Advancing composite outcome measures: Insights on weighting components from OMERACT 2023

George A Wells; Francis Guillemin; Peter A Merkel; Maarten de Wit; Sarah Mackie; Lyn March; Gunnar Tómasson; Lauren K King; Sam Michel Cembalo; Shawna Grosskleg; Lara J Maxwell; Sara Monti; Kaitlin A Quinn; Beverley J Shea; Peter Tugwell; Dorcas Beaton

doi:10.1016/j.semarthrit.2024.152503

Advancing composite outcome measures: Insights on weighting components from OMERACT 2023

Semin Arthritis Rheum. 2024 Dec:69:152503. doi: 10.1016/j.semarthrit.2024.152503. Epub 2024 Jun 30.

Authors

George A Wells¹, Francis Guillemin², Peter A Merkel³, Maarten de Wit⁴, Sarah Mackie⁵, Lyn March⁶, Gunnar Tómasson⁷, Lauren K King⁸, Sam Michel Cembalo⁹, Shawna Grosskleg¹⁰, Lara J Maxwell¹¹, Sara Monti¹², Kaitlin A Quinn¹³, Beverley J Shea¹⁴, Peter Tugwell¹⁵, Dorcas Beaton¹⁶

Affiliations

¹ Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Canada; School of Epidemiology and Public Health, University of Ottawa, Canada; Department of Medicine, University of Ottawa, Canada. Electronic address: gawells@ottawaheart.ca.
² Université de Lorraine, Inserm, INSPIIRE, Nancy, France.
³ Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA.
⁴ OMERACT Patient research partner, Netherlands.
⁵ Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
⁶ Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital and Kolling Institute, Faculty of Medicine and Health Sydney MSK, University of Sydney, Australia.
⁷ Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Internal Medicine and Emergency Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
⁸ Department of Medicine, University of Toronto, Canada; Li Ka Shing Research Institute, St. Michael's Hospital, Unity Health Toronto, Canada.
⁹ Patient Research Partner, France.
¹⁰ OMERACT, Toronto, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada.
¹¹ Ottawa Hospital Research Institute, Centre for Practice Changing Research and Faculty of Medicine, University of Ottawa, Ottawa, Canada.
¹² IRCCS Istituto Auxologico Italiano, Immunorheumatology research laboratory, Milan, Italy.
¹³ National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland.
¹⁴ Bruyère Research Institute, Senior Methodologist, Ottawa Hospital Research Institute, Adjunct Professor, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
¹⁵ University of Ottawa, Department of Medicine, Faculty of Medicine, K1H 8M5, Ottawa, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, K1Y 4E9, Ottawa, Canada; University of Ottawa, School of Epidemiology and Public Health, Faculty of Medicine, K1H 8M5, Ottawa, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, K1R 7G5, Ottawa, Canada.
¹⁶ Senior Scientist, Institute for Work & Health, Toronto, ON.

PMID: 39236373
DOI: 10.1016/j.semarthrit.2024.152503

Abstract

Objective: The OMERACT Composite Working Group hosted a workshop at OMERACT 2023 to explore the complexities of weighting components in the development of composite outcomes. This study presents the methodology and findings of this workshop, exploring the complexities of weighting the individual components of composite outcome measures.

Methods: The workshop featured a multifaceted program, beginning with a plenary session that introduced the concept of composite outcomes, shared a patient's journey with rheumatic disease through a narrative, illustrated a composite outcome for Osteoarthritis Flares, and outlined the five domains selected for this composite outcome. A breakout exercise engaged participants in ranking and assigning weights to these domains, followed by group discussions to reach a consensus on weights. The workshop concluded with another plenary session that discussed various weighting approaches, including discrete choice and conjoint analysis from the ANCA-Associated Vasculitis working group, and outlined future directions for research on composite outcome methods.

Results: The breakout exercise revealed the challenges in assigning relative importance to different domains, highlighting the variability in participant perspectives. Consensus discussions highlighted the diversity in approaches to weighting, the need for appropriate methods to determine domain weights and the impact of such weights on the interpretation of composite scores.

Conclusion: The OMERACT 2023 workshop underscored the significance of a systematic approach to weighting components in composite outcome development. It highlighted the complexity of achieving consensus on the importance of domains and the role of incorporating the perspectives of patient research partners in this process. Future research directions include refining weighting methodologies, moving composites through the OMERACT Filter and enhancing understanding of their implications for clinical trials. The findings contribute to the ongoing discourse on optimizing composite outcome measures in rheumatology and beyond, advocating for a balanced integration of scientific rigour and patient-centeredness in their development.

Keywords: Arthritis; Composite; OMERACT; Outcome measure; Weighting.

MeSH terms

Humans
Outcome Assessment, Health Care*
Rheumatic Diseases* / therapy
Rheumatology