PMID- 11327274
OWN - NLM
STAT- MEDLINE
DCOM- 20010809
LR  - 20191210
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 28
IP  - 4
DP  - 2001 Apr
TI  - Minimal clinically important difference in radiological progression of joint 
      damage over 1 year in rheumatoid arthritis: preliminary results of a validation 
      study with clinical experts.
PG  - 904-10
AB  - To determine the minimal clinically important difference (MCID) between hand and 
      foot films with a 1 year interval assessed with the Sharp/van der Heijde or 
      Larsen/Scott scoring method. Progression scores of the 2 methods were compared 
      with the opinion of an international expert panel on clinical relevance of 
      radiological joint damage in 4 predefined clinical settings. The expert panel 
      consisted of 3 rheumatologists, who evaluated 46 pairs of hand and foot films, 
      taken with 1 year intervals, of patients with early rheumatoid arthritis. 
      Receiver operating characteristics curves analyzed the accuracy of different 
      threshold values (progression scores) of the 2 scoring methods to detect the 
      presence or absence of clinically important difference, as defined by the expert 
      panel as external criterion. The threshold value with the highest accuracy was 
      subsequently chosen as the score representing the MCID. Five Sharp/van der Heijde 
      units and 2 Larsen/Scott units were the best cutoffs. The accompanying 
      sensitivities ranged from 77% to 100% for the Sharp/van der Heijde method and 
      from 73% to 84% for the Larsen/Scott method for the 4 clinical settings. The 
      specificities were between 78% and 84% for the Sharp/van der Heijde method and 
      between 74% and 94% for the Larsen/Scott method. The smallest progression score 
      that can be detected apart from interobserver measurement error, the smallest 
      detectable difference (SDD), was equal to or larger than the calculated MCID, 5 
      Sharp/van der Heijde units and 6 Larsen/Scott units in our study, if the mean 
      progression scores of the same 2 observers were used. The SDD is a conservative 
      estimate of the MCID; our panel rated progression at or below this level as 
      clinically significant.
FAU - Bruynesteyn, K
AU  - Bruynesteyn K
AD  - Department of Rheumatology, University Hospital Maastricht, The Netherlands. 
      kbru@sint.azm.nl
FAU - van der Heijde, D
AU  - van der Heijde D
FAU - Boers, M
AU  - Boers M
FAU - Lassere, M
AU  - Lassere M
FAU - Boonen, A
AU  - Boonen A
FAU - Edmonds, J
AU  - Edmonds J
FAU - Houben, H
AU  - Houben H
FAU - Paulus, H
AU  - Paulus H
FAU - Peloso, P
AU  - Peloso P
FAU - Saudan, A
AU  - Saudan A
FAU - van der Linden, S
AU  - van der Linden S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Validation Study
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
MH  - Arthritis, Rheumatoid/*diagnostic imaging
MH  - Arthrography/*methods
MH  - Disease Progression
MH  - Expert Testimony
MH  - Humans
MH  - Observer Variation
MH  - ROC Curve
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Single-Blind Method
EDAT- 2001/05/01 10:00
MHDA- 2001/08/10 10:01
CRDT- 2001/05/01 10:00
PHST- 2001/05/01 10:00 [pubmed]
PHST- 2001/08/10 10:01 [medline]
PHST- 2001/05/01 10:00 [entrez]
PST - ppublish
SO  - J Rheumatol. 2001 Apr;28(4):904-10.