Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis outcome score for joint reconstruction in orthopaedics

Man Hung, Jerry Bounsanga, Maren W Voss, Charles L Saltzman, Man Hung, Jerry Bounsanga, Maren W Voss, Charles L Saltzman

Abstract

Aim: To establish minimum clinically important difference (MCID) for measurements in an orthopaedic patient population with joint disorders.

Methods: Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS® PF) computerized adaptive test (CAT), hip disability and osteoarthritis outcome score for joint reconstruction (HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction (KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchor-based and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.

Results: There were 2226 patients who participated with a mean age of 61.16 (SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS® PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS® PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.

Conclusion: This is the first comprehensive study providing a wide range of MCIDs for the PROMIS® PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Keywords: Arthroplasty; Clinical outcomes; Hhip disability and osteoarthritis outcome score for joint reconstruction; Joint; Knee injury and osteoarthritis outcome score for joint reconstruction; Minimum clinically important difference; Minimum detectable change; Orthopaedics; Patient-Reported Outcomes Measurement Information System Physical Function; Physical function.

Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Multi-method minimum clinically important difference score ranges for PROMIS PF CAT, HOOS JR, and KOOS JR.

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