PMID- 31864584
OWN - NLM
STAT- MEDLINE
DCOM- 20201013
LR  - 20201013
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 36
IP  - 1
DP  - 2020 Jan
TI  - How Should We Define Clinically Significant Improvement on Patient-Reported 
      Outcomes Measurement Information System Test for Patients Undergoing Knee 
      Meniscal Surgery?
PG  - 241-250
LID - S0749-8063(19)30714-5 [pii]
LID - 10.1016/j.arthro.2019.07.036 [doi]
AB  - PURPOSE: The purpose of the study was to define the minimal clinically important 
      difference (MCID), substantial clinical benefit (SCB), and patient acceptable 
      symptomatic state (PASS) thresholds for the Patient-Reported Outcomes Measurement 
      Information System (PROMIS) Physical Function (PF) computerized adaptive test 
      (CAT) instrument in patients undergoing arthroscopic meniscal surgery. METHODS: 
      The PROMIS PF CAT was administered preoperatively and postoperatively to patients 
      undergoing arthroscopic meniscal surgery. At 6 months postoperatively, patients 
      graded their knee function based on a domain-specific anchor question. A 
      satisfaction anchor question was used to indicate achievement of the PASS. 
      Receiver operating characteristic analysis determined the relevant psychometric 
      values. Cutoff analysis was performed to find preoperative patient-reported 
      outcome scores predicting achievement of clinically significant outcomes (CSOs). 
      RESULTS: A total of 73 patients (41.1% female patients) were included, with a 
      mean age of 44.9 +/- 12.8.0 years and average follow-up period of 24.0 +/- 1.2 weeks. 
      The MCID on the PROMIS PF CAT was calculated to be 2.09 (area under the curve 
      [AUC], 0.75; 95% CI, 0.57-0.94). Net score improvement equivalent to achievement 
      of SCB was found to be 6.50 (AUC, 0.77; 95% CI, 0.55-0.99). The PASS was found to 
      be 46.1 (AUC, 0.86; 95% CI, 0.76-0.96). A preoperative score below 37.6 on the 
      PROMIS PF CAT predicted achievement of the MCID (AUC, 0.76; 95% CI, 0.62-0.87), 
      whereas scores above 41.9 predicted achievement of the PASS (AUC, 0.77; 95% CI, 
      0.65-0.90). Higher baseline functional status and the absence of pre-existing 
      arthritis were also found to be statistically significant predictors of achieving 
      CSOs. CONCLUSIONS: Our study defined the MCID, SCB, and PASS for the PROMIS PF 
      CAT. We found that a preoperative score below 37.6 was predictive of achieving a 
      meaningful clinical change with surgery whereas a preoperative score above 41.9 
      was predictive of patients who would attain an acceptable postoperative health 
      state. In addition, exercising more days per week and the absence of arthritis 
      increased the likelihood of achieving postoperative CSOs. LEVEL OF EVIDENCE: 
      Level III, retrospective cohort.
CI  - Copyright (c) 2019 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Okoroha, Kelechi R
AU  - Okoroha KR
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Lu, Yining
AU  - Lu Y
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Nwachukwu, Benedict U
AU  - Nwachukwu BU
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Beletsky, Alexander
AU  - Beletsky A
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Patel, Bhavik H
AU  - Patel BH
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Verma, Nikhil N
AU  - Verma NN
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Cole, Brian
AU  - Cole B
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Forsythe, Brian
AU  - Forsythe B
AD  - Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.. Electronic address: 
      brian.forsythe@rushortho.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2020 Jan;36(1):251-252. PMID: 31864585
MH  - Adult
MH  - Arthroscopy/*methods
MH  - Female
MH  - Humans
MH  - Knee Injuries/*surgery
MH  - Knee Joint/*surgery
MH  - Male
MH  - Meniscus/*surgery
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - *Patient Reported Outcome Measures
MH  - Postoperative Period
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2019/12/23 06:00
MHDA- 2020/10/21 06:00
CRDT- 2019/12/23 06:00
PHST- 2019/04/15 00:00 [received]
PHST- 2019/07/13 00:00 [revised]
PHST- 2019/07/28 00:00 [accepted]
PHST- 2019/12/23 06:00 [entrez]
PHST- 2019/12/23 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
AID - S0749-8063(19)30714-5 [pii]
AID - 10.1016/j.arthro.2019.07.036 [doi]
PST - ppublish
SO  - Arthroscopy. 2020 Jan;36(1):241-250. doi: 10.1016/j.arthro.2019.07.036.