School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
School of Health and Welfare, Dalarna University, Falun, Sweden.
J Pain. 2024 Sep;25(9):104559. doi: 10.1016/j.jpain.2024.104559. Epub 2024 May 10.
In both pain research and clinical practice, patient-reported outcome measures are used to assess dimensions of health. Interpreting these instruments requires understanding their measurement error and what magnitude of change has subjective importance for patients. This study estimated the standard error of measurement, 1-year minimal detectable change, and 1-year minimal clinically important difference (MCID) for the Short Form-36 Health Survey physical component summary and mental component summary, the Hospital Anxiety and Depression Scale subscales for anxiety symptoms and depression symptoms, and the numeric rating scale for past-week average pain intensity. MCIDs for these instruments have not previously been estimated in a large sample of chronic pain patients participating in interdisciplinary pain rehabilitation. Data were drawn from the Swedish Quality Registry for Pain Rehabilitation (n = 8,854 patients). MCID was estimated as average change and change difference based on 3 different anchors. MCID estimates were 2.62 to 4.69 for Short Form-36 Health Survey physical component summary, 4.46 to 6.79 for Short Form-36 Health Survey mental component summary, .895 to 1.48 for numeric rating scale, 1.17 to 2.13 for anxiety symptoms in the Hospital Anxiety and Depression Scale, and 1.48 to 2.54 for depression symptoms in the Hospital Anxiety and Depression Scale. The common assumption of an identical standard error of measurement for pre- and post-treatment measurements was not always applicable. When estimating MCID, researchers should select an estimation method and anchor aligned with the study's context and objectives. PERSPECTIVE: This article presents estimates of MCID and minimal detectable change for several commonly used patient-reported outcome measures among patients with chronic pain. These estimates can help clinicians and researchers to determine when a measured health improvement is subjectively important to the patient and greater than measurement error.
在疼痛研究和临床实践中，患者报告的结果测量被用于评估健康的各个方面。解释这些工具需要了解它们的测量误差以及对患者具有主观重要性的变化幅度。本研究估计了简明健康状况量表 36 项简短版（SF-36）物理成分综合评分和精神成分综合评分、医院焦虑和抑郁量表焦虑症状和抑郁症状亚量表以及过去一周平均疼痛强度数字评分量表的测量误差标准误、1 年最小可检测变化和 1 年最小临床重要差异（MCID）。这些工具的 MCID 以前尚未在参加跨学科疼痛康复的大量慢性疼痛患者中进行过估计。数据来自瑞典疼痛康复质量登记处（n=8854 例患者）。根据 3 种不同的锚定方法，将 MCID 估计为平均变化和变化差值。SF-36 物理成分综合评分的 MCID 估计值为 2.62 至 4.69，SF-36 精神成分综合评分的 MCID 估计值为 4.46 至 6.79，数字评分量表的 MCID 估计值为 0.895 至 1.48，医院焦虑和抑郁量表焦虑症状的 MCID 估计值为 1.17 至 2.13，医院焦虑和抑郁量表抑郁症状的 MCID 估计值为 1.48 至 2.54。治疗前后测量的测量误差标准误相同的常见假设并不总是适用。在估计 MCID 时，研究人员应根据研究的背景和目标选择与估计方法和锚定相匹配的方法。观点：本文介绍了几种常用于慢性疼痛患者的患者报告结局测量的 MCID 和最小可检测变化的估计值。这些估计值可以帮助临床医生和研究人员确定测量的健康改善对患者是否具有主观重要性，以及是否大于测量误差。
