Can J Occup Ther. 2023 Mar;90(1):92-102. doi: 10.1177/00084174221142177. Epub 2023 Jan 17.
The Canadian Occupational Performance Measure (COPM) assists occupational therapists to identify occupational performance problems using a client-centred approach. Since its first publication in 1991, there has been abundant evidence of the ability of the COPM to detect a significant difference as an outcome measure. There has also been a tacit understanding that a difference of 2 points from pre-test to post-test on either Performance or Satisfaction COPM score represents a clinically significant difference. There is however, some confusion about the origins of this claim. To ascertain empirical evidence for the claim that a clinically significant difference is a change score ≥2 points. We conducted a scoping review of peer-reviewed literature (1991-2020) for intervention studies using the COPM as an outcome measure and examined intervention type and change scores. One hundred studies were identified. The COPM was used to assess effectiveness of eight types of occupational therapy interventions. The common belief, however, was not empirically supported that clinical significance can be asserted on the basis of a two-point change in COPM scores. Further research is needed to test alternative approaches to asserting clinical significance or a minimal clinically important difference.
加拿大职业表现测量（COPM）通过以客户为中心的方法帮助职业治疗师识别职业表现问题。自 1991 年首次出版以来，已经有大量证据表明 COPM 有能力作为一种结果测量来检测显著差异。人们也默许地认为，在 COPM 的表现或满意度得分上，从预测试到后测试的差异为 2 分代表着具有临床意义的差异。然而，对于这一说法的起源存在一些混淆。为了确定声称的临床意义差异是变化分数≥2 分的实证证据。我们对使用 COPM 作为结果测量的干预研究进行了同行评审文献的范围综述（1991-2020 年），并检查了干预类型和变化分数。确定了一百项研究。COPM 用于评估八种类型的职业治疗干预措施的有效性。然而，普遍的看法是没有得到经验支持的，即不能仅仅根据 COPM 分数的两点变化来断言临床意义。需要进一步的研究来测试断言临床意义或最小临床重要差异的替代方法。
