Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.
Department of Statistics, University of Washington, Seattle, Washington, U.S.A.
Laryngoscope. 2020 Jul;130(7):1775-1779. doi: 10.1002/lary.28331. Epub 2019 Oct 8.
The Dyspnea Index (DI) is a validated patient-reported outcome (PRO) instrument that has been used in the management of laryngotracheal stenosis (LTS). The minimal clinically important difference (MCID) is an established concept to help determine the change in a PRO instrument that reflects meaningful change for the patient. It is not known what change in the DI is of clinical significance in airway surgery. This study aims to determine the MCID for the DI in patients undergoing surgical treatment for LTS.
This is a prospective cohort study in which 26 patients with LTS completed the DI (score range 0 to 40) before and 6 to 8 weeks postoperatively, in addition to a Global Ratings Change Questionnaire (GRCQ), scored from -7 to +7, at the postoperative interval. A hypothesis test was carried out to test the association between GRCQ and change in DI. The MCID for change in DI was determined using anchor-based analysis.
Overall mean change in DI was -11, and mean change in GRCQ was +5. Change in DI scores were significantly different among the improvement and no improvement groups (P value <0.002). Area under the receiver operating curve was 0.92, demonstrating high discriminatory ability of the change in DI score. A change of -4 was determined to be the threshold that discriminated between significant improvement and no improvement.
A decrease of 4 in the DI can be considered as the MCID for patients with LTS after surgical treatment.
2b Laryngoscope, 130:1775-1779, 2020.
呼吸困难指数（DI）是一种经过验证的患者报告结局（PRO）工具，已用于喉气管狭窄（LTS）的管理。最小临床重要差异（MCID）是一个已确立的概念，用于帮助确定 PRO 工具的变化，该变化反映了患者的有意义变化。尚不清楚在气道手术中，DI 的何种变化具有临床意义。本研究旨在确定接受 LTS 手术治疗的患者 DI 的 MCID。
这是一项前瞻性队列研究，26 例 LTS 患者在手术前后分别完成了 DI（评分范围 0 至 40），此外还在术后间隔内完成了全球评分变化问卷（GRCQ），评分范围为-7 至+7。进行假设检验以测试 GRCQ 与 DI 变化之间的关联。使用基于锚的分析确定 DI 变化的 MCID。
DI 的总体平均变化为-11，GRCQ 的平均变化为+5。在改善和无改善组之间，DI 评分的变化存在显著差异（P 值<0.002）。受试者工作特征曲线下面积为 0.92，表明 DI 评分变化具有较高的区分能力。确定-4 的变化为区分显著改善和无改善的阈值。
在接受手术治疗后，LTS 患者的 DI 减少 4 可被视为 MCID。
2b 喉镜，130：1775-1779，2020。
