Clement N D, Weir D, Holland J, Gerrand C, Deehan D J
Department of Orthopaedics, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.
Department of Orthopaedics, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, NE7 7DD, UK.
Knee. 2019 Aug;26(4):861-868. doi: 10.1016/j.knee.2019.04.018. Epub 2019 May 17.
The aim of this study was to identify minimal clinically important difference (MCID), minimal important change (MIC) and minimal detectable change (MDC) for the Short Form (SF-) 12 physical and mental component summary (PCS, MCS) scores after total knee arthroplasty (TKA) using an anchor based methodology.
During a 10-year period, 2589 TKA were performed. SF-12 PCS and MCS scores were recorded preoperatively and at one year postoperatively. At one year, patients were asked "How much did the knee replacement surgery improve the quality of your life?" Their response was recorded as: a great improvement, moderate improvement, little improvement, no improvement at all, or the quality of my life is worse. Patients recording a little (n = 211) and no (n = 115) were used to calculate the MCID and the MIC. The MDC90 was calculated using distribution based methods for the whole cohort.
The MCID was 1.8 (p = 0.04) for the PCS and 1.5 (p = 0.33) for the MCS score. The MIC was 2.7 (p = 0.04) for the PCS and -1.4 (p = 0.17) for the MCS score. The MDC90 was 8.9 for the PCS and 13.8 for the MCS score.
The MCID for the PCS can be used to compare the outcomes between groups, and the MIC can be used to ensure that a clinical difference has been observed for a cohort of patients. The values for the MDC90 can be used to assess whether or not an individual patient has experienced a change.
本研究旨在采用基于锚定的方法确定全膝关节置换术(TKA)后简短健康调查问卷(SF-12)身体和精神成分总结(PCS、MCS)评分的最小临床重要差异(MCID)、最小重要变化(MIC)和最小可检测变化(MDC)。
在10年期间,共进行了2589例TKA手术。术前和术后1年记录SF-12 PCS和MCS评分。术后1年,询问患者“膝关节置换手术在多大程度上改善了你的生活质量?”他们的回答记录为:极大改善、中度改善、略有改善、没有改善或我的生活质量变差。记录为略有改善(n = 211)和没有改善(n = 115)的患者用于计算MCID和MIC。使用基于分布的方法为整个队列计算MDC90。
PCS的MCID为1.8(p = 0.04),MCS评分的MCID为1.5(p = 0.33)。PCS的MIC为2.7(p = 0.04),MCS评分的MIC为-1.4(p = 0.17)。PCS的MDC90为8.9,MCS评分的MDC90为13.8。
PCS的MCID可用于比较组间结果,MIC可用于确保在一组患者中观察到临床差异。MDC90的值可用于评估个体患者是否经历了变化。