Minimal clinically important difference (MCID) for patient-reported shoulder outcomes.

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Clinical Outcomes Research

Background:

• The minimal clinically important difference (MCID) is crucial for interpreting patient-reported outcome (PRO) data in clinical practice.
• A consensus on MCID values for common PROs in shoulder surgery is lacking.
• This systematic review addresses the need for evaluating shoulder surgery MCID literature.

Purpose of the Study:

• To systematically review and evaluate existing literature on anchor-based minimal clinically important difference (MCID) values for shoulder surgery outcome instruments.
• To identify commonly used PROs in shoulder surgery and assess the reported MCID values.
• To inform clinical interpretation of shoulder outcome data.

Main Methods:

• Systematic literature review identifying studies reporting anchor-based MCID values.
• Focused on PROs recommended by the American Shoulder and Elbow Surgeons (ASES), including Veterans Rand 12, ASES score, SANE, WORC, WOOS, WOSI, Pennsylvania Shoulder Score, and OSS.
• Included 14 articles in the final analysis.

Main Results:

• No studies reported MCID for the Western Ontario Osteoarthritis Score (WOOS).
• The ASES score (6 studies), OSS (4 studies), and WORC score (2 studies) were most frequently reported.
• Average MCID values were 15.5 for ASES, 275.7 for OSS, and 6 for WORC, but study quality and reporting were often insufficient for validation.

Conclusions:

• The current utility of MCID for shoulder PROs is limited due to methodological weaknesses and inadequate reporting.
• Significant data gaps and poor study quality hinder the reliable definition of MCID values.
• Further high-quality research is essential to establish definitive MCID values for shoulder surgery outcomes.