PMID- 31096046 OWN - NLM STAT- MEDLINE DCOM- 20200917 LR - 20200917 IS - 1522-9653 (Electronic) IS - 1063-4584 (Linking) VI - 27 IP - 10 DP - 2019 Oct TI - A systematic review of estimates of the minimal clinically important difference and patient acceptable symptom state of the Western Ontario and McMaster Universities Osteoarthritis Index in patients who underwent total hip and total knee replacement. PG - 1408-1419 LID - S1063-4584(19)30977-X [pii] LID - 10.1016/j.joca.2019.05.002 [doi] AB - OBJECTIVE: To systematically review the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) estimates in pain and function measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in patients who underwent primary total knee replacement (TKR) and primary total hip replacement (THR). DESIGN: The study was carried out following PRISMA recommendations. We searched five electronic databases. Two reviewers independently screened titles, abstracts and full-text papers using a priori inclusion/exclusion criteria. Data were extracted by two independent reviewers. Data were synthesized, with WOMAC values converted to 0-100 scores (0 = best, 100 = worst). RESULTS: Thirteen studies were included. Research methods used to calculate MCIDs and PASS varied across studies (e.g., using anchor-based or distribution methods, wording of anchor questions within anchor-based methods). Baseline WOMAC scores also varied across studies. Across studies and methods, MCIDs for the WOMAC in patients undergoing TKR ranged from 13.3 to 36.0 for pain and 1.8-33.0 for function; values for WOMAC in THR ranged from 8.3 to 41.0 for pain and from 9.7 to 34.0 for function. PASS cut-offs for TKR ranged from 25.0 to 28.6 for pain and 32.3-36.7 for function, and cut-offs for THR from 15.0 to 30.6 for pain and 28.0-42.0 for function. CONCLUSION: Although the WOMAC is a commonly used measure for a single condition, the variability in methods used to calculate MCID and PASS estimates results in a range of values across studies making it unclear whether values reported in the literature can be applied with confidence. Future research is needed to refine methods used to calculate MCIDs and PASS. CI - Copyright (c) 2019 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved. FAU - MacKay, C AU - MacKay C AD - West Park Healthcare Centre, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: crystal.mackay@utoronto.ca. FAU - Clements, N AU - Clements N AD - Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; The National University of Ireland, Galway, Ireland. Electronic address: nicolle.clements@hotmail.com. FAU - Wong, R AU - Wong R AD - Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada. Electronic address: rwong@uhnresearch.ca. FAU - Davis, A M AU - Davis AM AD - Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada. Electronic address: adavis@uhnresearch.ca. LA - eng PT - Journal Article PT - Systematic Review DEP - 20190513 PL - England TA - Osteoarthritis Cartilage JT - Osteoarthritis and cartilage JID - 9305697 SB - IM CIN - Osteoarthritis Cartilage. 2019 Oct;27(10):1403-1404. PMID: 31153985 MH - *Arthroplasty, Replacement, Hip MH - *Arthroplasty, Replacement, Knee MH - Humans MH - *Minimal Clinically Important Difference MH - Ontario MH - Osteoarthritis, Hip/diagnosis/*surgery MH - Osteoarthritis, Knee/diagnosis/*surgery MH - Pain Measurement MH - Symptom Assessment OTO - NOTNLM OT - Minimal clinically important difference OT - Osteoarthritis OT - Patient acceptable symptom state OT - Systematic review OT - Western Ontario and McMaster Universities Osteoarthritis Index EDAT- 2019/05/17 06:00 MHDA- 2020/09/18 06:00 CRDT- 2019/05/17 06:00 PHST- 2019/01/08 00:00 [received] PHST- 2019/04/01 00:00 [revised] PHST- 2019/05/01 00:00 [accepted] PHST- 2019/05/17 06:00 [pubmed] PHST- 2020/09/18 06:00 [medline] PHST- 2019/05/17 06:00 [entrez] AID - S1063-4584(19)30977-X [pii] AID - 10.1016/j.joca.2019.05.002 [doi] PST - ppublish SO - Osteoarthritis Cartilage. 2019 Oct;27(10):1408-1419. doi: 10.1016/j.joca.2019.05.002. Epub 2019 May 13.