Khan Adam Z, Vaughan Alayna K, Aman Zachary S, Lazarus Mark D, Williams Gerald R, Namdari Surena
Southern California Permanente Medical Group, 13652 Cantara Street, Bldg 2, Panorama City, CA 91402, USA.
Rothman Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
J Clin Med. 2024 Apr 26;13(9):2550. doi: 10.3390/jcm13092550.
Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) serve as metrics to gauge orthopedic treatment efficacy based on anchoring questions that do not account for a patient's satisfaction with their surgical outcome. This study evaluates if reaching MCID, SCB, or PASS values for American Shoulder and Elbow Surgeons score (ASES), Single Alpha Numeric Evaluation (SANE), Simple Shoulder Test (SST), and Visual Analog Score (VAS) for pain following arthroscopic rotator cuff repair (RCR) correlates with overall patient satisfaction. This was a single-institution, retrospective study of patients who underwent RCR from 2015 to 2019. Pre-operative and 2 year postoperative ASES, SANE, SST, and VAS scores were recorded. Patients underwent a survey to assess: (1) what is your overall satisfaction with your surgical outcome? (scale 1 to 10); (2) if you could go back in time, would you undergo this operation again? (yes/no); (3) for the same condition, would you recommend this operation to a friend or family member? (yes/no). Spearman correlation coefficients were run to assess relationship between reaching MCID, SCB, or PASS and satisfaction. Ninety-two patients were included. Mean preoperative ASES was 51.1 ± 16.9, SANE was 43.3 ± 20.9, SST was 5.4 ± 2.9, and VAS was 4.6 ± 2.1. Mean 2 year ASES was 83.9 ± 18.5, SANE was 81.7 ± 27.0, SST was 9.8 ± 3.2, and VAS was 1.4 ± 1.9. Mean patient satisfaction was 9.0 ± 1.9; 89 (96.7%) patients would undergo surgery again and recommend surgery. Correlation for reaching PASS for SANE and satisfaction was moderate. Correlation coefficients were very weak for all other outcome metrics. Reaching MCID, SCB, and PASS in ASES, SANE, SST, or VAS following RCR did not correlate with a patient's overall satisfaction or willingness to undergo surgery again or recommend surgery. Further investigation into the statistical credibility and overall clinical value of MCID, SCB, and PASS is necessary.
最小临床重要差异（MCID）、显著临床获益（SCB）和患者可接受症状状态（PASS）作为衡量骨科治疗效果的指标，其基于一些未考虑患者对手术结果满意度的锚定问题。本研究评估关节镜下肩袖修复术（RCR）后，美国肩肘外科医师评分（ASES）、单字母数字评估（SANE）、简单肩部测试（SST）以及疼痛视觉模拟评分（VAS）达到MCID、SCB或PASS值是否与患者总体满意度相关。这是一项对2015年至2019年接受RCR治疗患者的单机构回顾性研究。记录术前和术后2年的ASES、SANE、SST和VAS评分。患者接受一项调查以评估：（1）你对手术结果的总体满意度如何？（1至10分）；（2）如果你能回到过去，你会再次接受这个手术吗？（是/否）；（3）对于相同病情，你会向朋友或家人推荐这个手术吗？（是/否）。采用Spearman相关系数评估达到MCID、SCB或PASS与满意度之间的关系。共纳入92例患者。术前ASES平均为51.1±16.9，SANE平均为43.3±20.9，SST平均为5.4±2.9，VAS平均为4.6±2.1。术后2年ASES平均为83.9±18.5，SANE平均为81.7±27.0，SST平均为9.8±3.2，VAS平均为1.4±1.9。患者平均满意度为9.0±1.9；89例（96.7%）患者会再次接受手术并推荐该手术。SANE达到PASS与满意度之间的相关性为中等。所有其他结局指标的相关系数非常弱。RCR术后ASES、SANE、SST或VAS达到MCID、SCB和PASS与患者的总体满意度、再次接受手术的意愿或推荐手术的意愿均不相关。有必要进一步研究MCID、SCB和PASS的统计可信度和总体临床价值。
