PMID- 23514218
OWN - NLM
STAT- MEDLINE
DCOM- 20131119
LR  - 20130403
IS  - 1541-2563 (Electronic)
IS  - 1541-2563 (Linking)
VI  - 10
IP  - 2
DP  - 2013 Apr
TI  - Do we know the minimal clinically important difference (MCID) for COPD 
      exacerbations?
PG  - 243-9
LID - 10.3109/15412555.2012.733463 [doi]
AB  - Frequent exacerbations of COPD are associated with accelerated loss of lung 
      function, declining health status, increased mortality, and increased health care 
      costs. Thus, a key objective in the management of COPD is preventing 
      exacerbations or at least reducing their number and severity. When new 
      interventions are examined, their value is sometimes assessed in reference to the 
      minimal clinically important difference (MCID), a theoretical construct that may 
      be defined and estimated numerically in several different ways. There have been 
      limited attempts to calculate the MCID for COPD exacerbations but a figure of 20% 
      reduction in exacerbation frequency is occasionally cited as the "established" 
      MCID from a single manuscript reviewing six clinical trials. Our review suggests 
      that defining and calculating the MCID for COPD exacerbations is problematic, not 
      only because the methodology around developing endpoints for MCIDs is 
      inconsistent, but because the impact of exacerbation reduction is likely to be 
      influenced dramatically by the definitions of exacerbation severity used and the 
      population's baseline status. Reference to current literature shows that at least 
      one other estimate for exacerbation MCID as low as 4%. MCID is sometimes 
      estimated by expert consensus; a review of articles used to shape COPD guidelines 
      shows frequent reference to articles in which interventions yielded exacerbation 
      differences as low as 11%. We find no evidence of an established MCID but suggest 
      that interventions reducing exacerbations by as little as 11% appear to be 
      regarded widely as clinically important.
FAU - Chapman, Kenneth R
AU  - Chapman KR
AD  - Asthma & Airway Centre, University Health Network, Toronto Western Hospital, 
      Toronto, Ontario, Canada. kchapman@ca.inter.net
FAU - Bergeron, Celine
AU  - Bergeron C
FAU - Bhutani, Mohit
AU  - Bhutani M
FAU - Bourbeau, Jean
AU  - Bourbeau J
FAU - Grossman, Ronald F
AU  - Grossman RF
FAU - Hernandez, Paul
AU  - Hernandez P
FAU - McIvor, R Andrew
AU  - McIvor RA
FAU - Mayers, Irvin
AU  - Mayers I
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20130320
PL  - England
TA  - COPD
JT  - COPD
JID - 101211769
SB  - IM
MH  - *Disease Progression
MH  - Humans
MH  - Pulmonary Disease, Chronic Obstructive/*therapy
MH  - *Terminology as Topic
MH  - Treatment Outcome
EDAT- 2013/03/22 06:00
MHDA- 2013/11/20 06:00
CRDT- 2013/03/22 06:00
PHST- 2013/03/22 06:00 [entrez]
PHST- 2013/03/22 06:00 [pubmed]
PHST- 2013/11/20 06:00 [medline]
AID - 10.3109/15412555.2012.733463 [doi]
PST - ppublish
SO  - COPD. 2013 Apr;10(2):243-9. doi: 10.3109/15412555.2012.733463. Epub 2013 Mar 20.