PMID- 17304654
OWN - NLM
STAT- MEDLINE
DCOM- 20070709
LR  - 20151119
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 34
IP  - 2
DP  - 2007 Feb
TI  - Determining the minimal clinically important differences in activity, fatigue, 
      and sleep quality in patients with rheumatoid arthritis.
PG  - 280-9
AB  - OBJECTIVE: To determine the minimal clinically important differences (MCID) in 
      the patient-reported outcomes of activity (0-30, number of days of limitation), 
      fatigue (0 = none, 100 = complete), and sleep quality (0 = no problems, 100 = 
      worst case) for patients with rheumatoid arthritis (RA). METHODS: Two randomized 
      controlled trials comparing abatacept to placebo in RA patients were considered: 
      ATTAIN (n = 391) and AIM (n = 652). An internal anchor-based approach was used to 
      derive the MCID using the Health Assessment Questionnaire, patient global 
      assessment, and pain as anchors. Minimal important change in activity, fatigue, 
      and sleep were determined by estimating mean changes in these outcomes in 
      patients showing change in a narrow range about the MCID of the internal anchor. 
      Correlation analysis was used to determine the consistency of the changes in the 
      outcomes and anchors, and a Delphi process was used to determine the final MCID 
      values. RESULTS: For the 2 trials, consistent patterns of change for activity, 
      fatigue, and sleep and the internal anchors were found with correlations in the 
      range of 0.5, 0.7, and 0.4, respectively. The mean changes for activity, fatigue, 
      and sleep in a narrow range about the MCID of the 3 internal anchors 
      corresponding to the 2 trials were: 3.4 to 4.3 for activity; 6.7 to 17.0 for 
      fatigue; and 4.1 to 7.3 for sleep. Following the Delphi process the MCID 
      determined were 4 for activity, 10 for fatigue, and 6 for sleep. CONCLUSION: 
      These MCID for activity limitation, fatigue, and sleep problems can be used in 
      designing clinical trials and providing benchmarks in assessing patient 
      improvement.
FAU - Wells, George
AU  - Wells G
AD  - Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, 
      Canada.
FAU - Li, Tracy
AU  - Li T
FAU - Maxwell, Lara
AU  - Maxwell L
FAU - MacLean, Ross
AU  - MacLean R
FAU - Tugwell, Peter
AU  - Tugwell P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
RN  - 0 (Antirheumatic Agents)
SB  - IM
MH  - Activities of Daily Living/*classification
MH  - Antirheumatic Agents/therapeutic use
MH  - *Arthritis, Rheumatoid/complications/diagnosis/drug therapy/physiopathology
MH  - Disability Evaluation
MH  - Fatigue/*diagnosis/etiology
MH  - *Health Status
MH  - Humans
MH  - Pain Measurement
MH  - Randomized Controlled Trials as Topic
MH  - Severity of Illness Index
MH  - Sleep Wake Disorders/*diagnosis/etiology
MH  - Surveys and Questionnaires
EDAT- 2007/02/17 09:00
MHDA- 2007/07/10 09:00
CRDT- 2007/02/17 09:00
PHST- 2007/02/17 09:00 [pubmed]
PHST- 2007/07/10 09:00 [medline]
PHST- 2007/02/17 09:00 [entrez]
AID - 0315162X-34-280 [pii]
PST - ppublish
SO  - J Rheumatol. 2007 Feb;34(2):280-9.