Table 3 Qualitative categories for individualized minimally important difference (MID) comparison (n = 415)

Easier or simpler (n = 40 OP, n = 42 MHP)

One version is simpler, easier to complete, more efficient or shorter (less time consuming). Includes not wanting to interact with the patient

n = 76

"It is simpler"

n = 6

“Easier to in[t]erp[r]et”

n = 0

Too complicated (n = 17 OP, n = 13 MHP)

Converse of "Easier or Simpler" where one or both of the options seems complicated or difficult

n = 18

”Version 4 difficult to ascertain use.”

n = 0

n = 12

"Both are confusing and difficult to interpret for both provider and patient"

Better Results (n = 14 OP, n = 11 MHP)

One version would provide better symptom assessment or be easier to interpret or compare patients

n = 7

”easier to compare and evaluate for validity of the PRO.”

n = 18

"Better for interpretation"

n = 0

Equal (n = 20 OP, n = 19 MHP)

No preference or each have merit in different situations

n = 0

n = 0

n = 39

"I feel that both version would provide useful information."

Variability (n = 20 OP, n = 39 MHP)

Version 4 captures patient variability or what is important to the patient better. Also, Version 3 is not individualized enough or the clinician prefers to have control over meaningful response definition

n = 2

”Patient decisions differ based on different reasons”

n = 57

"Allows for individualized responses"

n = 0

Confusion (n = 2 OP, n = 2 MHP)

Indicates that person misunderstood description

n = 3

"I dont think arbitrary "5" difference is meaningful"

n = 0

n = 1

“Likely easier to follow”

Need more data (n = 2 OP, n = 2 MHP)

Need more information about the options to make a decision

n = 1

”do not understand #4”

n = 0

n = 3

"Not enough description"

Objective (n = 22 OP, n = 23 MHP)

One version is perceived as less biased or more standardized

n = 42

"Much more objective"

n = 2

“less patient bias”

n = 1

“too time consuming and subjective”

Patient centered (n = 20 OP, n = 21 MHP)

One version uses patient input whereas the other does not

n = 1

”Patient decisions differ based on different reasons”

n = 40

"Patient centered"

n = 0

Patients should not be the one's choosing (n = 7 OP, n = 9 MHP)

Patients aren't able to choose what's important to them or don't know what is most relevant to them or may be inconsistent. Also included are reasons to not use a patient-defined method like norms are already established

n = 14

"[Patient] won't do a good job deciding this"

n = 1

“di[s]cussing personally helps to dig into whats going on, rather than just getting an answer and hence establish whether its truly cor[r]elated vs its emotional connection”

n = 1

“if patients scores it, there a lot of variation in perception of their symptoms (stoic patients will always undertstate pain for example). Maybe its best to let physician score depending on patient answers”

Prefer clinical interview or don't see the value (n = 3 OP, n = 2 MHP)

Do not prefer either because they prefer clinical judgment or interview

n = 0

n = 0

n = 5

"I prefer clinical interview"

Foster Collaboration (n = 8 OP, n = 12 MHP)

Encouraging a discussion would be helpful or one fosters buy in

n = 0

n = 20

"Results will be more accurate and promotes a dialogue with the provider and patient"

n = 0

Patients don't want to complete PROs (n = 0 OP, n = 1 MHP)

Prefers neither because patients don't want to complete PROs in general

n = 0

n = 0

n = 1

"Patients do not take these PROs seriously and often complain about having to complete them"

Scale is not meaningful (n = 9 OP, n = 7 MHP)

Don't agree with 5 point change on Version 3 or think the 0–100 scale is terrible

n = 0

n = 2

“0–100 scales are pretty arbitrary. It will be hard for a patient to be consistent from time to time so as to know if a 5 point difference is significant.”

n = 14

"Range of 100 is too broad/vague"

Want to compare patients (n = 4 OP, n = 5 MHP)

One version is preferred because it allows comparison of patients or promotes uniformity, sometimes for comparison

n = 8

"Able to compare with different patients"

n = 1

“Helps with uniformity amongst patients”

n = 0