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Discordance Abounds in Minimum Clinically Important Differences in THA: A Systematic Review
David G Deckey1, Jens T Verhey1, Zachary K Christopher1
1Department of Orthopaedic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
Clinical Orthopaedics and Related Research
|November 18, 2022
Summary
Minimum clinically important difference (MCID) values in total hip arthroplasty (THA) research show consistency across calculation methods. Anchor-based MCIDs are often larger than distribution-based MCIDs for key patient-reported outcome measures (PROMs).
Area of Science:
- Orthopaedic Surgery
- Clinical Outcomes Research
- Patient-Reported Outcome Measures (PROMs)
Background:
- Minimum clinically important difference (MCID) quantifies patient-appreciable changes in patient-reported outcome measures (PROMs).
- Growing use in total hip arthroplasty (THA) research necessitates understanding MCID calculation consistency and application.
- Inconsistencies in population-specific MCIDs and calculation methods highlight the need for systematic review.
Approach:
- Systematic review of EMBASE, MEDLINE, and PubMed databases (through March 2022) for THA studies reporting MCIDs.
- Extracted MCID values, calculation methods (anchor-based vs. distribution-based), and patient demographics from 30 included studies.
- Compared median MCID values and ranges between calculation methods using Wilcoxon rank sum test.
Key Points:
- Oxford Hip Score (OHS) and Hip Injury and Osteoarthritis Score (HOOS) subscores were most frequently reported.
- Anchor-based MCIDs for OHS (9) and HOOS Pain (33) were generally higher than distribution-based values (OHS: 6, HOOS Pain: 10).
- Most studies utilized anchor-based (Likert scale) or distribution-based (half standard deviation) methods; 30% used both.
Conclusions:
- MCID values show minimal variation across calculation methods for most PROMs in THA research.
- Anchor-based MCIDs tend to be larger than distribution-based MCIDs for frequently reported PROMs.
- Recommended MCIDs: OHS (9), HOOS Pain (33), and HOOS Quality of Life (25), favoring anchor-based calculations.
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