Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.
Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.
J Shoulder Elbow Surg. 2014 Aug;23(8):1083-90. doi: 10.1016/j.jse.2014.01.014. Epub 2014 Apr 13.
The purpose of this study was to determine the minimal important change (MIC) of improvement in the Constant-Murley score in patients with long-standing subacromial pain and in subgroups of patients with subacromial pain with and without rotator cuff ruptures.
The MIC was estimated by the anchor-based MIC distribution method, which integrates an anchor- and distribution-based approach: the optimal cutoff point of the receiver operating characteristic curve (MICROC) and the 95% limit cutoff point (MIC95% limit). The study population consisted of 93 patients included in a randomized clinical trial evaluating the effect of a specific exercise strategy.
The MICROC was found at a mean change of 17 points in the Constant-Murley score, which corresponds to a sensitivity of 91% and a specificity of 79%. The MIC95% limit was found at a mean change of 24 points. In the subgroup analysis, the MICROC was found at a mean change of 19 points and the MIC95% limit at 18 points in patients with an intact rotator cuff. In patients with rotator cuff ruptures, the MICROC was found at a mean change of 15 points and the MIC95% limit at 30 points.
The Constant-Murley score is able to detect the MIC in individual patients with long-standing subacromial pain when the rotator cuff is intact. The estimated MIC values could be used as an indication for relevant changes in the Constant-Murley score in clinical practice and guide the clinician in how to interpret the results of specific treatments.
本研究旨在确定长期肩峰下疼痛患者以及肩袖撕裂患者和无肩袖撕裂患者亚组中 Constant-Murley 评分改善的最小临床重要变化（MIC）。
通过锚定和分布相结合的 MIC 分布方法来估计 MIC，该方法结合了锚定和分布方法：最佳截断点的接收器工作特征曲线（MICROC）和 95%限界截断点（MIC95%限界）。研究人群由纳入评估特定运动策略效果的随机临床试验的 93 例患者组成。
MICROC 在 Constant-Murley 评分平均变化 17 分处，其灵敏度为 91%，特异性为 79%。MIC95%限界在平均变化 24 分处。在亚组分析中，肩袖完整的患者中 MICROC 在 Constant-Murley 评分平均变化 19 分处，MIC95%限界在 18 分处；肩袖撕裂的患者中 MICROC 在 Constant-Murley 评分平均变化 15 分处，MIC95%限界在 30 分处。
当肩袖完整时，Constant-Murley 评分能够检测出长期肩峰下疼痛患者的 MIC。估计的 MIC 值可作为临床实践中 Constant-Murley 评分相关变化的指标，并指导临床医生如何解释特定治疗的结果。
