Minimal clinically important decline in physical function over one year: EPOSA study

BMC Musculoskeletal Disorders

Laura A. Schaap¹  Suzan van der Pas¹  Dorly J. H. Deeg¹  Natasja M. van Schoor¹  Erik J. Timmermans¹  Antonella Gesmundo²  Sabina Zambon²  Michael D. Denkinger³  Richard Peter⁴  Florian Herbolsheimer⁴  Nancy L. Pedersen⁵  Rocio Queipo⁶  Ángel Otero⁶  Maria Victoria Castell⁶  Elaine M. Dennison⁷  Cyrus Cooper⁷  Mark H. Edwards⁸  Federica Limongi⁹  Paola Siviero⁹  Stefania Maggi⁹ 

[1] 0000 0004 0435 165X, grid.16872.3a, Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands;0000 0004 1757 3470, grid.5608.b, Department of Medicine, University of Padova, Via 8 Febbraio 2, 35122, Padova, Italy;0000 0004 1936 9748, grid.6582.9, Bethesda Geriatric Clinic, University of Ulm, Zollernring 26, 89073, Ulm, Germany;0000 0004 1936 9748, grid.6582.9, Institute of the History Philosophy and Ethics of Medicine, University of Ulm, Frauensteige 6, 89075, Ulm, Germany;0000 0004 1937 0626, grid.4714.6, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O.Box 281, Nobels väg 12A, SE-171 77, Stockholm, Sweden;0000000119578126, grid.5515.4, Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Arzobispo Morcillo 4, 28029, Madrid, Spain;MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD, Southampton, UK;MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD, Southampton, UK;0000 0004 0456 1761, grid.418709.3, Portsmouth Hospitals NHS Trust, PO6 3LY, Portsmouth, UK;National Research Council, Neuroscience Institute - Aging Branch, Via Giustiniani 2, ,35128, Padova, Italy;

关键词: Osteoarthritis;    MCID;    Functional decline;    Hand;    Hip/knee;    AUSCAN;    WOMAC;   

DOI  :  10.1186/s12891-019-2593-1

来源: publisher

【 摘 要 】

BackgroundThe Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities knee and hip Osteoarthritis Index (WOMAC) are the most commonly used clinical tools to manage and monitor osteoarthritis (OA). Few studies have as yet reported longitudinal changes in the AUSCAN index regarding the hand. While there are published data regarding WOMAC assessments of the hip and the knee, the two sites have always evaluated separately. The current study therefore sought to determine the minimal clinically important difference (MCID) in decline in the AUSCAN hand and WOMAC hip/knee physical function scores over 1 year using anchor-based and distribution-based methods.MethodsThe study analysed data collected by the European Project on Osteoarthritis, a prospective observational study investigating six adult cohorts with and without OA by evaluating changes in the AUSCAN and WOMAC physical function scores at baseline and 12–18 months later. Pain and stiffness scores, the performance-based grip strength and walking speed and health-related quality of life measures were used as the study’s anchors. Receiver operating characteristic curves and distribution-based methods were used to estimate the MCID in the AUSCAN and WOMAC physical function scores; only the data of those participants who possessed paired (baseline and follow up-measures) AUSCAN and WOMAC scores were included in the analysis.ResultsOut of the 1866 participants who were evaluated, 1842 had paired AUSCAN scores and 1845 had paired WOMAC scores. The changes in the AUSCAN physical function score correlated significantly with those in the AUSCAN pain score (r = 0.31). Anchor- and distribution-based approaches converged identifying 4 as the MCID for decline in the AUSCAN hand physical function. Changes in the WOMAC hip/knee physical function score were significantly correlated with changes in both the WOMAC pain score (r = 0.47) and the WOMAC stiffness score (r = 0.35). The different approaches converged identifying two as the MCID for decline in the WOMAC hip/knee physical function.ConclusionsThe most reliable MCID estimates of decline over 1 year in the AUSCAN hand and WOMAC hip/knee physical function scores were 4 and 2 points, respectively.

【 授权许可】

CC BY