Jean Paty’s research while affiliated with IQVIA and other places

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Publications (115)


Myelofibrosis symptom assessment form total symptom score version 4.0: measurement properties from the MOMENTUM phase 3 study
  • Article
  • Full-text available

November 2024

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40 Reads

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2 Citations

Quality of Life Research

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Ruben Mesa

Purpose The Myelofibrosis Symptom Assessment Form version 4.0 (MFSAF v4.0) comprises 7 common MF symptom items (fatigue, night sweats, pruritus, abdominal discomfort, pain under the left ribs, early satiety, bone pain) and is the first patient-reported outcome (PRO) instrument designed to assess MF symptom burden. Given that information on the psychometric properties of this instrument has been limited, we sought to evaluate its measurement properties and validate its use in the phase 3 MOMENTUM trial. Methods Data were pooled to assess MFSAF item distribution, structural validity, reliability (test-retest and internal consistency), construct validity (convergent, divergent, and known-groups), and sensitivity to change. Other PRO measures included Patient Global Impression of Severity/Change (PGIS/PGIC), EORTC QLQ-C30, PROMIS Physical Function Short Form 10b, and ECOG performance status. Results Participants (N = 195) showed high completion rates (> 93%) across 24 weeks. Moderate to strong Spearman correlation coefficients among items were mostly observed at baseline (range, 0.289–0.772) and week 24 (range, 0.391–0.829), which supported combining items into a multi-item scale and total score. Internal consistency (Cronbach’s α, 0.877 at baseline and 0.903 at week 24) and test-retest reliability (intraclass correlation coefficient, > 0.829) were satisfactory across selected time intervals. Reliability was also supported by McDonald’s omega (ω) coefficient (> 0.875). MFSAF moderately correlated with PRO measures of similar content, differentiated between PGIS and ECOG groups (P < .001), and was able to detect change over time. Conclusions The MFSAF v4.0 is a valid tool to assess MF symptom burden, supporting its use in future trials in similar populations.

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Development of an Item Bank to Assess Patient-Reported Outcomes: Signs, Symptoms, and Impacts of COVID-19

July 2022

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23 Reads

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2 Citations

The Patient Patient-Centered Outcomes Research

Background and objective: Patients experience a wide range of signs, symptoms, and impacts related to coronavirus disease 2019 (COVID-19). A patient-reported outcome (PRO) item bank that measures the most relevant patient experiences is needed to fully evaluate treatment benefit in COVID-19 clinical trials. Methods: A review of the literature and social media informed a novel PRO item bank of COVID-19 signs, symptoms, and impacts and general pandemic impacts. Twenty 1:1 concept elicitation and cognitive debriefing interviews were conducted with adults in the US who had symptomatic COVID-19. A conceptual model was developed and the PRO item bank refined following interviews. Results: A heterogenous set of signs, symptoms, and impacts of COVID-19, as well as impacts associated with the pandemic overall, was identified. Fifty-five short-term and long-term signs and symptom items, 26 items assessing disease-related impacts, and seven items evaluating pandemic-related impacts are included in the item bank. Conclusions: The novel and preliminarily content-valid IQVIA COVID-19 Daily Diary Item Bank© and the IQVIA COVID-19 Weekly Diary Item Bank© were developed to measure signs and symptoms, their associated severity, and disease-related and pandemic-related impacts. The items are arranged in seven groups and can be individually selected based on research needs.


Fig. 1 Summary of patient findings: symptoms
Fig. 2 Summary of patient findings: impacts
Qualitative interviews to improve patient-reported outcome measures in late-onset Pompe disease: the patient perspective

