A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke

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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Responsiveness, Minimal Detectable Change, and Minimal Clinically Important Difference of the Nottingham Extended Activities of Daily Living Scale in Patients With Improved Performance After Stroke Rehabilitation

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2011.03.008 ◽

2011 ◽

Vol 92 (8) ◽

pp. 1281-1287 ◽

Cited By ~ 32

Author(s):

Ching-yi Wu ◽

Li-ling Chuang ◽

Keh-chung Lin ◽

Shin-da Lee ◽

Wei-hsien Hong

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Stroke Rehabilitation ◽

Minimal Clinically Important Difference ◽

Minimal Detectable Change ◽

Detectable Change ◽

Clinically Important Difference ◽

Improved Performance

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The King’s Brief Interstitial Lung Disease (KBILD) questionnaire: an updated minimal clinically important difference

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2018-000363 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000363 ◽

Cited By ~ 8

Author(s):

Aish Sinha ◽

Amit Suresh Patel ◽

Richard J Siegert ◽

Sabrina Bajwah ◽

Toby M Maher ◽

...

Keyword(s):

Interstitial Lung Disease ◽

Lung Disease ◽

Minimal Clinically Important Difference ◽

Scale Transformation ◽

Global Rating ◽

Longitudinal Assessment ◽

Hrqol Questionnaire ◽

Clinically Important Difference ◽

The Mean ◽

Small Change

IntroductionThe King’s Brief Interstitial Lung Disease (KBILD) is a 15-item validated health-related quality of life (HRQOL) questionnaire. The method of scoring the KBILD has recently changed to incorporate a logit-scale transformation from one that used raw item responses, as this is potentially a more linear scale. The aim of this study was to re-evaluate the KBILD minimal clinically important difference (MCID) using the new logit -transformed scoring.Methods57 patients with interstitial lung disease (17 idiopathic pulmonary fibrosis, IPF) were asked to complete the KBILD questionnaire on two occasions in outpatient clinics. At the second visit, patients also completed a 15-item global rating of change of health status questionnaire (GRCQ). The MCID was calculated as the mean of four different methods: the change in KBILD for patients indicating a small change in GRCQ, patients with a 7%–12% change in FVC, 1 SE of measurement of baseline KBILD and effect size (ES) of 0.3.ResultsThe mean (SD) KBILD total score for all patients was 55.3 (15.6). 16 patients underwent a therapeutic intervention. 36 patients reported a change in their condition on the GRCQ; 22 deteriorated, 14 improved and 21 were unchanged. There was a significant change in KBILD total score in patients reporting a change in GRCQ; mean (SD) 57.0 (13.6) versus 50.0 (9.7); mean difference 7.0; 95% CI of difference 3.0 to 11.0; p<0.01. The change in KBILD total score correlated with the GRCQ scale; r=−0.49, p<0.01. The mean KBILD total score MCID was 5. The MCID of KBILD domains were 6 for Psychological, 7 for Breathlessness and Activities, and 11 for Chest Symptoms.ConclusionThe KBILD is a responsive tool for longitudinal assessment of HRQOL in patients with ILD. The MCID of the KBILD total score is a 5-unit change.

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Assessing the Stroke-Specific Quality of Life for Outcome Measurement in Stroke Rehabilitation: Minimal Detectable Change and Clinically Important Difference

Health and Quality of Life Outcomes ◽

10.1186/1477-7525-9-5 ◽

2011 ◽

Vol 9 (1) ◽

pp. 5 ◽

Cited By ~ 33

Author(s):

Keh-chung Lin ◽

Tiffany Fu ◽

Ching-yi Wu ◽

Ching-ju Hsieh

Keyword(s):

Quality Of Life ◽

Stroke Rehabilitation ◽

Outcome Measurement ◽

Minimal Detectable Change ◽

Detectable Change ◽

Clinically Important Difference

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Definition of Nonresponse to Analgesic Treatment of Arthritic Pain: An Analytical Literature Review of the Smallest Detectable Difference, the Minimal Detectable Change, and the Minimal Clinically Important Difference on the Pain Visual Analog Scale

