PMID- 11953967
OWN - NLM
STAT- MEDLINE
DCOM- 20020509
LR  - 20190718
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 46
IP  - 4
DP  - 2002 Apr
TI  - Determination of the minimal clinically important difference in rheumatoid 
      arthritis joint damage of the Sharp/van der Heijde and Larsen/Scott scoring 
      methods by clinical experts and comparison with the smallest detectable 
      difference.
PG  - 913-20
AB  - OBJECTIVE: To assess the minimal clinically important difference (MCID) in joint 
      damage on hand and foot radiographs of patients with early rheumatoid arthritis 
      (RA) as assessed with the Sharp/van der Heijde and Larsen/Scott methods, and to 
      study how the smallest detectable difference (SDD) relates to the MCID for each 
      method. METHODS: The judgments of an international panel of experts on the 
      clinical relevance of progression of joint damage as seen on sets of radiographs 
      obtained at 1-year intervals in 4 clinical settings (early versus late RA and 
      mild versus high disease activity) were used as the external criterion, which was 
      compared with the progression scores as determined by the 2 scoring methods. 
      Progression scores with the highest combined sensitivity and specificity for 
      detecting clinically relevant progression represented the MCID. Subsequently, the 
      sensitivity and specificity of the scoring methods were determined when using the 
      SDD as the threshold for relevant progression, and these were compared with the 
      sensitivity and specificity of the MCID. RESULTS: The panel judged changes in 
      joint damage around the level of the SDD (5.0) of the Sharp/van der Heijde method 
      as minimal clinically important, resulting in satisfactory sensitivity (mean 79%) 
      and specificity (mean 84%) for detecting clinically important progression in the 
      4 clinical settings when using the SDD as the threshold value. The MCID (mean 
      2.3) of the Larsen/Scott method was much smaller than its SDD (5.8), and the 
      sensitivity for detecting clinically important progression by applying the SDD as 
      threshold was consequently low (mean 51%), accompanied by high specificity (mean 
      99%). CONCLUSION: This study suggests that the SDD of the Sharp/van der Heijde 
      method can be used as the MCID, i.e., as the threshold level for individual 
      response criteria. The SDD of the Larsen/Scott method, however, turned out to be 
      too insensitive to use as the threshold for individual clinically relevant 
      change.
FAU - Bruynesteyn, Karin
AU  - Bruynesteyn K
AD  - Maastricht University, Maastricht, The Netherlands. kbru@sint.azm.nl
FAU - van der Heijde, Desiree
AU  - van der Heijde D
FAU - Boers, Maarten
AU  - Boers M
FAU - Saudan, Ariane
AU  - Saudan A
FAU - Peloso, Paul
AU  - Peloso P
FAU - Paulus, Harold
AU  - Paulus H
FAU - Houben, Harry
AU  - Houben H
FAU - Griffiths, Bridget
AU  - Griffiths B
FAU - Edmonds, John
AU  - Edmonds J
FAU - Bresnihan, Barry
AU  - Bresnihan B
FAU - Boonen, Annelies
AU  - Boonen A
FAU - van der Linden, Sjef
AU  - van der Linden S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
SB  - IM
MH  - Arthritis, Rheumatoid/*diagnostic imaging/*pathology
MH  - Arthrography/*methods/standards
MH  - Expert Testimony
MH  - Foot/diagnostic imaging
MH  - Hand/diagnostic imaging
MH  - Humans
MH  - Joints/pathology
MH  - Reproducibility of Results
MH  - Rheumatology/*methods/standards
MH  - Sensitivity and Specificity
EDAT- 2002/04/16 10:00
MHDA- 2002/05/10 10:01
CRDT- 2002/04/16 10:00
PHST- 2002/04/16 10:00 [pubmed]
PHST- 2002/05/10 10:01 [medline]
PHST- 2002/04/16 10:00 [entrez]
AID - 10.1002/art.10190 [pii]
AID - 10.1002/art.10190 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2002 Apr;46(4):913-20. doi: 10.1002/art.10190.