The importance of development standards for anchoring vignettes: an illustrative example from pediatric localized scleroderma quality of life.
PURPOSE
Anchoring vignettes (AVs) are a promising measurement technique to reduce bias in patient-reported outcome (PRO) measures by helping researchers understand differences in how individuals and groups interpret response options. However, little attention has been paid to ensure quality development of AVs, and their performance has not been well assessed in pediatric populations. In this study, we explore the application of a rigorous development process for AVs based upon current standards for PROs, as well as feasibility of AVs when administered to children and adolescents.


METHODS
We developed AVs using a rigorous, patient-centered mixed methods process including three phases: (1) development, (2) a pilot study, and (3) a field test. Our proposed process included the generation of a conceptual framework based on the PRO, the Localized Scleroderma Quality of Life Instrument, and numerous vignette-specific considerations. We qualitatively explored readability and comprehension of the AVs (pilot study) and then analyzed ranking patterns within vignette sets (field test).


RESULTS
Four sets of four vignettes were developed. Revisions were suggested at each phase of development. The pilot study demonstrated that children ≥ 10 years had no trouble indicating understanding of the AVs. In the field test, although appropriate rankings of vignettes were generally demonstrated by participants, the percentage of tied rankings was higher than expected in this pediatric group.


CONCLUSIONS
This work supports the need for rigorous developmental standards for AVs, as each stage of development suggested revisions. Additionally, AVs showed initial promise for use with pediatric populations; general feasibility and understanding were supported.
['Zigler|Christina K|CK|http://orcid.org/0000-0002-8996-7757', 'Jacobe|Heidi|H|http://orcid.org/0000-0001-5205-990X', 'Ardalan|Kaveh|K|http://orcid.org/0000-0001-5075-8846', 'Coles|Theresa M|TM|http://orcid.org/0000-0003-2941-8999', 'Lane|Suzane|S|', 'Schollaert|Kaila L|KL|http://orcid.org/0000-0001-9062-1772', 'Torok|Kathryn S|KS|http://orcid.org/0000-0002-1662-143X']
D000293:Adolescent D002648:Child D005260:Female D006801:Humans D008297:Male D000071066:Patient Reported Outcome Measures D010865:Pilot Projects D011594:Psychometrics D011788:Quality of Life D012015:Reference Standards D012594:Scleroderma, Localized D055815:Young Adult
Development standards Anchoring vignettes Pediatrics Patient-reported outcomes Mixed methods