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Mind the methods of determining minimal important differences: three critical issues to consider.
Tahira Devji1, Alonso Carrasco-Labra2, Gordon Guyatt3
1Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Canada devjits@mcmaster.ca.
Evidence-Based Mental Health
|August 26, 2020
Summary
Minimal important differences (MIDs) improve patient-reported outcome measures (PROMs) interpretability. Users must be aware of terminology, diverse estimation methods, and reporting issues for optimal application in clinical research.
Area of Science:
- Clinical research methodology
- Health outcomes measurement
Background:
- Patient-reported outcome measures (PROMs) are crucial in clinical research.
- Minimal important differences (MIDs) enhance PROM interpretability for clinicians and researchers.
- Growing use of MIDs necessitates a clear understanding of their application and limitations.
Purpose of the Study:
- To identify and elucidate critical issues concerning the use of MIDs in clinical research.
- To improve the understanding and application of MIDs for interpreting PROMs.
- To address common pitfalls in MID methodology and reporting.
Main Methods:
- Systematic review of electronic databases to identify studies calculating anchor-based MID estimates.
- Inclusion of studies on PROMs in adolescent and adult populations across all clinical areas.
- Analysis of 338 studies reporting 3389 MIDs for 358 PROMs published between 1989 and 2015.
Main Results:
- Identified three key issues in MID literature: (1) confusing terminology, (2) diverse and unresolved estimation methods, and (3) incomplete reporting of study design, methodology, and results.
- Inconsistent terminology complicates the identification of relevant MIDs.
- Lack of standardized reporting practices hinders the optimal use of MID estimates.
Conclusions:
- MIDs are valuable for interpreting PROMs in clinical research.
- Improved understanding of MID concepts and awareness of methodological pitfalls are essential.
- Enhanced reporting of MID studies is required to maximize their utility in decision-making.
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