1 Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT, USA.
2 Department of Family & Preventive Medicine, University of Utah, Salt Lake City, UT, USA.
Foot Ankle Int. 2019 Jan;40(1):65-73. doi: 10.1177/1071100718800304. Epub 2018 Oct 4.
: Establishing score points that reflect meaningful change from the patient perspective is important for interpreting patient-reported outcomes. This study estimated the minimum clinically important difference (MCID) values of 2 Patient-Reported Outcomes Measurement Information System (PROMIS) instruments and the Foot and Ankle Ability Measure (FAAM) Sports subscale within a foot and ankle orthopedic population.
: Patients seen for foot and ankle conditions at an orthopedic clinic were administered the PROMIS Physical Function (PF) v1.2, the PROMIS Pain Interference (PI) v1.1, and the FAAM Sports at baseline and all follow-up visits. MCID estimation was conducted using anchor-based and distribution-based methods.
: A total of 3069 patients, mean age of 51 years (range = 18-94), were included. The MCIDs for the PROMIS PF ranged from approximately 3 to 30 points (median = 11.3) depending on the methods being used. The MCIDs ranged from 3 to 25 points (median = 8.9) for the PROMIS PI, and from 9 to 77 points (median = 32.5) for the FAAM Sports.
: This study established a range of MCIDs in the PROMIS PF, PROMIS PI, and FAAM Sports indicating meaningful change in patient condition. MCID values were consistent across follow-up periods, but were different across methods. Values below the 25th percentile of MCIDs may be useful for low-risk clinical decisions. Midrange values (eg, near the median) should be used for high stakes decisions in clinical practice (ie, surgery referrals). The MCID values within the interquartile range should be utilized for most decision making.
: Level I, diagnostic study, testing of previously developed diagnostic measure on consecutive patients with reference standard applied.
从患者角度反映有意义变化的评分点对于解释患者报告的结局非常重要。本研究旨在评估 PROMIS 量表中的 2 项患者报告结局测量信息系统（PROMIS）量表和足部踝关节能力测量（FAAM）运动分量表在足部和踝关节矫形患者中的最小临床重要差异（MCID）值。
在矫形诊所就诊的足部和踝关节疾病患者在基线和所有随访就诊时接受 PROMIS 身体功能（PF）v1.2、PROMIS 疼痛干扰（PI）v1.1 和 FAAM 运动测试。采用基于锚定和基于分布的方法进行 MCID 估计。
共纳入 3069 例患者，平均年龄 51 岁（范围=18-94 岁）。基于所使用的方法，PROMIS PF 的 MCID 范围为 3-30 分（中位数=11.3）。PROMIS PI 的 MCID 范围为 3-25 分（中位数=8.9），FAAM 运动的 MCID 范围为 9-77 分（中位数=32.5）。
本研究确定了 PROMIS PF、PROMIS PI 和 FAAM 运动的 MCID 范围，表明患者病情有明显变化。MCID 值在随访期间保持一致，但在不同方法之间存在差异。低于 MCID 第 25 百分位数的值可能有助于做出低风险的临床决策。中值（如接近中位数）值应在临床实践中用于高风险决策（即手术转诊）。MCID 值的四分位间距内值应用于大多数决策。
Ⅰ级，诊断研究，在参考标准应用于连续患者的情况下对先前开发的诊断测量工具进行测试。
