Fig. 4

Patient Engagement In Research Scale (PEIRS) scores across phases I and II. PEIRS scores measure the degree of meaningful patient engagement across both stages of this COA research, from a patient perspective. The PEIRS-22 scoring manual [32] distributes the 22 items of the PEIRS-22 across three levels of meaningful engagement in research. Advanced engagement (gold level) is the most difficult to achieve as positive experiences of those important elements of meaningful engagement are least often reported by patient experts. Intermediate engagement (silver) and foundational engagement (bronze) reflect the aspects that are moderately and least difficult to achieve, respectively. COA clinical outcomes assessment, PEIRS Patient Engagement In Research Scale