Research Unit, Hospital Galdakao-Usansolo - CIBER Epidemiología y Salud Pública, Galdakao, Vizcaya, Spain.
Am J Ophthalmol. 2011 Aug;152(2):234-243.e3. doi: 10.1016/j.ajo.2011.01.045. Epub 2011 Jun 17.
To determine the minimal clinically important difference and the patient acceptable symptom state for visual acuity and visual function, 2 key visual outcomes for patients undergoing cataract extraction, as an aid for evaluating the outcome of cataract extraction.
Prospective cohort study.
Multicenter study of 17 hospitals.
A total of 4335 consecutive patients advised to undergo cataract extraction.
Sociodemographic and clinical data, including visual acuity (VA), patient satisfaction, and responses to the Visual Function Index 14 (VF-14) and transitional questions were collected before and after cataract extraction. The patient acceptable symptom state and minimal clinically important difference were estimated for the entire sample and for subgroups by preintervention status and presence of ocular comorbidities.
Among patients with simple cataract, postintervention patient acceptable symptom state values for VA ranged from 0.67 to 0.80, depending on preintervention VA, while VF-14 scores ranged from 88 to 90. For patients with any additional ocular comorbidity, VA ranged from 0.63 to 0.75, depending on preintervention VA, while VF-14 scores ranged from 86 to 92. For the entire sample, postintervention patient acceptable symptom state values were 0.75 for VA and 86.1 for VF-14 scores. Minimal clinically important difference for patients who reported being a little better ranged from 0.17 to 0.5 in VA and 0.41 to 37.46 in VF-14 scores, depending on preintervention status and presence of ocular comorbidities.
The minimal clinically important difference and patient acceptable symptom state values are complementary parameters that may help in the clinical decision-making process by providing more meaningful estimates of the impact of cataract extraction on 2 important outcomes, visual acuity and visual function.
确定视力和视觉功能的最小临床重要差异和患者可接受的症状状态，这是接受白内障摘除手术的患者的 2 个关键视觉结果，以帮助评估白内障摘除手术的结果。
前瞻性队列研究。
在 17 家医院进行的多中心研究。
共纳入 4335 例连续建议接受白内障摘除术的患者。
收集患者白内障摘除术前和术后的社会人口统计学和临床数据，包括视力（VA）、患者满意度以及对视觉功能指数 14（VF-14）和过渡性问题的反应。根据术前状态和眼部合并症的存在，对整个样本和亚组分别估计了患者可接受的症状状态和最小临床重要差异。
在单纯性白内障患者中，术后患者可接受的症状状态值（VA）在 0.67 到 0.80 之间，具体取决于术前 VA，而 VF-14 评分在 88 到 90 之间。对于任何其他眼部合并症患者，VA 范围为 0.63 到 0.75，具体取决于术前 VA，而 VF-14 评分范围为 86 到 92。对于整个样本，术后患者可接受的症状状态值为 VA 的 0.75 和 VF-14 评分的 86.1。VA 报告稍有改善的患者的最小临床重要差异在 0.17 到 0.5 之间，VF-14 评分在 0.41 到 37.46 之间，具体取决于术前状态和眼部合并症的存在。
最小临床重要差异和患者可接受的症状状态值是互补的参数，它们可以通过提供更有意义的白内障摘除对 2 个重要结果（视力和视觉功能）的影响估计，帮助临床决策过程。
