Divisão de Medicina Veterinária, Guarda Nacional Republicana (GNR), Lisbon, Portugal.
Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal.
PLoS One. 2023 Sep 20;18(9):e0291881. doi: 10.1371/journal.pone.0291881. eCollection 2023.
Osteoarthritis is the most common joint disease in companion animals. Several client-report outcome measures (CROMs) have been developed and validated to monitor patients and their response to treatment. However, estimates for minimal clinically-important differences for these CROMs in the context of osteoarthritis have not been published.
Data from the Clínica Veterinária de Cães (Portuguese Gendarmerie Canine Clinic) clinical records were extracted. Baseline and 30-day post-treatment follow-up data from 296 dogs treated for hip osteoarthritis were categorized based on an anchor question, and estimates of minimal clinically-important differences (MCIDs) using distribution-based and anchor-based methods were performed.
For the LOAD, the anchor-based methods provided a MCID estimate range of -2.5 to -9.1 and the distribution-based methods from 1.6 to 4.2. For the COI, the anchor-based methods provided a MCID estimate range of -4.5 to -16.6 and the distribution-based methods from 2.3 to 2.4. For the dimensions of COI, values varied from -0.5 to -4.9 with the anchor-based methods and from 0.6 to 2.7 with the distribution-based methods. Receiver operator characteristic curves provided areas under the curve >0.7 for the COI, indicating an acceptable cut-off point, and >0.8 for the LOAD, indicating an excellent cut-off point.
Our estimates of MCIDs for dogs with OA were consistent with previously proposed values of -4 for the LOAD and -14 for the COI in a post-surgical intervention context. ROC curve data suggest that LOAD may more reliably differentiate between anchor groups. We also presented estimates from COI of -4 for Stiffness, Function, and Gait and -3 for quality of life. These estimates can be used for research and patient monitoring.
骨关节炎是伴侣动物中最常见的关节疾病。已经开发并验证了几种患者报告的结局测量工具(CROM)来监测患者及其对治疗的反应。然而,尚未发表这些 CROM 在骨关节炎背景下的最小临床重要差异(MCID)的估计值。
从葡萄牙宪兵犬科诊所的临床记录中提取数据。根据锚定问题对 296 只接受髋关节骨关节炎治疗的犬的基线和 30 天治疗后随访数据进行分类,并使用基于分布和基于锚定的方法进行最小临床重要差异(MCID)的估计。
对于 LOAD,基于锚定的方法提供了 -2.5 到 -9.1 的 MCID 估计范围,而基于分布的方法提供了 1.6 到 4.2 的 MCID 估计范围。对于 COI,基于锚定的方法提供了 -4.5 到 -16.6 的 MCID 估计范围,而基于分布的方法提供了 2.3 到 2.4 的 MCID 估计范围。对于 COI 的维度,基于锚定的方法提供了从 -0.5 到 -4.9 的值,而基于分布的方法提供了从 0.6 到 2.7 的值。接受者操作特征曲线为 COI 提供了 >0.7 的曲线下面积,表明存在可接受的截断点,而 LOAD 的曲线下面积>0.8,表明存在极好的截断点。
我们对 OA 犬的 MCID 的估计值与先前提出的 -4 用于 LOAD 和 -14 用于 COI 的值一致,这些值适用于手术后干预的情况。ROC 曲线数据表明 LOAD 可能更可靠地区分锚定组。我们还提出了 COI 的刚度、功能和步态的 -4 和生活质量的 -3 的估计值。这些估计值可用于研究和患者监测。