometriosis treatment. Both qualitative concept elicitation and cognitive debriefing research yielded wording for item response options that resonated with adult women with endometriosis. Daily assessment of dysmenorrhea and nonmenstrual pelvic pain impact was the preferred measurement approach among adult women with endometriosis. Quantitatively, correlations between the dysmenorrhea and nonmenstrual pelvic pain items and other measures of pain impact provided endorsement for the items’ convergent validity. Longitudinal measurement properties, involving test-retest reliability and sensitivity to change/responsiveness, offered evidence for the adequacy of the measurement properties of the daily diary-based dysmenorrhea and nonmenstrual pelvic pain impact items. Data from a phase II trial provided evidence that the daily dysmenorrhea and nonmenstrual pelvic pain impact items, developed and tested through qualitative research involving both focus groups and individual interviews, are well-defined, reliable, valid, and responsive for measuring the impact of pain in endometriosis to assess therapeutic response.

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References

  1. Missmer SA, Hankinson SE, Spiegelman D, et al. Reproductive history and endometriosis among premenopausal women. Obstet Gynecol. 2004;104(5 pt 1):965–974.

    Article  PubMed  Google Scholar 

  2. Giudice LC. Clinical practice. Endometriosis. N Engl J Med. 2010;362(25):2389–2398.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mayo Clinic. Endometriosis: Diagnosis & Treatment 2018. https://www.mayoclinic.org/diseases-conditions/endometriosis/diagnosis-treatment/drc-20354661. Accessed July 10, 2018.

    Google Scholar 

  4. Nnoaham KE, Hummelshoj L, Webster P, et al. Impact of endometriosis on quality of life and work productivity: a multi-center study across ten countries. Fertil Steril. 2011;96(2): 366–373.e8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jia SZ, Leng JH, Shi JH, Sun PR, Lang JH. Health-related quality of life in women with endometriosis: a systematic review. J Ovarian Res. 2012;5(1): 29.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Soliman AM, Yang H, Du EX, Kelley C, Winkel C. The direct and indirect costs associated with endometriosis: a systematic literature review. Hum Reprod. 2016;31(4):712–722.

    Article  PubMed  Google Scholar 

  7. Simoens S, Dunselman G, Dirksen C, et al. The burden of endo-metriosis: costs and quality of life of women with endometriosis and treated in referral centres. Hum Reprod. 2012;27(5): 1292–1299.

    Article  PubMed  Google Scholar 

  8. Biberoglu KO, Behrman SJ. Dosage aspects of danazol therapy in endometriosis: short-term and long-term effectiveness. Am J Obstet Gynecol. 1981;139(6):645–654.

    CAS  PubMed  Google Scholar 

  9. Dmowski WP, Radwanska E, Binor Z, Tummon I, Pepping P. Ovarian suppression induced with Buserelin or danazol in the management of endometriosis: a randomized, comparative study. Fertil Steril. 1989;51(3):395–400.

    Article  CAS  PubMed  Google Scholar 

  10. Dlugi AM, Miller JD, Knittle J. Lupron depot (leuprolide acetate for depot suspension) in the treatment of endometriosis: a rando-mized, placebo-controlled, double-blind study. Lupron Study Group. Fertil Steril. 1990;54(3):419–427.

    Article  CAS  PubMed  Google Scholar 

  11. Wheeler JM, Knittle JD, Miller JD. Depot leuprolide versus dana-zol in treatment of women with symptomatic endometriosis. I. Efficacy results. Am J Obstet Gynecol. 1992;167(1): 1367–1371.

    Article  CAS  PubMed  Google Scholar 

  12. Hornstein MD, Surrey ES, Weisberg GW, Casino LA. Leuprolide acetate depot and hormonal add-back in endometriosis: a 12-month study. Lupron Add-Back Study Group. Obstet Gynecol. 1998;91(1): 16–24.

    Article  CAS  PubMed  Google Scholar 

  13. Shaw RW. An open randomized comparative study of the effect of goserelin depot and danazol in the treatment of endometriosis. Zoladex Endometriosis Study Team. Fertil Steril. 1992;58(2): 265–272.

