Statistics In Brief: Minimum Clinically Important Difference—Availability of Reliable Estimates

Maltenfort, Mitchell; Díaz-Ledezma, Claudio

doi:10.1007/s11999-016-5204-6

Cited by 67 publications

(66 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This close match in score distributions is particularly important given that the distributions were not normal. Furthermore, the inherent variability of the ASES shoulder survey, as reflected by the MCID of 12 points for the ASES score, 18,29,31 is substantially greater than the uncertainty introduced by the CAT prediction. The paired score differences were symmetrically and randomly distributed (ie, clustered around zero, with only insignificant bias toward the CAT or full-form score being consistently higher), and only 0.07% of the differences were greater than the MCID.…”

Section: Discussionmentioning

confidence: 99%

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

Plummer

Abboud

Bell

et al. 2019

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

Background: Patient-reported outcome measures enable quantitative and patient-centric assessment of orthopedic interventions; however, increased use of these forms has an associated burden for patients and practices. We examined the utility of a computerized adaptive testing (CAT) method to reduce the number of questions on the American Shoulder and Elbow Surgeons (ASES) instrument. Methods: A previously developed ASES CAT system was applied to the responses of 2763 patients who underwent shoulder evaluation and treatment and had answered all questions on the full ASES instrument. Analyses to assess the accuracy of the CAT score in replicating the full-form score included the mean and standard deviation of both groups of scores, frequency distributions of the 2 sets of scores and score differences, Pearson and intraclass correlation coefficients, and Bland-Altman assessment of patterns in score differences. Results: By tailoring questions according to prior responses, CAT reduced the question burden by 40%. The mean difference between CAT and full ASES scores was À0.14, and the scores were within 5 points in 95% of cases (a 12-point difference is considered the threshold for clinical significance) and were clustered around zero. The correlation coefficients were 0.99, and the frequency distributions of the CAT and full ASES scores were nearly identical. The differences between scores were independent of the overall score, and no significant bias for CAT scores was found in either a positive or negative direction. Conclusion: The ASES CAT system lessens respondent burden with a negligible effect on score integrity. No institutional review board approval was required.

show abstract

Section: Discussionmentioning

confidence: 99%

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

Plummer

Abboud

Bell

et al. 2019

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

show abstract

“…Most studies have not recently been updated, and none of these studies attempted to evaluate the quality of the MCID methodology or aim for triangulation. Outside the field of COPD, systematic reviews have emerged that summarise, quantify and make a quality assessment of the MCIDs of patient-reported outcomes and functional status tests [31,[58][59][60][61][62][63][64]. Our study is the first to do so within the field of COPD.…”

Section: Introductionmentioning

confidence: 99%

Clinically relevant differences in COPD health status: systematic review and triangulation

et al. 2018

View full text Add to dashboard Cite

The minimal clinically important difference (MCID) quantifies when measured differences can be considered clinically relevant. This study aims to review and triangulate MCIDs of chronic obstructive pulmonary disease (COPD) health status tools.A systematic search in PubMed, EMBASE and Cochrane Library was conducted (Prospero #CRD42015023221). Study details, patient characteristics, MCID methodology and estimates were assessed and extracted by two authors. A triangulated mean was obtained for each tool's MCID, with two-thirds weighting for anchor-based and one-third for distribution-based results. This was then multiplied by a weighted factor based upon the study size and quality rating.Overall, 785 records were reviewed of which 21 studies were included for analysis. MCIDs of 12 tools were presented. General quality and risk of bias were average to good. Triangulated MCIDs for the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ) and St. George's Respiratory Questionnaire (SGRQ) were -2.54, -0.43 and -7.43 for improvement. Too few and/or too diverse studies were present to triangulate MCIDs of other tools.Evidence for the MCID of the CAT and CCQ was strong and triangulation was valid. Currently used MCIDs in clinical practice for the SGRQ (4) and Chronic Respiratory Questionnaire (0.5) did not match the reviewed content, for which the MCIDs were much higher. Using too low MCIDs may lead to an overestimation of the interpretation of treatment effects. MCIDs for deterioration were scarce, which highlights the need for more research.

show abstract

“…The latter are easier to come by, since all one needs is a dataset and a calculator; for example, MCIDs can be estimated as a function of the standard deviation of the data, and some studies find this approach to be robust [13]. But many observers [5,14]-including the authors [12] of the review in this month's Statistics in Brief article in Clinical Orthopaedics and Related Research 1 -believe that anchor-based calculations of the MCID, which define ''clinically important'' in relation to changes identified as important by the patients themselves, are more relevant to clinical practice. Although this approach can seem subjective, ultimately it is the patient's perception that matters most, and anchoring a MCID to a difference that patients have defined as important makes the most sense to us, as well.…”

mentioning

confidence: 99%

“…In this month's CORR 1 , Maltenfort and Diaz-Ledezma [12] provide the MCIDs for dozens of the mostcommonly used orthopaedic outcomes tools. Studies using outcomes tools for which no MCIDs are available should consider suggesting how large the effects would need to be for them to matter to patients, and they should justify those contentions.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Editorial: The Minimum Clinically Important Difference—The Least We Can Do

Leopold

Porcher

2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Statistics In Brief: Minimum Clinically Important Difference—Availability of Reliable Estimates

Cited by 67 publications

References 35 publications

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

A concise shoulder outcome measure: application of computerized adaptive testing to the American Shoulder and Elbow Surgeons Shoulder Assessment

Clinically relevant differences in COPD health status: systematic review and triangulation

Editorial: The Minimum Clinically Important Difference—The Least We Can Do

Contact Info

Product

Resources

About