Munich University Hospital, Dr von Hauner Children's Hospital, German Center for Lung Research (DZL), Munchen, Germany
Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, German Center for Lung Research (DZL), Hannover, Germany.
Thorax. 2023 May;78(5):476-483. doi: 10.1136/thorax-2022-219206. Epub 2022 Dec 26.
Monitoring disease progression in childhood interstitial lung diseases (chILD) is essential. No information for the minimal important difference (MID), which is defined as the smallest change in a parameter that is perceived as important prompting a clinician to change the treatment, is available. We calculated MIDs for vital signs (respiratory rate, peripheral oxygen saturation in room air, Fan severity score) and health-related quality of life (HrQoL) scores.
This study used data from the Kids Lung Register, which is a web-based management platform that collects data of rare paediatric lung disorders with a focus on chILD. Data of vital signs and HrQoL scores (Health Status Questionnaire, chILD-specific questionnaire and PedsQL V.4.0) were collected. MIDs were calculated according to distribution-based (one-third SD) and anchor-based methods (using forced expiratory volume in 1 s and forced vital capacity) as anchors.
Baseline data of 774 children were used to calculate the following MIDs: respiratory rate 1.3 (z-score), O saturation in room air 3.0%, Fan severity score 0.2-0.4, Health Status Questionnaire 0.4-0.8, chILD-specific questionnaire 4.4%-8.2%, physical health summary score 7.8%-8.9%, psychosocial health summary score 3.4%-6.9% and total score 5.1%-7.4%. Results of the responsiveness analysis generally agreed with the MIDs calculated.
For the first time, we provide estimates of MIDs for vital signs and HrQoL scores in a large cohort of chILD using different methods.
监测儿童间质性肺病(chILD)的疾病进展至关重要。目前尚无最小临床重要差异(MID)的相关信息,MID 定义为参数变化的最小值,医生认为该变化重要到足以改变治疗方案。本研究旨在计算生命体征(呼吸频率、经皮氧饱和度、Fan 严重程度评分)和健康相关生活质量(HrQoL)评分的 MID。
本研究使用了儿童肺登记处(Kids Lung Register)的数据,该数据库是一个基于网络的管理平台,用于收集以儿童间质性肺病为重点的罕见儿科肺部疾病的数据。收集了生命体征和 HrQoL 评分(健康状况问卷、儿童特有的问卷和 PedsQL V.4.0)的数据。MID 根据分布基础(三分之一标准差)和基于锚定的方法(使用 1 秒用力呼气量和用力肺活量作为锚定)进行计算。
本研究使用了 774 名儿童的基线数据来计算以下 MID:呼吸频率 1.3(z 评分)、经皮氧饱和度 3.0%、Fan 严重程度评分 0.2-0.4、健康状况问卷 0.4-0.8、儿童特有的问卷 4.4%-8.2%、生理健康总分 7.8%-8.9%、社会心理健康总分 3.4%-6.9%和总分 5.1%-7.4%。反应性分析的结果与计算出的 MID 基本一致。
本研究首次使用不同方法在大规模儿童间质性肺病队列中提供了生命体征和 HrQoL 评分的 MID 估计值。