Minimal Clinically Important Difference After Carpal Tunnel Release Using the PROMIS Platform

Kazmers, Nikolas H.; Hung, Man; Bounsanga, Jerry; Voss, Maren Wright; Howenstein, Abby; Tyser, Andrew R.

doi:10.1016/j.jhsa.2019.03.006

Cited by 50 publications

(44 citation statements)

References 39 publications

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“…All studies used self-reported PROMIS data, no studies on proxy-reported data were found. Of these 50 studies, 10 studies used only distribution-based methods [49,50,52,55,58,66,68,74,75,77]; five studies estimated a minimal important difference (MID) rather than minimal important change (MIC) [44,62,63,72,73]; one study averaged estimates based on cross-sectional and longitudinal anchors as well as distribution-based estimates [84]; one study estimated a MIC value that referred to more than a minimal important change [92]; and two studies intended to calculate an anchor-based MIC but reported only a distribution-based MIC because the area under the ROC curve was considered too low [82,83]. Data from these 19 studies were not extracted.…”

Section: Resultsmentioning

confidence: 99%

Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures

et al. 2021

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We define the minimal important change (MIC) as a threshold for a minimal within-person change over time above which patients perceive themselves importantly changed. There is a lot of confusion about the concept of MIC, particularly about the concepts of minimal important change and minimal detectable change, which questions the validity of published MIC values. The aims of this study were: (1) to clarify the concept of MIC and how to use it; (2) to provide practical guidance for estimating methodologically sound MIC values; and (3) to improve the applicability of PROMIS by summarizing the available evidence on plausible PROMIS MIC values. We discuss the concept of MIC and how to use it and provide practical guidance for estimating MIC values. In addition, we performed a systematic review in PubMed on MIC values of any PROMIS measure from studies using recommended approaches. A total of 50 studies estimated the MIC of a PROMIS measure, of which 19 studies used less appropriate methods. MIC values of the remaining 31 studies ranged from 0.1 to 12.7 T-score points. We recommend to use the predictive modeling method, possibly supplemented with the vignette-based method, in future MIC studies. We consider a MIC value of 2–6 T-score points for PROMIS measures reasonable to assume at this point. For surgical interventions a higher MIC value might be appropriate. We recommend more high-quality studies estimating MIC values for PROMIS.

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Section: Resultsmentioning

confidence: 99%

Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures

et al. 2021

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“…In particular, many of the early investigations centered on the MCID of the PROMIS Physical Function questionnaire for spine, foot and ankle, and hand surgery. 5,16,32,34 In a psychometric comparison of the PROMIS Physical Function with the ASES score in patients undergoing shoulder arthroplasty, Fu et al 10 found that the PROMIS Physical Function was psychometrically inferior to the ASES and that the PROMIS UE may be a more appropriate PROMIS instrument in patients with shoulder disability. To our knowledge, this is the first study to evaluate clinically significant outcome measures of the PROMIS UE.…”

Section: Discussionmentioning

confidence: 99%

Establishing the Minimal Clinically Important Difference, Patient Acceptable Symptomatic State, and Substantial Clinical Benefit of the PROMIS Upper Extremity Questionnaire After Rotator Cuff Repair

Haunschild

Gilat

et al. 2020

Am J Sports Med

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Background: The Patient-Reported Outcome Measurement Information System Upper Extremity (PROMIS UE) questionnaire has been validated as an effective and efficient outcome measure after rotator cuff repair (RCR). However, definitions of clinically significant outcomes used in interpreting this outcome measure have yet to be defined. Purpose: To define clinically significant outcomes of the PROMIS UE questionnaire in patients undergoing arthroscopic RCR. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: We reviewed charts of consecutive patients undergoing RCR in our institution between 2017 and 2018 and included patients who were administered the PROMIS UE before surgery and 12 months after surgery. At 12 months postoperatively, patients were asked domain-specific anchor questions regarding their function and satisfaction after surgery, which were then used to determine the minimal clinically important difference (MCID), Patient Acceptable Symptomatic State (PASS), and substantial clinical benefit (SCB) using receiver operating characteristic and area under the curve (AUC) analysis. Univariate and multivariate logistic regression analysis was utilized to identify patient factors associated with clinically significant outcomes. Results: A total of 105 patients with RCR and minimum 12-month postoperative PROMIS UE were included in the analysis. The defined clinically significant outcomes were 4.87 for the MCID using a distribution-based method, 7.95 for the SCB (sensitivity, 0.708; specificity, 0.833; AUC, 0.760), and 39.00 for the PASS (sensitivity, 0.789; specificity, 0.720; AUC, 0.815). Among respondents, 79.0%, 62.9%, and 64.8% achieved the MCID, SCB, and PASS score thresholds, respectively. Workers’ compensation was negatively associated with achievement of the PASS. Lower preoperative PROMIS UE scores were associated with obtaining the MCID (odds ratio [OR], 0.871; P = .001) and the SCB (OR, 0.900; P = .040), whereas higher preoperative scores were predictive of achieving the PASS (OR, 1.111; P = .020). Conclusion: This study defines the clinically significant outcomes for the PROMIS UE after RCR, of which the majority of patients achieved the MCID, PASS, and SCB at 12 months after surgery. These thresholds should be considered in future study design and interpretation of PROMIS UE in patients with RCR.

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“…4 Anchor mean change methods AMC methods use an anchor question to compare outcomes of patients who respond different to the anchor question. 25 The first AMC method was conducted using the question "How is your satisfaction with the treatment result?" as an external anchor.…”

Section: Methodsmentioning

confidence: 99%

Determining the Minimally Important Change of the Michigan Hand outcomes Questionnaire in patients undergoing trigger finger release

Koopman

Kooij

Selles

et al. 2023

Journal of Hand Therapy

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Introduction:The Michigan Hand outcomes Questionnaire (MHQ) is a widely used instrument to evaluate treatment results for hand conditions. Establishing the Minimally Important Change (MIC) is essential for interpreting change in outcome that is clinically relevant. Purpose of the Study:The purpose of this study was to determine the MIC of the MHQ total and subscale scores in patients undergoing trigger finger release.Study Design: This is a prospective cohort study conducted between December 2011 and February 2020.Methods: Patients completed the MHQ prior to surgery and 3 months postoperatively. The MIC of the MHQ was determined using 5 anchor-based methods (ie, 2 anchor mean change methods and 3 receiver operating characteristic methods). The median MIC value was determined to represent the triangulated MIC.Results: A total of 1814 patients were included. The MIC for the MHQ total score ranged from 7.7 to 10.9, with a triangulated estimate of 9.3. The MIC estimates for 5 of 6 of the MHQ subscales ranged from 7.7 to 20.0. No MICs could be determined for the MHQ subscale "aesthetics" due to low correlations between the anchor questions and MHQ change scores.Conclusions: These MIC estimates can contribute to the interpretation of clinical outcomes following trigger finger release and for assessment of power in prospective trials.

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Minimal Clinically Important Difference After Carpal Tunnel Release Using the PROMIS Platform

Cited by 50 publications

References 39 publications

Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures

Minimal important change (MIC): a conceptual clarification and systematic review of MIC estimates of PROMIS measures

Establishing the Minimal Clinically Important Difference, Patient Acceptable Symptomatic State, and Substantial Clinical Benefit of the PROMIS Upper Extremity Questionnaire After Rotator Cuff Repair

Determining the Minimally Important Change of the Michigan Hand outcomes Questionnaire in patients undergoing trigger finger release

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