Minimal important difference, patient acceptable symptom state and longitudinal validity of oxford elbow score and the quickDASH in patients with tennis elbow

BMC Medical Research Methodology

Research

Joona Juurakko¹  Teemu Karjalainen²  Clare L Ardern³  Mikko Salmela³  Tuomas Lähdeoja³  Teppo LN Järvinen³  Simo Taimela³ 

[1] Central Finland Healthcare District, Hospital Nova, Hoitajantie 3, 40620, Jyväskylä, Finland;Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland;Central Finland Healthcare District, Hospital Nova, Hoitajantie 3, 40620, Jyväskylä, Finland;Finnish Centre for Evidence-Based Orthopaedics (FICEBO), Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;

关键词: Clinimetrics;    DASH;    Oxford elbow score;    Tennis elbow;    Minimal clinically important change;    MID;    MCID;    Patient accepted symptom state;    PASS;   

DOI  :  10.1186/s12874-023-01934-4

 received in 2022-10-17, accepted in 2023-04-25,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe Oxford Elbow Score (OES) and the short version of Disabilities of Arms, Shoulder and Hand (QuickDASH) are common patient-reported outcomes for people with elbow problems. Our primary objective was to define thresholds for the Minimal Important Difference (MID) and Patient-Acceptable Symptom State (PASS) for the OES and QuickDASH. The secondary aim was to compare the longitudinal validity of these outcome measures.MethodsWe recruited 97 patients with clinically-diagnosed tennis elbow for a prospective observational cohort study in a pragmatic clinical setting. Fifty-five participants received no specific intervention, 14 underwent surgery (11 as primary treatment and 4 during follow-up), and 28 received either botulinum toxin injection or platelet rich plasma injection. We collected OES (0 to 100, higher is better) and QuickDASH (0 to 100, higher is worse), and global rating of change (as an external transition anchor question) at six weeks, three months, six months and 12 months. We defined MID and PASS values using three approaches. To assess the longitudinal validity of the measures, we calculated the Spearman’s correlation coefficient between the change in the outcome scores and external transition anchor question, and the Area Under the Curve (AUC) from a receiver operating characteristics (ROC) analysis. To assess signal-to-noise ratio, we calculated standardized response means.ResultsDepending on the method, MID values ranged from 16 to 21 for OES Pain; 10 to 17 for OES Function; 14 to 28 for OES Social-psychological; 14 to 20 for OES Total score, and − 7 to -9 for QuickDASH. Patient-Acceptable Symptom State (PASS) cut offs were 74 to 84 for OES Pain; 88 to 91 for OES Function; 75 to 78 with OES Social-psychological; 80 to 81 with OES Total score and 19 to 23 with Quick-DASH. OES had stronger correlations with the anchor items, and AUC values suggested superior discrimination (between improved and not improved) compared with QuickDASH. OES also had superior signal-to-noise ratio compared with QuickDASH.ConclusionThe study provides MID and PASS values for OES and QuickDASH. Due to better longitudinal validity, OES may be a better choice for clinical trials.Trial registrationClinicalTrials.gov NCT02425982 (first registered April 24, 2015).

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2023_38_Article_IEq47.gif