Wright Alexis, Hannon Joseph, Hegedus Eric J, Kavchak Alicia Emerson
Department of Physical Therapy, High Point University, High Point, NC, USA.
J Man Manip Ther. 2012 Aug;20(3):160-6. doi: 10.1179/2042618612Y.0000000001.
Minimal clinically important difference (MCID) scores are commonly used by clinicians when determining patient response to treatment and to guide clinical decision-making during the course of treatment. For research purposes, the MCID score is often used in sample size calculations for adequate powering of a study to minimize the false-positives (type 1 errors) and the false-negatives (type 2 errors). For clinicians and researchers alike, it is critical that the MCID score is a valid and stable measure. A low MCID value may result in overestimating the positive effects of treatment, whereas a high MCID value may incorrectly classify patients as failing to respond to treatment when in fact the treatment was beneficial. The wide range of methodologies for calculating the MCID score results in varied outcomes, which leads to difficulties with interpretation and application. This clinimetrics corner outlines key factors influencing MCID estimates and discusses limitations with the use of the MCID in both clinical and research practice settings.
最小临床重要差异（MCID）分数在临床医生确定患者对治疗的反应以及在治疗过程中指导临床决策时经常被使用。出于研究目的，MCID分数常用于样本量计算，以使研究具有足够的效力，从而将假阳性（I型错误）和假阴性（II型错误）降至最低。对于临床医生和研究人员而言，MCID分数是一种有效且稳定的测量方法至关重要。较低的MCID值可能导致高估治疗的积极效果，而较高的MCID值可能会在实际上治疗有益时将患者错误地归类为对治疗无反应。计算MCID分数的方法多种多样，导致结果各异，这给解释和应用带来了困难。本临床计量学专栏概述了影响MCID估计的关键因素，并讨论了在临床和研究实践环境中使用MCID的局限性。
