Research Unit, Hospital Universitario Basurto, Avda. Montevideo 18, 48013 Bilbao, Spain.
Osteoarthritis Cartilage. 2013 Dec;21(12):2006-12. doi: 10.1016/j.joca.2013.09.009. Epub 2013 Oct 2.
To provide new data on minimally clinical important difference (MCID) and percentages of responders on pain and functional dimensions of Western Ontario and McMaster Osteoarthritis Index (WOMAC) in patients who have undergone total knee replacement (TKR).
1-year prospective multicentre study with two different cohorts. Consecutive patients on the waiting list were recruited. There were 415 and 497 patients included. Pain and function were collected by the reverse scoring option of the WOMAC (0-100, worst to best). Transition items (five point scale) were collected at 1-year and MCID was calculated through mean change in patients somewhat better, Receiver Operating Characteristic (ROC) and two other questions about satisfaction. Analysis was performed in the whole sample and by tertiles of baseline severity. Likewise were calculated the percentages of patients who attained cut-off values.
Global MCID for pain were about 30 in both cohorts and 32 for. By ROC these values were about 20 and 24 respectively. According to the other two transitional questions these values were for pain 27 and 20 for function. By tertiles the worst the baseline score the higher the cut-off values. Percentage of responders does not change when comparing responders to the global MCID with their own tertile MCID and were about 61% for pain and 50% for function.
Due to the wide variations, MCID estimates should be calculated and used according to the baseline severity score.
提供全膝关节置换术后患者在疼痛和功能方面的西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）的最小临床重要差异（MCID）和应答者百分比的新数据。
这是一项为期 1 年的前瞻性多中心研究，分为两个不同队列。招募了等候名单上的连续患者。共纳入了 415 名和 497 名患者。疼痛和功能通过 WOMAC 的反向评分选项（0-100，最差到最好）进行收集。在 1 年时收集转移项目（五分制），并通过患者略好的平均变化、接受者操作特征（ROC）和另外两个关于满意度的问题计算 MCID。在整个样本和基线严重程度的三分位数中进行分析。同样计算了达到临界值的患者百分比。
两个队列的疼痛总体 MCID 约为 30，功能为 32。通过 ROC，这些值分别约为 20 和 24。根据另外两个过渡问题，这些值分别为疼痛 27 和功能 20。根据三分位数，基线评分越差，临界值越高。当将对整体 MCID 的应答者与自己的三分位数 MCID 进行比较时，应答者的百分比不会改变，疼痛为 61%，功能为 50%。
由于变化范围较大，应根据基线严重程度评分计算和使用 MCID 估计值。