October 2021

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141 Reads

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12 Citations

Orphanet Journal of Rare Diseases

Background: Late-onset Pompe Disease (LOPD) is a rare, heterogeneous disease manifested by a range of symptoms varying in severity. Research establishing the frequency of these symptoms and their impact on patients' daily lives is limited. The objective of this study was to develop a conceptual model that captures the most relevant symptoms and functional limitations experienced by patients with LOPD, to inform the development of new patient-reported outcome (PRO) tools. Methods: A preliminary conceptual model was constructed following a literature review and revised through interviews with expert clinicians to identify important and relevant concepts regarding symptoms and impacts of LOPD. This preliminary model informed the development of a qualitative patient interview guide, which was used to gather the patient perspective on symptoms and impacts relating to LOPD or its treatment (including symptom/impact frequency and levels of disturbance). Patient interviews aided further refinement of the conceptual model. The findings from the patient interviews were triangulated with the literature review and clinician interviews to identify the most relevant and significant effects of LOPD from the patient perspective. Results: Muscle weakness, fatigue, pain, and breathing difficulties (especially while lying down) were the most common and highly disturbing symptoms experienced by patients. Limitations associated with mobility (e.g., difficulty rising from a sitting position, getting up after bending) and activities of daily living, (e.g., reduced ability to participate in social/family activities or work/study) were the most frequently reported impacts with the highest levels of disturbance on the patient's daily life. These identified symptoms and impacts were included in the new conceptual model of disease. Conclusions: This qualitative patient interview study, also informed by a literature review and clinician interviews, identified the most frequent and relevant symptoms and the functional impact of LOPD on patients. The study interviews also captured the patient-preferred language to describe symptoms and impacts of LOPD. The results from this study can be used to develop future PRO instruments that are tailored to the specific symptoms and impacts experienced by patients with LOPD.


Fig. 1 Overview of the study. PROQOLID Patient-Reported Outcome and Quality of Life Instruments Database
Patient Global Impression of Benefit–Risk (PGI-BR): Incorporating Patients’ Views of Clinical Benefit–Risk into Assessment of New Medicines

June 2021

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201 Reads

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3 Citations

Drug Safety

IntroductionThere is a need to understand how patients assess perceived benefits and risks of treatments.Objectives The study aimed to (i) elucidate how patients evaluate treatment experiences and (ii) develop a brief patient-reported outcome (PRO) instrument for use across disease areas for perceived benefit–risk evaluation of a new medicine in a clinical trial setting.Methods Concepts relating to patient-perceived benefit–risk were identified from literature reviews and qualitative concept elicitation interviews with patients across a variety of primary medical conditions. Draft instrument items were developed from identified concepts and evaluated for clarity, relevance and appropriateness of response options in cognitive interviews. Items were iteratively revised to address patient feedback.ResultsQualitative interviews were conducted with 47 patients (primary condition: 20 oncological, 12 respiratory, 10 metabolic, 5 cardiovascular), of whom 32 contributed to concept elicitation and 42 to cognitive debriefing. Elicited concepts could be grouped into four medication-related categories: effectiveness of treatment, burden of side effects, convenience of use and overall acceptance/satisfaction. Cost, trial experience and altruism were additional concept categories unrelated to medication. The final instrument contained one item each on the medication’s effectiveness, side effects and convenience, and an overall item capturing patient benefit–risk assessment. An upfront question was included to separate out non-medication aspects of patients’ experiences.Conclusion We developed a brief PRO instrument, the Patient Global Impression of Benefit–Risk (PGI-BR), which can be applied across disease areas to assess patient views of benefit–risk of a new medicine in the clinical trial setting.




