PMID- 30139774
OWN - NLM
STAT- MEDLINE
DCOM- 20190731
LR  - 20190731
IS  - 1399-3003 (Electronic)
IS  - 0903-1936 (Linking)
VI  - 52
IP  - 3
DP  - 2018 Sep
TI  - Clinically relevant differences in COPD health status: systematic review and 
      triangulation.
LID - 1800412 [pii]
LID - 10.1183/13993003.00412-2018 [doi]
AB  - The minimal clinically important difference (MCID) quantifies when measured 
      differences can be considered clinically relevant. This study aims to review and 
      triangulate MCIDs of chronic obstructive pulmonary disease (COPD) health status 
      tools.A systematic search in PubMed, EMBASE and Cochrane Library was conducted 
      (Prospero #CRD42015023221). Study details, patient characteristics, MCID 
      methodology and estimates were assessed and extracted by two authors. A 
      triangulated mean was obtained for each tool's MCID, with two-thirds weighting 
      for anchor-based and one-third for distribution-based results. This was then 
      multiplied by a weighted factor based upon the study size and quality 
      rating.Overall, 785 records were reviewed of which 21 studies were included for 
      analysis. MCIDs of 12 tools were presented. General quality and risk of bias were 
      average to good. Triangulated MCIDs for the COPD Assessment Test (CAT), Clinical 
      COPD Questionnaire (CCQ) and St. George's Respiratory Questionnaire (SGRQ) were 
      -2.54, -0.43 and -7.43 for improvement. Too few and/or too diverse studies were 
      present to triangulate MCIDs of other tools.Evidence for the MCID of the CAT and 
      CCQ was strong and triangulation was valid. Currently used MCIDs in clinical 
      practice for the SGRQ (4) and Chronic Respiratory Questionnaire (0.5) did not 
      match the reviewed content, for which the MCIDs were much higher. Using too low 
      MCIDs may lead to an overestimation of the interpretation of treatment effects. 
      MCIDs for deterioration were scarce, which highlights the need for more research.
CI  - Copyright (c)ERS 2018.
FAU - Alma, Harma
AU  - Alma H
AD  - Dept of General Practice and Elderly Care Medicine, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
AD  - Groningen Research Institute for Asthma and COPD (GRIAC), University Medical 
      Center Groningen, University of Groningen, Groningen, The Netherlands.
FAU - de Jong, Corina
AU  - de Jong C
AD  - Dept of General Practice and Elderly Care Medicine, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
AD  - Groningen Research Institute for Asthma and COPD (GRIAC), University Medical 
      Center Groningen, University of Groningen, Groningen, The Netherlands.
FAU - Tsiligianni, Ioanna
AU  - Tsiligianni I
AD  - Dept of General Practice and Elderly Care Medicine, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
AD  - Groningen Research Institute for Asthma and COPD (GRIAC), University Medical 
      Center Groningen, University of Groningen, Groningen, The Netherlands.
AD  - Clinic of Social and Family Medicine, Medical School, University of Crete, 
      Heraklion, Greece.
FAU - Sanderman, Robbert
AU  - Sanderman R
AD  - Dept of Health Psychology, University Medical Center Groningen, University of 
      Groningen, Groningen, The Netherlands.
AD  - Dept of Psychology, Health and Technology, University of Twente, Enschede, The 
      Netherlands.
FAU - Kocks, Janwillem
AU  - Kocks J
AD  - Dept of General Practice and Elderly Care Medicine, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
AD  - Groningen Research Institute for Asthma and COPD (GRIAC), University Medical 
      Center Groningen, University of Groningen, Groningen, The Netherlands.
FAU - van der Molen, Thys
AU  - van der Molen T
AD  - Dept of General Practice and Elderly Care Medicine, University Medical Center 
      Groningen, University of Groningen, Groningen, The Netherlands.
AD  - Groningen Research Institute for Asthma and COPD (GRIAC), University Medical 
      Center Groningen, University of Groningen, Groningen, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20180906
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
MH  - *Health Status
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - Pulmonary Disease, Chronic Obstructive/physiopathology/*rehabilitation
MH  - *Quality of Life
MH  - Surveys and Questionnaires
COIS- Conflict of interest: I. Tsiligianni received personal fees from Boehringer 
      Ingelheim, Novartis, AstraZeneca and GlaxoSmithKline, all outside the submitted 
      work. Conflict of interest: J. Kocks reports personal fees from Novartis, IPCRG 
      and Springer Media; research grants and personal fees from Boehringer Ingelheim 
      and GlaxoSmithKline; research grants from Stichting Zorgdraad; and travel 
      arrangements from Chiesi BV, GlaxoSmithKline BV and IPCRG, all outside the 
      submitted work. Conflict of interest: T. van der Molen reports personal 
      reimbursements from GlaxoSmithKline, TEVA, AstraZeneca and Boehringer Ingelheim; 
      and study grants from AstraZeneca and GlaxoSmithKline, all outside the submitted 
      work. After this study was terminated, he became an employee of 
      GlaxoSmithKline. T. van der Molen developed the CCQ and holds the copyright.
EDAT- 2018/08/25 06:00
MHDA- 2019/08/01 06:00
CRDT- 2018/08/25 06:00
PHST- 2018/02/27 00:00 [received]
PHST- 2018/07/18 00:00 [accepted]
PHST- 2018/08/25 06:00 [pubmed]
PHST- 2019/08/01 06:00 [medline]
PHST- 2018/08/25 06:00 [entrez]
AID - 13993003.00412-2018 [pii]
AID - 10.1183/13993003.00412-2018 [doi]
PST - epublish
SO  - Eur Respir J. 2018 Sep 6;52(3):1800412. doi: 10.1183/13993003.00412-2018. Print 
      2018 Sep.