International Journal of Inflammation ◽

10.4061/2011/231926 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 57

Author(s):

Melissa E. Stauffer ◽

Stephanie D. Taylor ◽

Douglas J. Watson ◽

Paul M. Peloso ◽

Alan Morrison

Keyword(s):

Minimal Clinically Important Difference ◽

Minimal Detectable Change ◽

Detectable Change ◽

Analog Scale ◽

Analgesic Treatment ◽

Clinically Important Difference ◽

Detectable Difference ◽

Pain Visual Analog Scale ◽

Smallest Detectable Difference ◽

Definition Of

Our objective was to develop a working definition of nonresponse to analgesic treatment of arthritis, focusing on the measurement of pain on the 0–100 mm pain visual analog scale (VAS). We reviewed the literature to assess the smallest detectable difference (SDD), the minimal detectable change (MDC), and the minimal clinically important difference (MCID). The SDD for improvement reported in three studies of rheumatoid arthritis was 18.6, 19.0, and 20.0. The median MDC was 25.4 for 7 studies of osteoarthritis and 5 studies of rheumatoid arthritis (calculated for a reliability coefficient of 0.85). The MCID increased with increasing baseline pain score. For baseline VAS tertiles defined by scores of 30–49, 50–65, and >65, the MCID for improvement was, respectively, 7–11 units, 19–27 units, and 29–37 units. Nonresponse can thus be defined in terms of the MDC for low baseline pain scores and in terms of the MCID for high baseline scores.

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Responsiveness, minimal detectable change, and minimal clinically important difference of the sitting balance scale and function in sitting test in people with stroke

Physiotherapy Theory and Practice ◽

10.1080/09593985.2020.1756016 ◽

2020 ◽

pp. 1-10

Author(s):

Jehad Alzyoud ◽

Ann Medley ◽

Mary Thompson ◽

Linda Csiza

Keyword(s):

Minimal Clinically Important Difference ◽

Minimal Detectable Change ◽

Detectable Change ◽

Balance Scale ◽

Clinically Important Difference ◽

Sitting Balance ◽

And Function

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Minimal clinically important difference and minimal detectable change of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) amongst patients with chronic musculoskeletal pain

Clinical Rehabilitation ◽

10.1177/0269215520942573 ◽

2020 ◽

Vol 34 (12) ◽

pp. 1506-1511

Author(s):

Niina Katajapuu ◽

Ari Heinonen ◽

Mikhail Saltychev

Keyword(s):

Musculoskeletal Pain ◽

Minimal Clinically Important Difference ◽

Chronic Musculoskeletal Pain ◽

World Health ◽

Minimal Detectable Change ◽

Average Intensity ◽

Detectable Change ◽

Whodas 2.0 ◽

Clinically Important Difference ◽

The Mean

Objectives: The aim of this study is to estimate a minimal clinically important difference (MCID) and a minimal detectable change (MDC) of the 12-item WHODAS 2.0 amongst patients with chronic musculoskeletal pain. Design: Cross-sectional cohort study. Setting: Outpatient Physical and Rehabilitation Medicine clinic. Subjects: A total of 1988 consecutive patients with musculoskeletal pain. Interventions: A distribution-based approach was employed to estimate a minimal clinically important difference, a minimal detectable change, and a minimal detectable percent change (MDC%). Results: The mean age of the patients was 48 years, and 65% were women. The average intensity of pain was 6,3 (2.0) points (0–10 numeric rating scale) and the mean WHODAS 2.0 total score was 13 (9) points out of 48. The minimal clinically important difference ranged between 3.1 and 4.7 points. The minimal detectable change was 8.6 points and minimal detectable % change was unacceptably high 66%. Conclusions: Amongst patients with chronic musculoskeletal pain, the 12-item WHODAS 2.0 demonstrated a high minimal detectable change of almost nine points. As the minimal detectable change exceeded the level of minimal clinically important difference, nine points were considered to be the amount of change perceived by a respondent as clinically significant.