    Article  CAS  PubMed  Google Scholar 

  14. Crosignani PG, Luciano A, Ray A, Bergqvist A. Subcutaneous depot medroxyprogesterone acetate versus leuprolide acetate in the treatment of endometriosis-associated pain. Hum Reprod. 2006;21(1): 248–256.

    Article  CAS  PubMed  Google Scholar 

  15. Lockhat FB, Emembolu JO, Konje JC. The efficacy, side-effects and continuation rates in women with symptomatic endometriosis undergoing treatment with an intra-uterine administered proges-togen (levonorgestrel): a 3 year follow-up. Hum Reprod. 2005; 20(3):789–793.

    Article  CAS  PubMed  Google Scholar 

  16. Overton CE, Lindsay PC, Johal B, et al. A randomized, double-blind, placebo-controlled study of luteal phase dydrogesterone (Duphaston) in women with minimal to mild endometriosis. Fertil Steril. 1994;62(4):701–707.

    Article  CAS  PubMed  Google Scholar 

  17. Deal LS, DiBenedetti DB, Williams VS, Fehnel SE. The devel-opment and validation of the daily electronic endometriosis pain and bleeding diary. Health Qual Life Outcomes. 2010;8:64.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Vincent K, Kennedy S, Stratton P. Pain scoring in endometriosis: entry criteria and outcome measures for clinical trials. Report from the Art and Science of Endometriosis meeting. Fertil Steril. 2010;93(1): 62–67.

    Article  PubMed  Google Scholar 

  19. Taylor HS, Giudice LC, Lessey BA, et al. Treatment of endometriosis-associated pain with elagolix, an oral GnRH antagonist. N Engl J Med. 2017;377(1): 28–40.

    Article  CAS  PubMed  Google Scholar 

  20. Food and Drug Administration. Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. 2009. http://www.fda.gov/downloads/Drugs/Guidances/UCM193282.pdf. Accessed July 10, 2018.

    Google Scholar 

  21. Carr B, Guidice L, Dmowski WP, et al. Elagolix, an oral GnRH antagonist for endometrosis-associated pain: a randomized con-trolled study. J Endriomet Pelvic Pain Disord. 2013;5:105–115.

    Google Scholar 

  22. Jones G, Jenkinson C, Kennedy S. Development of the short form Endometriosis Health Profile Questionnaire: the EHP-5. Qual Life Res. 2004;13(3):695–704.

    Article  PubMed  Google Scholar 

  23. Muhr T. User’s Manual for ATLAS. ti 5.0, ATLAS.ti Scientific Software Development. Berlin, Germany: Scientific Software Development GmbH; 2004.

    Google Scholar 

  24. Hinkle DE, Jurs SG, Wiersma W. Applied Statistics for the Behavioral Sciences. Boston, MA: Houghton Mifflin; 1988.

    Google Scholar 

  25. Deyo RA, Diehr P, Patrick DL. Reproducibility and responsive-ness of health status measures. Control Clin Trials. 1991;12(4 suppl 1):142S–158S.

    Article  CAS  PubMed  Google Scholar 

  26. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174.

    Article  CAS  PubMed  Google Scholar 

  27. Hufford MR, Stone AA, Shiftman S, Schwartz JE, Broderick JE. Paper vs. electronic diaries: compliance and subject evaluations. Appl Clin Trials. August, 2002:38–43.

    Google Scholar 

  28. Stone AA, Shiffman S. Capturing momentary, self-report data: a proposal for reporting guidelines. Ann Behav Med. 2002;24(3): 236–243.

    Article  PubMed  Google Scholar 

  29. Dansie EJ, Turk DC. Assessment of patients with chronic pain. Br JAnaesth. 2013;111(1):19–25.

    Article  CAS  Google Scholar 

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Correspondence to Kristof Chwalisz MD, PhD.

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Wyrwich, K.W., O’Brien, C.F., Soliman, A.M. et al. Development and Validation of the Endometriosis Daily Pain Impact Diary Items to Assess Dysmenorrhea and Nonmenstrual Pelvic Pain. Reprod. Sci. 25, 1567–1576 (2018). https://doi.org/10.1177/1933719118789509

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