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Minimal important difference estimates for patient-reported outcomes: A systematic survey.

Alonso Carrasco-Labra1, Tahira Devji2, Anila Qasim2

  • 1Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Oral and Craniofacial Health Science, School of Dentistry, University of North Carolina at Chapel Hill, 385 S Columbia St, Chapel Hill, NC 27599, USA.

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|December 15, 2020
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Summary

This study created a comprehensive inventory of anchor-based minimal important difference (MID) estimates for patient-reported outcome measures (PROMs). This resource aids in interpreting treatment effect magnitudes in clinical research and guidelines.

Keywords:
Minimal important differencePatient-reported outcome measure

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Area of Science:

  • Clinical research methodology
  • Health outcomes assessment
  • Evidence synthesis

Background:

  • Patient-reported outcome measures (PROMs) are crucial for evaluating treatment effectiveness.
  • Interpreting the clinical significance of changes in PROMs requires minimal important difference (MID) estimates.
  • A consolidated inventory of existing anchor-based MIDs is needed to standardize interpretation.

Purpose of the Study:

  • To develop a comprehensive inventory of all anchor-based minimal important difference (MID) estimates for PROMs.
  • To systematically summarize MID estimates reported in the medical literature.
  • To facilitate the interpretation of PROM data in clinical research and guideline development.

Main Methods:

  • Systematic literature search of multiple databases (MEDLINE, EMBASE, CINAHL, PsycINFO) and internal libraries from January 1989 to October 2018.
  • Inclusion of primary studies reporting empirically calculated anchor-based MIDs for any PROM in adults and adolescents.
  • Independent screening, data extraction, and credibility assessment of MIDs by pairs of reviewers.

Main Results:

  • Identified 585 eligible studies reporting 5,324 MID estimates for 526 distinct PROMs.
  • The majority of studies were conducted in Europe and North America, focusing on surgical, pharmacological, and rehabilitation interventions.
  • Common credibility limitations included weak or absent correlation between PROMs and anchors (89%) and imprecise MID estimates (47%).

Conclusions:

  • A substantial number of anchor-based MIDs are available to aid in the interpretation of PROMs.
  • The developed MID inventory will enhance the consistent use of MID estimates in clinical research and guideline development.
  • Addressing credibility limitations in MID estimation is essential for reliable interpretation of treatment effects.