Minimal Clinically Important Difference for PROMIS Physical Function in Patients With Distal Radius Fractures

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Health Outcomes Research

Background:

• Distal radius fractures are common injuries impacting physical function.
• The Patient-Reported Outcomes Information System (PROMIS) Physical Function computer adaptive test (CAT) is widely used to assess function.
• Establishing the minimal clinically important difference (MCID) is crucial for interpreting PROMIS CAT score changes.

Purpose of the Study:

• To determine the MCID of the PROMIS Physical Function CAT in patients with distal radius fractures.
• To provide evidence-based values for assessing meaningful functional recovery after nonsurgical treatment.

Main Methods:

• Retrospective analysis of 187 adults with distal radius fractures treated nonsurgically.
• PROMIS Physical Function CAT scores and clinical anchor questions were collected.
• Anchor-based and distribution-based methods were used to estimate MCID.

Main Results:

• The anchor-based MCID estimate was 3.6 points (SD, 8.4).
• The distribution-based MCID estimate was 4.6 points (SD, 1.8).
• Both estimates exceeded the minimum detectable change (MDC) of 2.3 points.

Conclusions:

• The MCID for PROMIS Physical Function after nonsurgical distal radius fracture treatment is estimated to be between 3.6 and 4.6 points.
• Clinical improvement is associated with smaller PROMIS Physical Function score changes in patients with better baseline function.
• These MCID estimations are vital for research sample size calculations and clinical relevance assessment.