Dominique I Dabija1, Nitin B Jain. 1. From the Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee (DID); Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (NBJ); and Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (NBJ).
Abstract
OBJECTIVE: Patient-reported outcome scales determine response to treatment. The minimal clinically important difference of these scales is a measure of responsiveness: the smallest change in a score associated with a clinically important change to the patient. This study sought to summarize the literature on minimal clinically important difference for the most commonly reported shoulder outcome scales. DESIGN: A literature search of PubMed and EMBASE databases identified 193 citations, 27 of which met the inclusion/exclusion criteria. RESULTS: For rotator cuff tears, a minimal clinically important difference range of 9-26.9 was reported for American Shoulder and Elbow Surgeons, 8 or 10 for Constant, and 282.6-588.7 for the Western Ontario Rotator Cuff Index. For patients who underwent arthroplasty, a minimal clinically important difference range of 6.3-20.9 was reported for American Shoulder and Elbow Surgeons, 5.7-9.4 for Constant, and 14.1-20.6 for the Shoulder Pain and Disability Index. For proximal humeral fractures, a minimal clinically important difference range of 5.4-11.6 was reported for Constant and 8.1-13.0 for Disability of the Arm, Shoulder, and Hand. CONCLUSIONS: A wide range of minimal clinically important difference values was reported for each patient population and instrument. In the future, a uniform outcome instrument and minimal clinically important difference will be useful to measure clinically meaningful change across practices and the spectrum of shoulder diagnoses.
OBJECTIVE:Patient-reported outcome scales determine response to treatment. The minimal clinically important difference of these scales is a measure of responsiveness: the smallest change in a score associated with a clinically important change to the patient. This study sought to summarize the literature on minimal clinically important difference for the most commonly reported shoulder outcome scales. DESIGN: A literature search of PubMed and EMBASE databases identified 193 citations, 27 of which met the inclusion/exclusion criteria. RESULTS: For rotator cuff tears, a minimal clinically important difference range of 9-26.9 was reported for American Shoulder and Elbow Surgeons, 8 or 10 for Constant, and 282.6-588.7 for the Western Ontario Rotator Cuff Index. For patients who underwent arthroplasty, a minimal clinically important difference range of 6.3-20.9 was reported for American Shoulder and Elbow Surgeons, 5.7-9.4 for Constant, and 14.1-20.6 for the Shoulder Pain and Disability Index. For proximal humeral fractures, a minimal clinically important difference range of 5.4-11.6 was reported for Constant and 8.1-13.0 for Disability of the Arm, Shoulder, and Hand. CONCLUSIONS: A wide range of minimal clinically important difference values was reported for each patient population and instrument. In the future, a uniform outcome instrument and minimal clinically important difference will be useful to measure clinically meaningful change across practices and the spectrum of shoulder diagnoses.
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