PMID- 37198708
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230520
IS  - 2524-7948 (Electronic)
IS  - 2524-7948 (Linking)
VI  - 5
IP  - 1
DP  - 2023 May 18
TI  - Defining a successful total knee arthroplasty: a systematic review of metrics of 
      clinically important changes.
PG  - 25
LID - 10.1186/s42836-023-00178-3 [doi]
LID - 25
AB  - BACKGROUND: Despite the increasing use of patient-reported outcome measures 
      (PROMs), the methodology used to evaluate clinically significant postoperative 
      outcomes after total knee arthroplasty (TKA) is variable. The review aimed to 
      survey studies with identified PROM-based metrics of clinical efficacy and the 
      assessment procedures after TKA. METHODS: The MEDLINE database was queried from 
      2008-2020. Inclusion criteria were: full texts, English language, primary TKA 
      with minimum one-year follow-up, use of metrics for assessing clinical outcomes 
      with PROMs, and primary derivations of metrics. The following PROM-based metrics 
      were identified: minimal clinically important difference (MCID), minimum 
      detectable change (MDC), patient acceptable symptom state (PASS), and substantial 
      clinical benefit (SCB). Study design, PROM value data, and methods of derivation 
      for metrics were recorded. RESULTS: We identified 18 studies (including 46,173 
      patients) that met the inclusion criteria. Across these studies, 10 different 
      PROMs were employed, and MCID was derived in 15 studies (83%). The MCID was 
      calculated using anchor-based techniques in nine studies (50%) and distribution 
      techniques in eight studies (44%). PASS values were presented in two studies 
      (11%) and SCB in one study (6%) using an anchor-based method; MDC was derived in 
      four studies (22%) using the distribution method. CONCLUSION: There is 
      variability in the TKA literature with respect to the definition and derivation 
      of measurements of clinically significant outcomes. Standardization of these 
      values may have implications for optimal case selection and PROM-based quality 
      measurement, ultimately improving patient satisfaction and outcomes.
CI  - (c) 2023. The Author(s).
FAU - Beiene, Zodina A
AU  - Beiene ZA
AUID- ORCID: 0000-0002-7458-6775
AD  - Department of Anesthesiology and Critical Care, Johns Hopkins Hospital, 1800 
      Orleans Street, Baltimore, MD, 21287, USA. zodinabeiene@gmail.com.
FAU - Tanghe, Kira K
AU  - Tanghe KK
AD  - Albert Einstein Medical College, Bronx, NY, 10461, USA.
FAU - Kahlenberg, Cynthia A
AU  - Kahlenberg CA
AD  - Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 
      10021, USA.
FAU - McLawhorn, Alexander S
AU  - McLawhorn AS
AD  - Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 
      10021, USA.
FAU - MacLean, Catherine H
AU  - MacLean CH
AD  - Center for the Advancement of Value in Musculoskeletal Care, Hospital for Special 
      Surgery, New York, NY, 10021, USA.
AD  - Department of Medicine, Weill Cornell Medical College, New York, NY, 10021, USA.
FAU - Gausden, Elizabeth B
AU  - Gausden EB
AD  - Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, 
      10021, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230518
PL  - England
TA  - Arthroplasty
JT  - Arthroplasty (London, England)
JID - 101773073
PMC - PMC10193600
OTO - NOTNLM
OT  - Minimal clinically important difference
OT  - Patient acceptable symptom state
OT  - Patient-reported outcome measure
OT  - Total knee arthroplasty
OT  - Total knee replacement
COIS- The authors declare that they have no competing interests.
EDAT- 2023/05/18 01:07
MHDA- 2023/05/18 01:08
PMCR- 2023/05/18
CRDT- 2023/05/17 23:45
PHST- 2022/11/30 00:00 [received]
PHST- 2023/03/07 00:00 [accepted]
PHST- 2023/05/18 01:08 [medline]
PHST- 2023/05/18 01:07 [pubmed]
PHST- 2023/05/17 23:45 [entrez]
PHST- 2023/05/18 00:00 [pmc-release]
AID - 10.1186/s42836-023-00178-3 [pii]
AID - 178 [pii]
AID - 10.1186/s42836-023-00178-3 [doi]
PST - epublish
SO  - Arthroplasty. 2023 May 18;5(1):25. doi: 10.1186/s42836-023-00178-3.