How Much Change in the FOSQ-10 in Clinically Meaningful?

A 10-item version of the Functional Outcomes of Sleep Questionnaire is analyzed.

For years, the Functional Outcomes of Sleep Questionnaire (FOSQ) has served as an important tool for patients to report on how daytime sleepiness has affected their ability to carry out daily tasks that healthy sleepers usually don’t think twice about such as driving, eating, or even talking to someone on the phone.

In the past, clinicians and researchers didn’t have clear guidelines to determine the minimal important distance for the FOSQ-10. However, a recent study explained just how the tool could be used to expand a providers’ understanding of their patients.

This recent breakthrough was made possible by the push among clinicians, researchers, and patients themselves to pay more attention to patients’ firsthand reports of their symptoms and how it affects the quality of their lives. In fact, in 2018, the FDA put out a digital tool that aims to make it even easier for patients to provide more data, like symptoms or medication use.

Terri Weaver, PhD, RN, FAAN, ATSF, dean of the University of Illinois at Chicago College of Nursing, has been behind the movement to give patients more platforms to share their perspectives for many years. In 1997, she coauthored the FOSQ, which would become a go-to self-report assessment for patients with narcolepsy and sleep apnea.

“It’s important for clinicians to look at patient perceptions of change in their quality of life, in addition to monitoring the physiological changes of individuals with daytime sleepiness,” says Weaver, who was recently named to the first class of fellows of the American Thoracic Society.

Years later in 2009, Weaver and her coauthor found a way to make the questionnaire even more accessible to patients—by abbreviating the original 30-question format to just 10. From there, other research questions emerged, such as: How do you measure whether a treatment approach is clinically meaningful using data from the FOSQ-10? In other words, Weaver and her colleagues sought out to find the ways to calculate the minimal important difference (MID) for the FOSQ-10.

In a SLEEP 2018 abstract, supported by Jazz Pharmaceuticals, she looked at the numbers from 690 patients and used distribution and anchor-based methods to find the minimal important difference for the FOSQ-10. The study concluded that clinicians can determine treatment efficacy if the MID for the FOSQ-10 ranges from 1.7 to 2.0 points for a population of adults with excessive daytime sleepiness.

“In practice, what this means is that if I’m a provider I have the tools to use these analyses to not only look at movement from the mean in terms of standard deviation, but also look at its relationship with the patient and provider’s assessment of change,” Weaver says.

Now that providers can have a way to track the differences in narcolepsy and obstructive sleep apnea patients’ daily functioning over a large span of time, providers can go off on more than just patient-supplied testimonials.

“The FOSQ is a very comprehensive assessment that helps providers better understand patients with excessive daytime sleepiness,” Weaver says.

Yoona Ha is a freelance writer and digital strategist.

from Sleep Review http://www.sleepreviewmag.com/2018/12/fosq-10-minimal-important-difference/

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