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Minimal clinically important difference of the 6-min walking test in patients with asthma

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.20.0928 ◽

2021 ◽

Vol 25 (3) ◽

pp. 215-221

Author(s):

E. Zampogna ◽

N. Ambrosino ◽

R. Centis ◽

F. Cherubino ◽

G. B. Migliori ◽

...

Keyword(s):

Outcome Measures ◽

Operating Characteristic ◽

Minimal Clinically Important Difference ◽

Walking Ability ◽

Walking Test ◽

Receiver Operating Characteristic Curves ◽

Clinically Important Difference ◽

Copd Assessment Test ◽

Before And After ◽

Perceived Change

BACKGROUND: The 6‐min walking test (6MWT) is responsive to physiological changes and pulmonary rehabilitation (PR) in patients with asthma. The minimal clinically important difference (MCID) has not been established yet.OBJECTIVE: To determine the MCID of 6MWT in patients with asthma.METHODS: Using the perceived change in walking ability and the modified Medical Research Council (mMRC) score as anchors, receiver operating characteristic curves and quantile regression, we evaluated 6MWT before and after PR in these patients. The St George Respiratory Questionnaire (SGRQ), the COPD assessment test (CAT) and other outcome measures were also assessed.RESULTS: Of 142 patients with asthma, 37 were enrolled. After PR, 6MWT increased from 453.4 m ± 88.8 to 493.0 m ± 97.2 (P = 0.0001); other outcome measures also increased. There was a slight correlation between baseline 6MWT and SGRQ, CAT and mMRC. No significant correlations were found between post‐PR changes in 6MWT and in other outcome measures. Comparing different methods of assessment, the MCID ranged from 26 m to 27 m.CONCLUSION: The most conservative estimate of the MCID of 6MWT after PR was 26 m in patients with asthma. This estimate may be useful in clinical interpretation of data, particularly in response to intervention studies.

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Responsiveness, Minimal Clinically Important Difference, and Validity of the MoCA in Stroke Rehabilitation

Occupational Therapy International ◽

10.1155/2019/2517658 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Ching-Yi Wu ◽

Shuan-Ju Hung ◽

Keh-chung Lin ◽

Kai-Hua Chen ◽

Poyu Chen ◽

...

Keyword(s):

Cognitive Deficits ◽

Minimal Clinically Important Difference ◽

Criterion Validity ◽

Stroke Survivors ◽

Future Studies ◽

Clinically Important Difference ◽

Stroke Impact Scale ◽

Impact Scale ◽

Before And After ◽

Larger Sample

Objective. Persons with stroke frequently suffer from cognitive impairment. The Montreal Cognitive Assessment (MoCA), a recently developed screening tool, is sensitive to poststroke cognitive deficits. The present study assessed its psychometric and clinimetric properties (i.e., responsiveness, minimal clinically important difference (MCID), and criterion validity) in stroke survivors receiving rehabilitative therapy. Method. The MoCA and the Stroke Impact Scale (SIS) were administered to 65 stroke survivors before and after 4 to 5 weeks of therapy. The effect size and standardized response mean (SRM) were calculated for responsiveness. Anchor- and distribution-based methods were used to estimate the MCID. Criterion validity was measured with the Spearman correlation coefficient. Results. The responsiveness of the MoCA was moderate (SRM=0.67). Participants exceeding the MCID according to the anchor- and distribution-based approaches were 33 (50.77%) and 20 (30.77%), respectively. Fair to good concurrent validity was reported between the MoCA and the SIS communication subscale. The MoCA had satisfactory predictive validity with the SIS communication and memory subscales. Conclusion. This study may support the responsiveness, MCID, and criterion validity of the MoCA in stroke populations. Future studies with larger sample sizes are needed to validate the current findings.

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