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Minimal clinically important decline in physical function over one year: EPOSA study.

Paola Siviero1, Federica Limongi2, Antonella Gesmundo3

  • 1National Research Council, Neuroscience Institute - Aging Branch, Via Giustiniani 2, ,35128, Padova, Italy. paola.siviero@in.cnr.it.

BMC Musculoskeletal Disorders
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Summary
This summary is machine-generated.

The minimal clinically important difference (MCID) for hand osteoarthritis (OA) using the Australian/Canadian hand Osteoarthritis Index (AUSCAN) is 4 points. For hip and knee OA, the MCID using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is 2 points.

Keywords:
AUSCANFunctional declineHandHip/kneeMCIDOsteoarthritisWOMAC

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Area of Science:

  • Rheumatology
  • Orthopedics
  • Clinical Measurement

Background:

  • Osteoarthritis (OA) management relies on validated indices like the Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
  • Longitudinal data on hand OA changes using AUSCAN are limited, and WOMAC assessments for hip and knee have historically been analyzed separately.
  • Determining the minimal clinically important difference (MCID) is crucial for interpreting score changes in OA clinical trials and practice.

Purpose of the Study:

  • To establish the MCID for decline in physical function scores over one year for both hand OA (AUSCAN) and hip/knee OA (WOMAC).
  • To utilize both anchor-based and distribution-based methods for robust MCID estimation.
  • To provide reliable benchmarks for assessing meaningful change in OA patient populations.

Main Methods:

  • Analysis of data from the European Project on Osteoarthritis, a prospective observational study with six adult cohorts.
  • Evaluation of changes in AUSCAN and WOMAC physical function scores from baseline to 12-18 months.
  • Utilized pain and stiffness scores, grip strength, walking speed, and quality of life measures as anchors; employed Receiver Operating Characteristic curves and distribution-based methods for MCID estimation.

Main Results:

  • Data from 1866 participants were analyzed, with paired scores available for 1842 (AUSCAN) and 1845 (WOMAC).
  • MCID for decline in AUSCAN hand physical function was determined to be 4 points, showing significant correlation with AUSCAN pain scores (r=0.31).
  • MCID for decline in WOMAC hip/knee physical function was determined to be 2 points, correlating significantly with WOMAC pain (r=0.47) and stiffness (r=0.35) scores.

Conclusions:

  • The study provides reliable MCID estimates for assessing meaningful decline in physical function over one year for both hand and hip/knee osteoarthritis.
  • The established MCID values of 4 for AUSCAN (hand) and 2 for WOMAC (hip/knee) can aid in the interpretation of clinical trial outcomes and patient monitoring.
  • These findings contribute to a better understanding of clinically significant changes in osteoarthritis, facilitating more effective management strategies.