Application of the bother concept across cultures: A follow-up review of research and presentation of alternatives

In American English, the concept of bother is versatile in that it may connote negative mental states and physical sensations, as well as social disturbances. Because of this versatility, the concept has many different meanings across cultures. As a follow-up to the original analysis of bother as translated in Patient Reported Outcomes instruments, alternative concepts for measurement will be recommended and evaluated to determine achievement of conceptual equivalency in translation and respondent burden, as compared to bother. The disease used as a baseline for this analysis is psoriasis, as its symptoms can negatively impact patients physically, emotionally, and socially, presenting a challenge for creation of a measurement tool that encompasses all of these domains. 

This research was selected for presentation at ISPOR in Washington DC, June 2012, and cited by the FDA in their draft guidance on “Incorporating Clinical Outcome Assessments Into Endpoints For Regulatory Decision-Making” in April 2023.