PMID- 24947644
OWN - NLM
STAT- MEDLINE
DCOM- 20140926
LR  - 20151119
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 156
IP  - 2
DP  - 2014 Aug
TI  - Measuring postoperative recovery: what are clinically meaningful differences?
PG  - 319-27
LID - S0039-6060(14)00098-1 [pii]
LID - 10.1016/j.surg.2014.03.005 [doi]
AB  - BACKGROUND: Surgical innovations are introduced to improve "recovery," a complex 
      construct often operationalized by the use of patient-reported outcomes. The 
      minimal clinically important difference (MCID) is the smallest change in an 
      outcome sufficiently important to influence management and is crucial for 
      designing and interpreting comparative effectiveness trials. Our objective was to 
      generate MCID estimates for three postoperative recovery metrics. METHODS: 
      Prospectively collected data on two cohorts of 281 and 130 adult patients 
      undergoing abdominal surgery were analyzed. At each of three visits, patients had 
      completed the 36-Item Short Form Survey from the RAND Medical Outcomes Study 
      (SF-36) and either Community Healthy Activities Model Program for Seniors 
      (CHAMPS) or the 6-minute walk test (6MWT). The MCID was estimated with an 
      anchor-based approach with random effects linear regression models. Patients' 
      rating of their own health was used to predict SF-36 domain, CHAMPS, and 6MWT 
      scores. Results are reported as MCID (95% confidence interval). RESULTS: On the 
      SF-36 domains analyzed, MCIDs were consistently smaller for patients rating their 
      health as "excellent" or "very good" (from 8 [6-9] to 15 [12-18]) compared with 
      those for patients rating their health as "fair" or "poor" (from 15 [12-19] to 32 
      [28-36]). For CHAMPS, the MCID was 8 kcal/kg/week (7-9), and for the 6MWT, 14 
      meters (9-18). CONCLUSION: Plausible MCIDs and ranges around each estimate are 
      provided. These values should be considered when planning and interpreting 
      abdominal surgery clinical trials where patient-reported outcomes are assessed.
CI  - Copyright (c) 2014 Mosby, Inc. All rights reserved.
FAU - Antonescu, Ioana
AU  - Antonescu I
AD  - Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill 
      University Health Centre, Montreal, QC, Canada.
FAU - Scott, Susan
AU  - Scott S
AD  - Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, 
      Canada.
FAU - Tran, Tung T
AU  - Tran TT
AD  - Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill 
      University Health Centre, Montreal, QC, Canada.
FAU - Mayo, Nancy E
AU  - Mayo NE
AD  - Division of Clinical Epidemiology, McGill University Health Centre, Montreal, QC, 
      Canada.
FAU - Feldman, Liane S
AU  - Feldman LS
AD  - Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill 
      University Health Centre, Montreal, QC, Canada. Electronic address: 
      liane.feldman@mcgill.ca.
LA  - eng
GR  - R21HS021857/HS/AHRQ HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20140315
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - IM
MH  - Adult
MH  - Aged
MH  - Clinical Protocols
MH  - Cohort Studies
MH  - Cross-Sectional Studies
MH  - Exercise Test
MH  - Female
MH  - Humans
MH  - Inventions/trends
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Postoperative Period
MH  - Prospective Studies
MH  - Quality of Life
MH  - Surgical Procedures, Operative/*trends
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Walking
EDAT- 2014/06/21 06:00
MHDA- 2014/09/27 06:00
CRDT- 2014/06/21 06:00
PHST- 2013/10/26 00:00 [received]
PHST- 2014/03/07 00:00 [accepted]
PHST- 2014/06/21 06:00 [entrez]
PHST- 2014/06/21 06:00 [pubmed]
PHST- 2014/09/27 06:00 [medline]
AID - S0039-6060(14)00098-1 [pii]
AID - 10.1016/j.surg.2014.03.005 [doi]
PST - ppublish
SO  - Surgery. 2014 Aug;156(2):319-27. doi: 10.1016/j.surg.2014.03.005. Epub 2014 Mar 
      15.