Minimal important change in physical function in trauma patients: a study using the short musculoskeletal function
M W de Graaf1, I H F Reininga2, E Heineman3
1Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, PO Box 30 001, 9700 RB, Groningen, The Netherlands. m.w.de.graaf@umcg.nl.
Summary
This study determined minimal important change (MIC) values for the Dutch Short Musculoskeletal Function Assessment (SMFA-NL) in patients with traumatic injuries. These values help interpret if functional improvements are clinically meaningful, though some subscales require cautious use.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Health Outcomes Research
Background:
- The Short Musculoskeletal Function Assessment (SMFA) is utilized to assess physical functioning in individuals with traumatic injuries.
- Determining the minimal important change (MIC) is crucial for understanding patient-perceived functional improvements.
- The Dutch version of the SMFA (SMFA-NL) requires established MIC values for clinical interpretation.
Purpose of the Study:
- To establish the minimal important change (MIC) values for the subscales of the Dutch Short Musculoskeletal Function Assessment (SMFA-NL).
- To provide benchmarks for interpreting meaningful improvements in physical functioning for patients with diverse traumatic injuries.
Main Methods:
- A cohort of 225 patients (aged 18-65) with traumatic injuries completed the SMFA-NL and Global Rating of Effect (GRE) at 6 weeks and 12 months post-injury.
- Anchor-based minimal important change (MIC) values were calculated using univariable logistic regression analyses.
Main Results:
- The minimal important change (MIC) values were determined for SMFA-NL subscales: Upper Extremity Dysfunction (UED) at 8 points (43% misclassification), Lower Extremity Dysfunction at 14 points (29% misclassification), Problems with Daily Activities at 25 points (33% misclassification), and Mental and Emotional Problems (MEP) at 7 points (37% misclassification).
Conclusions:
- Minimal important change (MIC) values for the SMFA-NL subscales have been established, aiding the interpretation of clinical significance in physical functioning changes.
- Caution is advised when utilizing the MIC values for the Upper Extremity Dysfunction (UED) and Mental and Emotional Problems (MEP) subscales due to notable misclassification rates.