Figure 1. Treatment-related symptoms. (A) Mean scores over time from mixed model for repeated measures, and (B) proportion of dacomitinib patients with no or little problem after dose adjustments in treatment-related symptoms for diarrhea and sore mouth. (A) Baseline mean scores and 95% CI are calculated from descriptive analysis. The 95% CI is truncated to be in (0, 100). The lower reference has been set to 0 if it is below 0. Higher scores imply higher symptom burden. The upper reference line represents the highest baseline mean plus ten points and the lower reference line represents the lowest baseline mean minus ten points. Patients who have baseline and post-baseline measurements are included in the analysis. An asterisk at the cycles represents a statistically significant difference with a nominal p-value ≤0.05. Time is considered as a categorical variable with variance/covariance structure ARH(1). (B) Cycle 0 represents the distribution at the cycle of the first dose reduction and cycles 1-6 represents distributions in the first six cycles following the first dose reduction. BL: Baseline; LS: Least square.
Figure 3. Health-related quality of life. (A) Mean scores over time from mixed model for repeated measures, and (B) scores after dose adjustments in global health status/quality of life and physical function. (A) Baseline mean scores and 95% CI are calculated from descriptive analysis. The 95% CI is truncated to be in (0, 100). The lower reference has been set to 0 if it is below 0. Higher scores imply better health-related quality of life and functioning. The upper reference line represents the highest baseline mean plus ten points and the lower reference line represents the lowest baseline mean minus ten points. Patients who have baseline and post-baseline measurements are included in the analysis. An asterisk at the cycles represents a statistically significant difference with a nominal p-value ≤0.05. Time is considered as a categorical variable with variance/covariance structure ARH(1). (B) Cycle 0 represents the mean score at the cycle of the first dose reduction and cycles 1-6 represents the mean scores in the first six cycles following the first dose reduction. The 95% CI of mean absolute scale scores is truncated to be in (0, 100). BL: Baseline; EORTC-QLQ-C30: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; LS: Least square; QoL, Quality of life.
The Patient’s Perspective on Treatment with Dacomitinib: Patient-Reported Outcomes from the Phase III Trial ARCHER 1050

November 2020

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31 Reads

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2 Citations

Aim: Patient-reported symptoms, functioning and overall quality of life (QoL) were compared between dacomitinib and gefitinib in ARCHER 1050. Patients & methods: Patients (n = 448) with advanced EGFR mutation-positive non-small-cell lung cancer completed the EORTC-QLQ-C30 questionnaire and its lung-specific module, LC-13. Mean scores over time were analyzed using a mixed model for repeated measures. Results: Both treatments showed early improvement in disease-related symptoms that was maintained during treatment. Treatment-related diarrhea and sore mouth decreased following dose reduction with dacomitinib. There were no clinically meaningful changes in functioning and overall QoL in either treatment group. Conclusion: Longer treatment duration, enabled by dose reduction, allowed patients on dacomitinib to improve treatment-related symptoms and maintain functioning and overall QoL for longer than gefitinib. Trial registration: ClinicalTrials.gov identifier: NCT01774721


Citations (74)


... A second limitation is the potential subjectivity and sensitivity restrictions of the MFSAF for assessment of symptoms. However, this instrument captures the broad spectrum of symptoms of myelofibrosis and has been comprehensively validated, which has led to its use in clinical trials for myeloproliferative neoplasm patients 30 . ...

Reference:

Pelabresib plus ruxolitinib for JAK inhibitor-naive myelofibrosis: a randomized phase 3 trial
Myelofibrosis symptom assessment form total symptom score version 4.0: measurement properties from the MOMENTUM phase 3 study

Quality of Life Research

... Three qualitative studies reported the humanistic burden of people with focal epilepsy (Table S4). [71][72][73] Studies evaluated mental health (anxiety, depression, and stigma), symptoms and function (disease symptoms, postictal phenomena, functional impairment, return to normal activities), and disease management (coping strategies, self-management). A high level of burden was associated with everyday tasks and disease management. ...

Symptoms and Impacts in Epilepsy: Findings from Qualitative Patient Interviews (P1.5-009)
  • Citing Article
  • April 2019

Neurology

... Res. Public Health 2022, 19, 12775 2 of 24 abstinence [18]. Secondly, context not only influences behavior directly, but context can also shape individual factors that determine behavior, such as personality traits [16], personal preferences, and response patterns [19]. ...

Does Smoking Abstinence Self-Efficacy Vary Across Situations? Identifying Context-Specificity Within the Relapse Situation Efficacy Questionnaire

... The Oscar utilizes codes that may signify problems with the estimation of ABP readings. Based on prior research [93], we deleted readings associated with weak Korotkoff sounds, measurement timeout, and air leaks. Outliers associated with artifactual readings identified using criteria by Marler, Jacobs, Lehoczky, and Shapiro [94] were also discarded. ...

