Is there any guidance on the use of multi-state transition models w.r.t patient reported outcomes ? I am curious as most of the patient reported outcomes have multiple scales with scores for each scale (e.g EORTC QLQ C30 provides scores for 5 functional scales, 7 symptom scales and 1 global health / quality of life scale). The scores are standardized such that they range between 0 - 100 where 100 means the worst symptom or the best functional outcome. I would like to thank you for the discussion we had on a related topic here but will a multi-state transition model be a better choice for trial design and analysis ?