The minimal clinically important difference after simple decompression for ulnar neuropathy at the elbow

Area of Science:

• Orthopedics
• Neurosurgery
• Outcomes Research

Background:

• Establishing minimally clinically important difference (MCID) is crucial for patient-reported outcomes in treating ulnar neuropathy at the elbow (UNE).
• Understanding patient satisfaction requires quantifying meaningful changes in questionnaire scores post-treatment.

Purpose of the Study:

• To determine the MCID for the Michigan Hand Outcomes Questionnaire (MHQ), Disabilities of the Arm, Shoulder, and Hand (DASH), and Carpal Tunnel Questionnaire (CTQ) in patients with UNE.
• To assess patient satisfaction based on score changes after simple decompression surgery for UNE.

Main Methods:

• Calculated score changes in MHQ, DASH, and CTQ from preoperative to 3, 6, and 12 months post-surgery.
• Employed the anchor-based approach using receiver operating characteristic curves to define MCID.
• Classified as Therapeutic II study.

Main Results:

• Identified average MCIDs: MHQ (pain 10, function 12, ADL 7), DASH (7), CTQ-symptom (0.7), CTQ-function (0.3).
• Time-point MCIDs varied, e.g., MHQ pain ranged from 8-13, function 12, ADL 6-8; DASH ranged from 7-8; CTQ scales ranged from 0.3-0.7.

Conclusions:

• Small MCIDs for MHQ, DASH, and CTQ suggest that minor score improvements indicate patient satisfaction after UNE surgery.
• Simple decompression for UNE is highly effective, with responsive questionnaires minimizing sample size needs for future UNE research.