Data Based Threshold Determination for Presenting In-depth Case Finding Instruments

Objectives: Introduction: The web based interdisciplinary symptom evaluation (WISE) enables the time- and cost-effective collection of personalized, response-tailored data for comprehensive qualitative as well as symptom-focused quantitative analysis. Based on low (1) or high (2) symptom burden of checklist items, a heuristic algorithm uses these threshold values to form a gate for presenting more in-depth case finding instruments. Based on collected data, this study aimed at determining the optimal threshold for maximizing the probability of proper case identification.
Methods: Materials and methods: The following five in-depth case finding instruments were presented based on either a low or a high symptom burden during the preceding four weeks: Tinnitus Handicap Inventory (THI-12), ID-Migraine Screener, and Jaw Function Questionnaire (JFQ). The mean scores of each instrument were compared between the low and high symptom burden groups and differences analyzed using parametric statistical tests.
Results: On the THI-12, scores > 11 identify a moderate or severe tinnitus handicap. Taking into account one standard deviation of the mean, data reveal that only patients reporting a high ear noise related burden reach this score.
On the Migraine-screener, Scores > 2 discriminates migraine from other headaches. Taking into account one standard deviation of the mean, data reveal that only patients reporting a high headache related burden reach this score.
For the JFQ, no cut-off value exists for identifying clinically relevant jaw function limitation. Nonetheless, data reveal that only a high symptom burden on the related checklist items indicates a clinically relevant jaw function limitation.
Conclusions: In the WISE, a high symptom burden for related checklist items identifies cases that will likely report clinically relevant scores on the THI-12, ID-Migraine Screener, and JFQ as opposed to a low symptom burden.