PMID- 19132791
OWN - NLM
STAT- MEDLINE
DCOM- 20090421
LR  - 20191210
IS  - 0315-162X (Print)
IS  - 0315-162X (Linking)
VI  - 36
IP  - 2
DP  - 2009 Feb
TI  - The minimally important difference for the health assessment questionnaire in 
      rheumatoid arthritis clinical practice is smaller than in randomized controlled 
      trials.
PG  - 254-9
LID - 10.3899/jrheum.080479 [doi]
AB  - OBJECTIVE: Patient-reported outcomes are used in clinical practice and trials. We 
      studied a large clinical practice to determine the minimally important difference 
      (MID) estimates for (1) the Health Assessment Questionnaire-Damage Index 
      (HAQ-DI): improvement and worsening using patient global assessment anchor; and 
      (2) pain using a patient-reported pain anchor. METHODS: Patients with rheumatoid 
      arthritis (RA; N = 225) had clinic visits at 2 timepoints within 1 year, 
      completed the HAQ-DI and pain visual analog scale (VAS; 0-100 mm), and answered 
      the question, "How would you describe your overall status/overall pain since the 
      last visit?", as much worsened, somewhat worsened, the same, somewhat improved, 
      or much improved. If rated as somewhat improved or worsened, they were defined as 
      the minimally changed subgroups. RESULTS: Eighty-three percent were women, mean 
      age 60 years, with disease duration 11.7 +/- 10.7 years. The baseline HAQ-DI was 
      0.97 +/- SD 0.76, and at followup 1.0 +/- 0.77 (mean change +0.03 +/- 0.40). The 
      baseline pain VAS was 42.3 +/- 28.8, and at followup 38.5 +/- 27.9 (mean change 
      -2.8 +/- 25.9). The mean (SD) HAQ-DI change score was -0.09 (0.42) for somewhat 
      improved and 0.15 (0.33) for somewhat worsened. The HAQ-DI change for 
      somewhat/much better was -0.20 +/- 0.52, and for somewhat/much worse +0.21 +/- 
      0.33. For pain, somewhat improved changed by -11.9 mm on the VAS, and somewhat 
      worsened by 6.8 mm. Estimates for HAQ-DI and pain were larger than the for 
      no-change group, 0.03 (0.32) and -3.2 (20.9). CONCLUSION: The MID for HAQ-DI in 
      clinical practice is smaller than it is in trials. This may have implications for 
      observational studies and clinical care.
FAU - Pope, Janet E
AU  - Pope JE
AD  - Division of Rheumatology, Department of Medicine, University of Western Ontario, 
      London, Canada.
FAU - Khanna, Dinesh
AU  - Khanna D
FAU - Norrie, Deborah
AU  - Norrie D
FAU - Ouimet, Janine M
AU  - Ouimet JM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Canada
TA  - J Rheumatol
JT  - The Journal of rheumatology
JID - 7501984
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Data Interpretation, Statistical
MH  - Disability Evaluation
MH  - Disease Progression
MH  - Female
MH  - Health Status
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods/*statistics & numerical data
MH  - Pain Measurement/methods/statistics & numerical data
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic/*statistics & numerical data
MH  - Reproducibility of Results
MH  - *Surveys and Questionnaires
MH  - Young Adult
EDAT- 2009/01/10 09:00
MHDA- 2009/04/22 09:00
CRDT- 2009/01/10 09:00
PHST- 2009/01/10 09:00 [entrez]
PHST- 2009/01/10 09:00 [pubmed]
PHST- 2009/04/22 09:00 [medline]
AID - 36/2/254 [pii]
AID - 10.3899/jrheum.080479 [doi]
PST - ppublish
SO  - J Rheumatol. 2009 Feb;36(2):254-9. doi: 10.3899/jrheum.080479.