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Minimal Clinically Important Difference After Carpal Tunnel Release Using the PROMIS Platform.

Nikolas H Kazmers1, Man Hung2, Jerry Bounsanga1

  • 1Department of Orthopaedics.

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|May 11, 2019
PubMed
Summary

This study determined the minimal clinically important difference (MCID) for patient-reported outcomes after carpal tunnel release (CTR). MCID values for PROMIS instruments and QuickDASH were estimated using the one-half SD method.

Keywords:
Carpal tunnelPROMISQuickDASHminimal clinically important difference (MCID)upper extremity

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Area of Science:

  • Orthopedic surgery
  • Patient-reported outcomes
  • Musculoskeletal disorders

Background:

  • Carpal tunnel release (CTR) is a common surgical procedure.
  • Assessing treatment effectiveness requires understanding the minimal clinically important difference (MCID) for patient-reported outcome measures.
  • Recent quality measures for CTR necessitate MCID elucidation.

Purpose of the Study:

  • To estimate the MCID for Patient-Reported Outcomes Measurement Information System (PROMIS) instruments and the short Disabilities of the Arm, Shoulder, and Hand (QuickDASH) following CTR.
  • To provide clinically relevant benchmarks for interpreting patient outcomes after carpal tunnel surgery.

Main Methods:

  • Adult patients undergoing isolated unilateral CTR were included.
  • Outcome measures comprised PROMIS Upper Extremity (UE) CAT, Physical Function (PF) CAT, QuickDASH, and Pain Interference (PI) CAT.
  • MCID was calculated using the one-half standard deviation (SD) method due to limited anchor-based data.

Main Results:

  • The one-half SD method yielded MCID values of 3.6 for UE CAT, 4.6 for PF CAT, 10.4 for QuickDASH, and 3.4 for PI CAT.
  • 88.6% of patients reported improvement post-surgery.
  • An anchor-based MCID calculation was not statistically feasible due to a low number of patients reporting no or minimal change.

Conclusions:

  • MCID values for key PROMs after CTR have been calculated using the one-half SD method.
  • These estimates are valuable for interpreting clinical outcomes and designing future research.
  • The calculated MCID values aid in understanding the meaningfulness of treatment response following carpal tunnel release.