Do older adults with shoulder disorders who meet the minimal clinically important difference also present low disability at discharge? An observational study.
Journal Article (Journal Article)
BACKGROUND: The choice of outcome success thresholds may influence clinical management, pay-for-performance, and assessment of value-based care. OBJECTIVE: To evaluate outcomes success thresholds in older adults using two different methods: 1) Minimal clinically important differences (MCIDs) of the Quick-DASH and 2) Dichotomization of the Quick-DASH based on low disability rating at discharge DESIGN: An observational design (retrospective database study). SETTING: Dataset of 1109 patients with shoulder disorders. PARTICIPANTS: 297 older adults patients who were diagnosed with rotator cuff related shoulder disorders and were managed through physical therapy treatment. MAIN OUTCOME MEASURES: We categorized and calculated how many patients met 8.0 and 16.0 point changes on the Quick-DASH. To evaluate outcomes success thresholds using dichotomization, patients who discharge score of ≤20 on the Quick-DASH were considered positive responders with successful outcomes. RESULTS: The percentage of positive responders who met the MCID thresholds for the Quick-DASH were 63.3% using MCID of 8.0 points, 39.7% using the MCID of 16.0 points, and 46.12% who met discharge score of ≤ 20 on the Quick-DASH. 39.0% met both MCID of 8.0 points and discharge score of ≤ 20 on the Quick-DASH. Only 28% met both MCID of 16.0 points and discharge score of = 20 on the Quick-DASH. CONCLUSION: Three different success threshold derivations classified patients into three very different assessments of success. Quick-DASH scores of ≤ 20 represent low levels of self-report disability at discharge and can be a stable clinical option for a measure of success to capture whether a treatment results in meaningful improvement.
Full Text
Duke Authors
Cited Authors
- Garcia, AN; Thigpen, CA; Lake, AD; Martinez, C; Myers, H; Cook, C
Published Date
- March 2020
Published In
Volume / Issue
- 24 / 2
Start / End Page
- 152 - 160
PubMed ID
- 30885628
Pubmed Central ID
- PMC7082669
Electronic International Standard Serial Number (EISSN)
- 1809-9246
Digital Object Identifier (DOI)
- 10.1016/j.bjpt.2019.02.003
Language
- eng
Conference Location
- Brazil