Do the reported estimates of minimal clinically important difference scores amongst hiprelated patient-reported outcome measures support their use?

Background: The use of minimal clinically important difference (MCID) scores has become increasingly popular amongst clinicians when determining patient response to treatment. Recent evidence has suggested that MCID scores are context specific and a single MCID estimate does not exist within an outcome measure. Objective: The objective of this review was to systematically review the evidence regarding reported MCID scores amongst hip-related patient-reported outcome measures. Methods: Articles were selected following a comprehensive search of PUBMED, CINAHL, EMBASE, and MEDLINE databases (from database inception through October 2012). Inclusion criteria involved: (1) a patient-reported outcome measure used within a hip population was reported, (2) an MCID score was calculated and/or reported, and (3) the article was available in full text. Results: A total of nine studies met the inclusion criteria; seven different patient-reported outcomes were reported amongst varying hip pathologies, a range of follow-up time points, and different treatment approaches. Of the nine studies included, four studies reported MCID estimates on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) ranging from 6.1 to 26.54 on the WOMAC function subscale. Conclusions: This review highlights the wide range of reported MCID scores specific to WOMAC, as well as scores that were calculated from seven other patient-reported outcome measures. We encourage the reader to use caution when utilizing specific MCID estimates as values are highly variable depending upon the study population, follow-up time point, intervention, and methodology from which they were derived.

Duke Scholars

Author Chad E. Cook Orthopaedic Surgery, Physical Therapy