犬类骨关节炎利物浦问卷(LOAD)和犬科骨科指数(COI)客户报告结局测量的最小临床重要差异。

Minimal clinically-important differences for the 'Liverpool Osteoarthritis in Dogs' (LOAD) and the 'Canine Orthopedic Index' (COI) client-reported outcomes measures.

机构信息

Movement Veterinary Referrals, Preston Brook, Runcorn, Cheshire, United Kingdom.

School of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, Liverpool, United Kingdom.

出版信息

PLoS One. 2023 Feb 2;18(2):e0280912. doi: 10.1371/journal.pone.0280912. eCollection 2023.

Abstract

Client-reported outcomes measures (CROMs) have been previously validated for the evaluation of canine osteoarthritis. A published systematic review indicated that the 'Liverpool Osteoarthritis in Dogs' (LOAD) and the 'Canine Orthopedic Index' (COI) can be recommended for use in dogs with osteoarthritis; these CROMs have also been used in the context of measuring surgical outcomes of dogs with orthopaedic conditions. However, the minimal clinically-important differences (MCIDs) for these CROMs have not been investigated. Such estimates would be useful for investigators and regulators so that these CROMs can be used in clinical trials. Data from the RCVS Knowledge Canine Cruciate Registry were extracted, and baseline and 6 week follow-up data on dogs that had received surgery for cranial cruciate ligament rupture were used to make estimates of MCIDs using distribution-based and anchor-based methods. Data from 125 dogs were categorised based on the anchor question and LOAD and COI scores analysed accordingly. The four anchor-based methods provided a range of MCIDs for each CROM (1 to 8.8 for LOAD and 3.5 to 17.6 for COI). In the two different distribution-based methods, the MCIDs for LOAD ranged from 1.5 (effect size) to 2.4 (standard error of measurement) and the effect size method yielded a result of 2.2 for COI. The results showed that the value of the MCIDs depended on the method that was applied. Receiver operator characteristic curves provided areas under the curve (AUCs) greater than 0.7, which indicated that the cut-off point was acceptable; LOAD had the greater AUC at 0.867. In summary, the authors currently recommend a MCID of '4' for LOAD and '14' for COI although further work in other clinical contexts (such as osteoarthritis associated with chronic pain) is required to add confidence to these estimates. For the first time, we have provided estimates for MCIDs for these two CROMs which will facilitate sample size estimates in future clinical studies that use these CROMs as outcomes measures.

摘要

客户报告的结果测量(CROM)已被先前验证可用于评估犬骨关节炎。一项已发表的系统评价表明,“利物浦犬骨关节炎(LOAD)”和“犬骨科指数(COI)”可推荐用于患有骨关节炎的犬;这些 CROM 也已用于测量骨科疾病犬的手术结果。然而,这些 CROM 的最小临床重要差异(MCID)尚未得到研究。这些估计值对于研究人员和监管机构非常有用,以便这些 CROM 可用于临床试验。从 RCVS 知识犬十字韧带登记处提取数据,并使用分布和锚定方法对接受前十字韧带断裂手术的犬的基线和 6 周随访数据进行 MCID 估计。根据锚定问题对 125 只犬的数据进行分类,并相应地分析 LOAD 和 COI 评分。四种基于锚定的方法为每个 CROM 提供了一系列 MCID(LOAD 为 1 至 8.8,COI 为 3.5 至 17.6)。在两种不同的基于分布的方法中,LOAD 的 MCID 范围从 1.5(效应大小)到 2.4(测量标准误差),效应大小方法为 COI 产生了 2.2 的结果。结果表明,MCID 的值取决于所应用的方法。接收者操作特征曲线提供了大于 0.7 的曲线下面积(AUC),这表明截止值是可以接受的;LOAD 的 AUC 为 0.867。总之,作者目前建议 LOAD 的 MCID 为“4”,COI 的 MCID 为“14”,尽管需要在其他临床环境(如与慢性疼痛相关的骨关节炎)中开展进一步工作,以增加这些估计值的可信度。我们首次为这两个 CROM 提供了 MCID 的估计值,这将有助于未来使用这些 CROM 作为结果测量的临床研究中进行样本量估计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0445/9894389/3ce9bb021ba2/pone.0280912.g001.jpg

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