PMID- 34854345
OWN - NLM
STAT- MEDLINE
DCOM- 20230209
LR  - 20231107
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 51
IP  - 2
DP  - 2023 Feb
TI  - The Minimal Clinically Important Difference: A Review of Clinical Significance.
PG  - 520-524
LID - 10.1177/03635465211053869 [doi]
AB  - BACKGROUND: The minimal clinically important difference (MCID) is a term 
      synonymous with orthopaedic clinical research over the past decade. The term 
      represents the smallest change in a patient-reported outcome measure that is of 
      genuine clinical value to patients. It has been derived in a myriad of ways in 
      existing orthopaedic literature. PURPOSE: To describe the various modalities for 
      deriving the MCID. STUDY DESIGN: Narrative review; Level of evidence, 4. METHODS: 
      The definitions of common MCID determinations were first identified. These were 
      then evaluated by their clinical and statistical merits and limitations. RESULTS: 
      There are 3 primary ways for determining the MCID: anchor-based analysis, 
      distribution-based analysis, and sensitivity- and specificity-based analysis. 
      Each has unique strengths and weaknesses with respect to its ability to evaluate 
      the patient's clinical status change from baseline to posttreatment. Anchor-based 
      analyses are inherently tied to clinical status yet lack standardization. 
      Distribution-based analyses are the opposite, with strong foundations in 
      statistics, yet they fail to adequately address the clinical status change. 
      Sensitivity and specificity analyses offer a compromise of the other 
      methodologies but still rely on a somewhat arbitrarily defined global transition 
      question. CONCLUSION: This current concepts review demonstrates the need for (1) 
      better standardization in the establishment of MCIDs for orthopaedic 
      patient-reported outcome measures and (2) better study design-namely, until a 
      universally accepted MCID derivation exists, studies attempting to derive the 
      MCID should utilize the anchor-based within-cohort design based on Food and Drug 
      Administration recommendations. Ideally, large studies reporting the MCID as an 
      outcome will also derive the value for their populations. It is important to 
      consider that there may be reasonable replacements for current derivations of the 
      MCID. As such, future research should consider an alternative threshold score 
      with a more universal method of derivation.
FAU - Bloom, David A
AU  - Bloom DA
AD  - NYU Langone Health, New York, New York, USA.
FAU - Kaplan, Daniel J
AU  - Kaplan DJ
AD  - NYU Langone Health, New York, New York, USA.
FAU - Mojica, Edward
AU  - Mojica E
AD  - NYU Langone Health, New York, New York, USA.
FAU - Strauss, Eric J
AU  - Strauss EJ
AD  - NYU Langone Health, New York, New York, USA.
FAU - Gonzalez-Lomas, Guillem
AU  - Gonzalez-Lomas G
AD  - NYU Langone Health, New York, New York, USA.
FAU - Campbell, Kirk A
AU  - Campbell KA
AUID- ORCID: 0000-0002-5633-1760
AD  - NYU Langone Health, New York, New York, USA.
FAU - Alaia, Michael J
AU  - Alaia MJ
AD  - NYU Langone Health, New York, New York, USA.
FAU - Jazrawi, Laith M
AU  - Jazrawi LM
AD  - NYU Langone Health, New York, New York, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20211202
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
CIN - Am J Sports Med. 2023 Nov;51(13):NP51-NP52. PMID: 37917817
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - Clinical Relevance
MH  - Sensitivity and Specificity
MH  - *Orthopedics
MH  - Patient Reported Outcome Measures
OTO - NOTNLM
OT  - clinical assessment
OT  - education
OT  - grading scales
OT  - statistics
EDAT- 2021/12/03 06:00
MHDA- 2023/02/10 06:00
CRDT- 2021/12/02 08:42
PHST- 2021/12/03 06:00 [pubmed]
PHST- 2023/02/10 06:00 [medline]
PHST- 2021/12/02 08:42 [entrez]
AID - 10.1177/03635465211053869 [doi]
PST - ppublish
SO  - Am J Sports Med. 2023 Feb;51(2):520-524. doi: 10.1177/03635465211053869. Epub 
      2021 Dec 2.