Journal
JOURNAL OF CLINICAL EPIDEMIOLOGY
Volume 67, Issue 4, Pages 433-440Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jclinepi.2013.10.009
Keywords
Minimal clinically important difference; Questionnaires; Sensitivity and specificity; Item response theory; Rasch models; Patient-reported outcomes
Funding
- French National Research Agency [N-2010-PRSP-008-01]
- Institut de recherche en sante publique (IRESP) grant from Inserm
- Programme Hospitalier de Recherche Clinique (PHRC) national grant from French Ministry of Health, France
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Objectives: Determining the minimal clinically important difference (MCID) of questionnaires on an interval scale, the trait level (TL) scale, using item response theory (IRT) models could overcome its association with baseline severity. The aim of this study was to compare the sensitivity (Se), specificity. (Sp), and predictive values (PVs) of the MCID determined on the score scale (MCID-Sc) or the TL scale (MCID-TL). Study Design and Setting: The MCID-Sc and MCID-TL of the MOS-SF36 general health subscale were determined for deterioration and improvement on a cohort of 1,170 patients using an anchor-based method and a partial credit model. The Se, Sp, and PV were calculated using the global rating of change (the anchor) as the gold standard test. Results: The MCID-Sc magnitude was smaller for improvement (1.58 points) than for deterioration (-7.91 points). The Se, Sp, and PV were similar for MCID-Sc and MCID-TL in both cases. However, if the MCID was defined on the score scale as a function of a range of baseline scores, its Se, Sp, and PV were consistently higher. Conclusion: This study reinforces the recommendations concerning the use of an MCID-Sc defined as a function of a range of baseline scores. (C) 2014 Elsevier Inc. All rights reserved.
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