Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland.
J Shoulder Elbow Surg. 2013 Dec;22(12):1650-5. doi: 10.1016/j.jse.2013.05.002. Epub 2013 Jul 12.
The minimal clinically important difference (MCID) is increasingly used to evaluate treatment effectiveness. The MCID for the Constant score has not been previously reported.
A prospectively collected cohort of 802 consecutive shoulders with arthroscopically treated partial- or full-thickness rotator cuff tears was analyzed. The Constant score was measured preoperatively and at 3 months and 1 year postoperatively. At follow-up visits, the patients were asked a simple 2-stage question: Is the shoulder better or worse after the operation compared with the preoperative state? This single 2-level question was used as an indicator of patient satisfaction and as an anchor to calculate the MCID for the Constant score.
At 1 year, 781 (97.4%) patients (474 men, 307 women) were available for follow-up. The preoperative Constant score was 53.1 (SD 17.2) in all patients, 56.2 (SD 17.4) in male patients, and 48.2 (SD 15.6) in female patients. Postoperatively at 3 months, the scores were 61.7 (SD 16.4) in all patients, 65.1 (SD 16.1) in male patients, and 56.8 (SD 15.5) in female patients. At 1 year, the scores were 75.9 (SD 15.2) in all patients, 79.0 (SD 14.9) in male patients, and 71.0 (SD 14.3) in female patients. At 3 months postoperatively, 92.2% of male patients and 87.2% of female patients were satisfied with the outcome (P = .027); at 1 year, the satisfaction was 93.2% and 89.5%, respectively (P = .067). Five different statistical approaches yielded 5 different MCID estimates (range, 2-16). The 3-month mean change estimate of MCID was 10.4 points.
Our study demonstrates an MCID estimate of 10.4 points as the threshold for the Constant score in patients with rotator cuff tear.
Basic science study, validation of outcomes instruments/classification systems.
最小临床重要差异（MCID）越来越多地被用于评估治疗效果。目前尚未报道 Constant 评分的 MCID。
前瞻性收集了 802 例接受关节镜下部分或全层肩袖撕裂修复的连续肩关节患者，分析其 Constant 评分。术前、术后 3 个月和 1 年均进行 Constant 评分测量。在随访时，患者被问到一个简单的两阶段问题：与术前相比，手术后肩部是更好还是更差？这个简单的两水平问题被用作患者满意度的指标，并作为计算 Constant 评分 MCID 的锚点。
术后 1 年，781 例（97.4%）患者（474 例男性，307 例女性）可获得随访。所有患者术前 Constant 评分为 53.1（17.2）分，男性为 56.2（17.4）分，女性为 48.2（15.6）分。术后 3 个月，所有患者评分为 61.7（16.4）分，男性为 65.1（16.1）分，女性为 56.8（15.5）分。术后 1 年，所有患者评分为 75.9（15.2）分，男性为 79.0（14.9）分，女性为 71.0（14.3）分。术后 3 个月时，92.2%的男性患者和 87.2%的女性患者对结果满意（P =.027）；术后 1 年时，满意度分别为 93.2%和 89.5%（P =.067）。5 种不同的统计方法得出了 5 种不同的 MCID 估计值（范围为 2-16）。MCID 的 3 个月平均变化估计值为 10.4 分。
本研究得出肩袖撕裂患者 Constant 评分的 MCID 估计值为 10.4 分。
基础科学研究，对结局评估工具/分类系统的验证。
