Determination and comparison of the smallest detectable change (SDC) and the minimal important change (MIC) of four-shoulder patient-reported outcome measures (PROMs)

Journal of Orthopaedic Surgery and Research

Caroline B Terwee¹  Vanessa A B Scholtes²  Rene M Castelein³  Loes W A H van Beers²  W Jaap Willems²  Derk A van Kampen⁴ 

[1] Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam 1081, BT, The Netherlands;Department of Orthopaedic Surgery and Traumatology, OLVG Hospital, Amsterdam 1091, AC, The Netherlands;Department of Orthopaedic Surgery and Traumatology, University Medical Center Utrecht, Utrecht 3584, CX, The Netherlands;Department of Orthopaedic Surgery and Traumatology, Waterland Hospital, Waterlandlaan 250, Purmerend 1441 RN, The Netherlands

关键词: Oxford shoulder score;    Simple shoulder test;    DASH;    SDC;    MIC;    Interpretation;    PROM;    Shoulder;   

Others  :  814353
DOI  :  10.1186/1749-799X-8-40

 received in 2013-04-28, accepted in 2013-11-04,  发布年份 2013

【 摘 要 】

Background

There is a need for better interpretation of orthopedic treatment effects. Patient-reported outcome measures (PROMs) are already commonly used for patient evaluation. PROMs can be used to determine treatment effects in research as well as in clinical settings by calculating change scores, with pre- and post-treatment evaluation. The smallest detectable change (SDC) and minimal important change (MIC) are two important benchmarks for interpreting these change scores. The purpose was to determine the SDC and the MIC for four commonly used shoulder-related PROMs: Simple Shoulder Test (SST), Disabilities of the Arm, Shoulder and Hand (DASH and QuickDASH), and the Oxford Shoulder Score (OSS).

Methods

A cohort of 164 consecutive patients with shoulder problems visiting an orthopedic outpatient clinic completed the SST, DASH, and the OSS at their first visit and 6 months after operative or non-operative treatment. The SDC was calculated with a test re-test protocol (0–2 weeks). For the MIC, change scores (0–6 months of evaluation) were calculated in seven subgroups of patients, according to an additional self-administered ranking of change over time (anchor-based mean change technique). The MIC is defined as the average score of the ‘slightly improved’ group according to the anchor. The QuickDASH was computed from the DASH.

Results

The SDC of the SST was 2.8, DASH 16.3, QuickDASH 17.1, and OSS 6.0. The MIC change score for the SST was 2.2, DASH 12.4, QuickDASH 13.4, and OSS 6.0.

Conclusion

This study shows that on an individual patient-based level, when taking into account SDC and MIC, the change score should exceed 2.8 points for the SST, 16.3 points for the DASH, 17.1 points for the QuickDASH, and 6.0 points for the OSS to have a clinically relevant change on a PROM, which is not due to measurement error.

【 授权许可】

   
2013 van Kampen et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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