On the recoding of continuous and bounded indexes to a binomial form: an application to quality-of-life scores

The statistical analysis of patient-reported outcomes (PROs) as endpoints has shown to be of great practical relevance. The resulting scores or indexes from the questionnaires used to measure PROs could be treated as continuous or ordinal. The goal of this study is to propose and evaluate a recoding process of the scores, so that they can be treated as binomial outcomes and, therefore, analyzed using logistic regression with random effects. The general methodology of recoding is based on the observable values of the scores. In order to obtain an optimal recoding, the evaluation of the recoding method is tested for different values of the parameters of the binomial distribution and different probability distributions of the random effects. We illustrate, evaluate and validate the proposed method of recoding with the Short Form-36 (SF-36) Survey and real data. The optimal recoding approach is very useful and flexible. Moreover, it has a natural interpretation, not only for ordinal scores, but also for questionnaires with many dimensions and different profiles, where a common method of analysis is desired, such as the SF-36.