Minimal Clinically Important Difference for PROMIS Physical Function in Patients With Distal Radius Fractures

Sandvall, Brinkley K.; Okoroafor, Ugochi C.; Gerull, William D.; Guattery, Jason; Calfee, Ryan P.

doi:10.1016/j.jhsa.2019.02.015

Cited by 77 publications

(46 citation statements)

References 25 publications

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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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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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“…Third, we analyzed whether the MCID estimated by each method can reflect true health changes at individual and group levels, which allowed us to determine the reliability of MCID and avoid the incorrect application or interpretation of the MCID. Although judging whether MCID differs from the measurement error is a logical next step after MCID estimation [42], only a few studies have done this [55,56]. Finally, there was no investigator-based measurement bias because both time-point surveys for each patient were performed by the same investigator.…”

Section: Discussionmentioning

confidence: 99%

Responsiveness and minimal clinically important difference of the EQ-5D-5L in cervical intraepithelial neoplasia: a longitudinal study

Jing

Zhang

et al. 2020

Health Qual Life Outcomes

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Background With the widespread clinical application of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L), whether the questionnaire scores are responsive to changes in patients’ health and how much changes in questionnaire scores represent patients’ real health changes require consideration. Consequently, we assessed responsiveness and estimated the minimal clinically important difference (MCID) of the EQ-5D-5L in surgically treated patients with cervical intraepithelial neoplasia (CIN) to determine the relationship between MCID and minimal detectable change (MDC). Methods We conducted a longitudinal, observational study. Participants were patients with CIN from the gynecology inpatient department of a grade-A tertiary hospital in Shihezi, Xinjiang, China. Participants completed the EQ-5D-5L and the Global Rating of Change Questionnaire (GRCQ) at baseline and one month post-surgery. The Wilcoxon signed-rank test was used to compare EQ-5D-5L scores pre- and post-treatment. We calculated the effect size (ES) and the standardized response mean (SRM) to quantitatively assess responsiveness. Distribution-based, anchor-based, and instrument-defined methods were used to estimate MCID. MCID to MDC ratios at individual- and group-levels were also calculated. Results Fifty patients with CIN completed the follow-up investigation (mean age 44.76 ± 8.72 years; mean follow-up time 32.28 ± 1.43 days). The index value and EQ visual analogue scale (EQ VAS) of the EQ-5D-5L improved by 0.025 and 6.92 (all p < 0.05) at follow-up as compared to baseline respectively. The ES and the SRM of the index value were 0.47 and 0.42 respectively, indicating small responsiveness; while the ES and the SRM of EQ VAS were 0.50 and 0.49 respectively, indicating small to moderate responsiveness. The average (range) of MCIDs for index value and EQ VAS were 0.039 (0.023–0.064) and 5.35 (3.12–6.99) respectively. These values can only be used to determine whether patients have experienced clinically meaningful health improvements at the group level. Conclusions The EQ-5D-5L has only small to moderate responsiveness in post-surgical patients with CIN, and the MCIDs developed in this study can be used for group-level health assessment. However, further study is needed concerning health changes at the individual level.

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“…The observed difference of 11.8 for the PROMIS PF median, however, is well above published minimal clinically important difference estimates between 2.8 and 3.6. 6,22 This is likely reflective of the fact that in contrast to the large ceiling effects of the upper extremity-specific metrics the PROMIS Physical Function CAT exhibited a relatively low ceiling effect of 6.7%. Only 18 of the study subjects reached the highest possible score using this metric.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the performance of PROMIS and QuickDASH instruments in an intercollegiate Division 1 athlete population

Tyser

Allen

Presson

et al. 2021

Journal of Shoulder and Elbow Surgery

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Minimal Clinically Important Difference for PROMIS Physical Function in Patients With Distal Radius Fractures

Cited by 77 publications

References 25 publications

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

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

Responsiveness and minimal clinically important difference of the EQ-5D-5L in cervical intraepithelial neoplasia: a longitudinal study

Evaluating the performance of PROMIS and QuickDASH instruments in an intercollegiate Division 1 athlete population

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