4.2 Article

Minimal Clinically Important Difference for PROMIS Physical Function and Pain Interference in Patients Following Surgical Treatment of Distal Radius Fracture

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JOURNAL OF HAND SURGERY-AMERICAN VOLUME
卷 47, 期 2, 页码 137-144

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2021.08.025

关键词

Distal radius fracture; MCID; minimal clinically important difference; patient-reported outcomes; PROMIS

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The study aimed to estimate the minimal clinically important difference (MCID) of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) computer adaptive tests (CATs) in patients who underwent surgical treatment for distal radius fracture (DRF). The results showed significant differences in the changes in PROMIS PF and PI scores among patients who responded to the clinical anchor question. The anchor-based estimates were 5.2 for PROMIS PF and 6.8 for PI, while the distribution-based estimates were 3.8 for PROMIS PF and 3.7 for PI.
Purpose We estimated the minimal clinically important difference (MCID) for the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) computer adaptive tests (CATs) following surgical treatment of distal radius fracture (DRF). Methods Adult patients surgically treated between November 2017 and November 2020 for isolated DRF were identified. Demographic and patient-reported outcome data were extracted from the electronic health record. Outcomes of interest were the PROMIS PF and PI CATs. Inclusion criteria were met if: (1) PROMIS PF and PI scores were available at preoperative and postoperative visits; and (2) a postoperative clinical anchor question asking about overall response to treatment was answered. An anchor-based MCID estimate was determined by calculating the average absolute score change in PROMIS PF and PI for patients who indicated a mild change to the anchor question. A distribution-based MCID estimate was also calculated using the standard en-or of measurement and effect sizes of change. Result The changes in PROMIS PF and PI scores were significantly different between patients who gave responses of much change (n = 73), mild change (n = 51), and no change (n = 19) to the clinical anchor question. The average score changes in the mild change group for PROMIS PF and PI were 5.2 (SD, 3.7) and 6.8 (SD, 4.3) points, respectively, representing the anchor-based MCID estimates. The PROMIS PI anchor-based estimate was moderately con-elated with the preoperative score (r = -0.41), time between visits (r = -0.39), and age (r = 0.30). The distribution-based MCID estimates were 3.8 (SD, 1.3) and 3.7 (SD, 1.3) points for the PROMIS PF and PI, respectively. Conclusion The MCIDs were estimated as 5.2 and 6.8 for the PROMIS PF and PI CATs, respectively, following surgery for DRF. Copyright (C) 2022 by the American Society for Surgery of the Hand. All rights reserved.

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