Establishing the minimal clinically important difference for the PROMIS Physical domains in cervical deformity patients

Objective: To determine the minimal clinically important difference of the Mini-BESTest in individuals’ post-stroke. Design: Prospective cohort study. Setting: Outpatient stroke rehabilitation. Subjects: Fifty outpatients with stroke with a mean (SD) age of 60.8 (9.4). Intervention: Outpatients with stroke were assessed with the Mini-BESTest before and after a course of conventional rehabilitation. Rehabilitation sessions occurred one to two times/week for one hour and treatment duration was 1.3–42 weeks (mean (SD) = 17.4(10.6)). Main measures: We used a combination of anchor- and distribution-based approaches including a global rating of change in balance scale completed by physiotherapists and patients, the minimal detectable change with 95% confidence, and the optimal cut-point from receiver operating characteristic curves. Results: The average (SD) Mini-BESTest score at admission was 18.2 (6.5) and 22.4 (5.2) at discharge (effect size: 0.7) ( P = 0.001). Mean change scores on the Mini-BESTest for patient and physiotherapist ratings of small change were 4.2 and 4.3 points, and 4.7 and 5.3 points for substantial change, respectively. The minimal detectable change with 95% confidence for the Mini-BESTest was 3.2 points. The minimally clinical importance difference was determined to be 4 points for detecting small changes and 5 points for detecting substantial changes. Conclusions: A change of 4–5 points on the Mini-BEST is required to be perceptible to clinicians and patients, and beyond measurement error. These values can be used to interpret changes in balance in stroke rehabilitation research and practice.

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Letter: Contemporary Analysis of Minimal Clinically Important Difference in the Neurosurgical Literature

Neurosurgery ◽

10.1093/neuros/nyab115 ◽

2021 ◽

Author(s):

Sumit Raj ◽

Pradeep Chouksey ◽

Adesh Shrivastava ◽

Rakesh Mishra ◽

Amit Agrawal

Keyword(s):

Minimal Clinically Important Difference ◽

Clinically Important Difference

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The ENDOPAIN 4D Questionnaire: A New Validated Tool for Assessing Pain in Endometriosis

Journal of Clinical Medicine ◽

10.3390/jcm10153216 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3216

Author(s):

Anne Puchar ◽

Pierre Panel ◽

Anne Oppenheimer ◽

Joseph Du Cheyron ◽

Xavier Fritel ◽

...

Keyword(s):

Minimal Clinically Important Difference ◽

Patient Reported Outcome ◽

Measurement Properties ◽

Dimensional Structure ◽

Clinically Important Difference ◽

Urinary Tract Symptoms ◽

New Instrument ◽

Patient Reported ◽

Good Internal Consistency ◽

Pain Symptoms

Objectives: To study the measurement properties, the responsiveness and the minimal clinically important difference of the ENDOPAIN-4D: a new questionnaire for assessing pain in endometriosis. Methods: A prospective, observational, multicentre study was conducted including all women ≥18 years consulting for symptomatic proven endometriosis between 1 January 2017 and 30 June 2018 and volunteering to participate. Each patient had to answer a new self-administered patient-reported outcome (PRO) questionnaires (the ENDOPAIN-4D) at inclusion (T0) and 12 months after medical or surgical treatment (T1). Criteria defined by COSMIN were used to validate the questionnaire's measurement properties. The minimal clinically important difference was estimated by the anchor-based method. Results: The study included 199 women. The ENDOPAIN-4D score had a four dimensional structure with good internal consistency (measured by Cronbach α): I) pain-related disability (α = 0.79), II) painful bowel symptoms (α = 0.80), III) dyspareunia (α = 0.83), and IV) painful urinary tract symptoms (α = 0.77). They produced four subscores that can be summed to obtain a single score (α = 0.61). The ENDOPAIN-4D total score ranged from 0 to 94.00 (mean ± SD: 46.7 ± 22). The total score was significantly correlated with the PROs used in endometriosis. Sensitivity to change was good with large effect sizes (ES) (mean of the differences: 36.3 p = 1.8 10−7, ES 0.76). The minimal clinically important difference of the global score was determined to be 10.9. Conclusions: The ENDOPAIN-4D questionnaire is easy to use, valid, and effective in assessing patient reported pain symptoms in women treated for endometriosis. This new instrument can be used as the primary outcome for future clinical trials and as a tool for routine patient follow-up.