Effects of Task Strain, Social Conflict, and Emotional Activation on Ambulatory Cardiovascular Activity: Daily Life Consequences of Recurring Stress in a Multiethnic Adult Sample

... Such an outcome is for example seen in studies of mood, where negative affect may have floor effects accounting for substantial proportions of the observations. This article is motivated by a smoking cessation study (further described below) where a key outcome is smoking urge after having quit smoking (Shiffman et al., 1997). Figure 1 shows the histogram for this outcome where the categories range from 0 (no urge) to 10 (extremely strong urge) with 43% of the observations at the lowest value of 0. Ignoring this strong floor effect, using regular analysis with modeling assumptions suitable for a continuous-normal outcome, is likely to give misleading results. ...

A Day at a Time: Predicting Smoking Lapse From Daily Urge

Journal of Abnormal Psychology

... In the present study, payment for abstinence was highest on the initial 2 days of the abstinence attempt and these initial days of an abstinence attempt are particularly difficult for many cigarette users (e.g., Allen et al., 2008;Carpenter & Hughes, 2005). The current findings thus align with those reported in the literature suggesting that the early days of an abstinence attempt may be uniquely challenging for cigarette users, even when extrinsic incentives for abstinence are higher during these days as than during later days (e.g., Allen et al., 2008;Carpenter & Hughes, 2005;Hughes et al., 1994;Shiffman et al., 2009). We believe that the present findings are still interpretable outside of the context of abstinence timing because the analyses demonstrated that person-day mean craving did not differ on early (1-2) and later (3-10) days of the AIP (1-10). ...

Immediate antecedents of cigarette smoking: An analysis from ecological momentary assessment.
  • Citing Chapter
  • January 2009

... 5 In qualitative interviews, participants are asked open-ended questions, probing their experience with the disease in question, in order to elicit feedback on relevant concepts for inclusion in the measure (ie, concept elicitation). 5,6 To be in full alignment with FDA PRO guidance 7 and patient-focused drug development guidance documents, 8 this study, composed of both a targeted literature review and 30 qualitative patient interviews, aimed to evaluate the content validity of the CSDD and to determine if it is fit for the purpose of supporting efficacy endpoints in planned clinical trials of treatments for COVID- 19. In addition, the qualitative interviews provided the opportunity to obtain evidence to facilitate the interpretation of CSDD scores and meaningful change thresholds via the debriefing of patient global impression items (ie, impression of severity and return to usual activities and health). ...

Development of an Item Bank to Assess Patient-Reported Outcomes: Signs, Symptoms, and Impacts of COVID-19
  • Citing Article
  • July 2022

The Patient Patient-Centered Outcomes Research

... Patients with LOPD require increased medical care and support with daily activities, and many limit or cease their employment [23][24][25][26]. Patient-reported outcomes (PRO) measures are important endpoints to assess the impact of disease and therapeutic outcomes on patients' lives [27,28]. The Rasch-built Pompe-specific Activity (R-PAct) scale, a PRO instrument designed to evaluate disease progression in LOPD, explicitly assesses the limitations patients face in their daily activities and social participation [29]. ...

Qualitative interviews to improve patient-reported outcome measures in late-onset Pompe disease: the patient perspective

Orphanet Journal of Rare Diseases

... The present study helps to address some of the limitations of the PQAT instrument that were highlighted by Eek and colleagues. 10 Specifically, unlike the PQAT, the PQAT-RW was tested in a heterogeneous patient population and updated, as required, based on patient feedback. However, some limitations of our study should be noted. ...

Patient Global Impression of Benefit–Risk (PGI-BR): Incorporating Patients’ Views of Clinical Benefit–Risk into Assessment of New Medicines

Drug Safety

... Content analysis was led by MIT, with support from four additional student assistants. To ensure consistency and shared understanding, assistants were briefed on the project's aims, methods, and literature covering PD [4,7,19,22,[31][32][33][34][35], HRQoL, and related concepts [15][16][17][36][37][38][39][40]. A set of main categories and subcategories was derived in several analytical steps (see Fig. 1). ...

The qualitative development of the Pompe Disease Symptom Scale and the Pompe Disease Impact Scale
  • Citing Article
  • February 2021

Molecular Genetics and Metabolism