PMID- 33517717
OWN - NLM
STAT- MEDLINE
DCOM- 20210215
LR  - 20210317
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Print)
IS  - 2049-4394 (Linking)
VI  - 103-B
IP  - 2
DP  - 2021 Feb
TI  - What constitutes a clinically important change in Mayo Elbow Performance Index 
      and range of movement after open elbow arthrolysis?
PG  - 366-372
LID - 10.1302/0301-620X.103B2.BJJ-2020-0259.R3 [doi]
AB  - AIMS: This study aimed to determine the minimal detectable change (MDC), minimal 
      clinically important difference (MCID), and substantial clinical benefit (SCB) 
      under distribution- and anchor-based methods for the Mayo Elbow Performance Index 
      (MEPI) and range of movement (ROM) after open elbow arthrolysis (OEA). We also 
      assessed the proportion of patients who achieved MCID and SCB; and identified the 
      factors associated with achieving MCID. METHODS: A cohort of 265 patients treated 
      by OEA were included. The MEPI and ROM were evaluated at baseline and at two-year 
      follow-up. Distribution-based MDC was calculated with confidence intervals (CIs) 
      reflecting 80% (MDC 80), 90% (MDC 90), and 95% (MDC 95) certainty, and MCID with 
      changes from baseline to follow-up. Anchor-based MCID (anchored to somewhat 
      satisfied) and SCB (very satisfied) were calculated using a five-level Likert 
      satisfaction scale. Multivariate logistic regression of factors affecting MCID 
      achievement was performed. RESULTS: The MDC increased substantially based on 
      selected CIs (MDC 80, MDC 90, and MDC 95), ranging from 5.0 to 7.6 points for the 
      MEPI, and from 8.2 degrees  to 12.5 degrees  for ROM. The MCID of the MEPI were 8.3 points under 
      distribution-based and 12.2 points under anchor-based methods; distribution- and 
      anchor-based MCID of ROM were 14.1 degrees  and 25.0 degrees . The SCB of the MEPI and ROM were 
      17.3 points and 43.4 degrees , respectively. The proportion of the patients who attained 
      anchor-based MCID for the MEPI and ROM were 74.0% and 94.7%, respectively; 
      furthermore, 64.2% and 86.8% attained SCB. Non-dominant arm (p = 0.022), higher 
      preoperative MEPI rating (p < 0.001), and postoperative visual analogue scale 
      pain score (p < 0.001) were independent predictors of not achieving MCID for the 
      MEPI, while atraumatic causes (p = 0.040) and higher preoperative ROM (p = 0.005) 
      were independent risk factors for ROM. CONCLUSION: In patients undergoing OEA, 
      the MCID for the increased MEPI is 12.2 points and 25 degrees  increased ROM. The SCB is 
      17.3 points and 43.3 degrees , respectively. Future studies using the MEPI and ROM to 
      assess OEA outcomes should report not only statistical significance but also 
      clinical importance. Cite this article: Bone Joint J 2021;103-B(2):366-372.
FAU - Sun, Ziyang
AU  - Sun Z
AUID- ORCID: 0000-0002-8673-9521
AD  - Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth 
      People's Hospital, Shanghai, China.
FAU - Li, Juehong
AU  - Li J
AUID- ORCID: 0000-0002-0177-2534
AD  - Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth 
      People's Hospital, Shanghai, China.
FAU - Luo, Gang
AU  - Luo G
AUID- ORCID: 0000-0001-7478-2461
AD  - Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth 
      People's Hospital, Shanghai, China.
FAU - Wang, Feiyan
AU  - Wang F
AUID- ORCID: 0000-0003-4695-0047
AD  - Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth 
      People's Hospital, Shanghai, China.
FAU - Hu, Yuehao
AU  - Hu Y
AUID- ORCID: 0000-0001-8253-3158
AD  - Department of Orthopedics, Ruijin Hospital Affiliated to Shanghai Jiao Tong 
      University, Shanghai, China.
FAU - Fan, Cunyi
AU  - Fan C
AUID- ORCID: 0000-0002-7854-5233
AD  - Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth 
      People's Hospital, Shanghai, China.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Elbow Joint/physiopathology/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Joint Diseases/physiopathology/*surgery
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - *Orthopedic Procedures
MH  - Patient Satisfaction/statistics & numerical data
MH  - *Range of Motion, Articular
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC7954179
OTO - NOTNLM
OT  - Elbow stiffness
OT  - Heterotopic ossification
OT  - Mayo Elbow Performance Index
OT  - Minimal clinically important difference
OT  - Minimal detectable change
OT  - Range of movement
OT  - Substantial clinical benefit
EDAT- 2021/02/02 06:00
MHDA- 2021/02/16 06:00
PMCR- 2021/02/01
CRDT- 2021/02/01 05:29
PHST- 2021/02/01 05:29 [entrez]
PHST- 2021/02/02 06:00 [pubmed]
PHST- 2021/02/16 06:00 [medline]
PHST- 2021/02/01 00:00 [pmc-release]
AID - BJJ-103B-366 [pii]
AID - 10.1302/0301-620X.103B2.BJJ-2020-0259.R3 [doi]
PST - ppublish
SO  - Bone Joint J. 2021 Feb;103-B(2):366-372. doi: 
      10.1302/0301-620X.103B2.BJJ-2020-0259.R3.