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The Foot and Ankle Outcome Score (FAOS) During Early Recovery After Ankle Fracture

Foot & Ankle International ◽

10.1177/10711007211002811 ◽

2021 ◽

pp. 107110072110028

Author(s):

Peter Larsen ◽

Mohammed Al-Bayati ◽

Rasmus Elsøe

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Ankle Fracture ◽

Minimal Clinically Important Difference ◽

Ankle Fractures ◽

Foot And Ankle ◽

Early Recovery ◽

Clinically Important Difference ◽

Test Retest Reliability

Background: Several patient-reported outcome measures (PROMs) are available for assessing the outcomes following ankle fractures. This study aimed to evaluate validity, reliability, and responsiveness and detect the minimal clinically important difference of the Foot and Ankle Outcome Score (FAOS) in patients with ankle fractures. Methods: The study design is a prospective cohort study, including all patients treated both conservatively and surgically following an ankle fracture (AO-43A/B/C). Content validity, test-retest reliability, responsiveness, and minimal clinically important difference were evaluated from 14 days to 3 months following the fracture. Results: The study population consisted of 52 females and 24 males. The mean age was 52.0 years (range, 15-75 years). The percentage of patients at 12 weeks reporting the 5 subscales at least somewhat relevant were pain, 77%; symptoms, 75%; activities of daily living (ADL), 64%; sport, 81%; and quality of life (QOL), 88%. High test-retest reliability of the FAOS questionnaire was observed. The interclass coefficients were 0.78, 0.77, 0.71, 0.73, and 0.74 for the pain, symptoms, ADL, sport, and QOL subscales, respectively. Responsiveness was evaluated with high effect size for the symptoms (0.83), ADL (1.19), sport (4.36), and QOL (2.12) subscales. The minimal clinically important difference of the FAOS was 14 (95% CI, 12-17). Conclusion: The FAOS during early recovery after ankle fracture has high reliability and validity. Level of Evidence: Level II, prospective cohort study

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Development of machine learning algorithms to predict achievement of minimal clinically important difference for the KOOS‐PS following total knee arthroplasty

Journal of Orthopaedic Research® ◽

10.1002/jor.25125 ◽

2021 ◽

Author(s):

Akhil Katakam ◽

Aditya V. Karhade ◽

Austin Collins ◽

David Shin ◽

Charles Bragdon ◽

...

Keyword(s):

Machine Learning ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Minimal Clinically Important Difference ◽

Learning Algorithms ◽

Machine Learning Algorithms ◽

Clinically Important Difference ◽

Total Knee

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How much improvement can satisfy patients? Exploring patients’ satisfaction 3 years after total knee arthroplasty

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02514-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xiao Yu Fan ◽

Jin Hui Ma ◽

Xinjie Wu ◽

Xin Xu ◽

Lijun Shi ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Minimal Clinically Important Difference ◽

Important Change ◽

Score Change ◽

Patients Satisfaction ◽

Clinically Important Difference ◽

Total Knee ◽

Hss Score ◽

Varus Angle

Abstract Background Despite the innovations in total knee arthroplasty (TKA), there is still a subset of patients who do not acquire significant relief or expected satisfaction after primary TKA. However, this subgroup of patients still gains improvements more or less in terms of objective or quantified assessments after the procedure. The purpose of our study is to explore the factors that correlate with patients’ satisfaction and identify minimal clinically important difference (MCID) and minimum important change (MIC) in clinical parameters. Methods We conducted a retrospective study of 161 patients diagnosed with osteoarthritis who underwent unilateral total knee arthroplasty from January 2017 to December 2017. We collected the following parameters: body mass index (BMI), duration of disease, education level, depression state, preoperative flexion contracture angle of knee, HSS scores, 11-point NRS scores, and radiological parameters (preoperative minimal joint space width and varus angle of knee). The satisfaction was graded by self-reported scores in percentage (0–100). Results We revealed that 80.8% of patients were satisfied 3 years overall after primary TKA. HSS score change, NRS-Walking score change, age, and pre-mJSW showed significant difference between satisfied and dissatisfied group. The varus angle change revealed statistical significance according to the levels of satisfaction. Simple linear regression identified the MCID for HSS score to be 5.41 and for the NRS-Walking to be 1.24. The receiver operating characteristics (ROC) curve identified the MIC for HSS score to be 25.5 and for the NRS-Walking score to be 6.5. Conclusions In summary, we identified several factors that correlated with patients’ satisfaction independently after TKA in a long term. In addition, we revealed the minimal clinically important difference (MCID) and minimum important change (MIC) for HSS and NRS score in these patients.

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