A Clinically Significant Difference on the COPM: A Review.

Area of Science:

• Occupational Therapy
• Measurement in Health Sciences

Background:

• The Canadian Occupational Performance Measure (COPM) is a client-centered tool used by occupational therapists to identify and address performance issues.
• While the COPM effectively detects statistically significant changes, the empirical basis for a clinically significant difference (≥2 points) is unclear.

Approach:

• A scoping review of peer-reviewed literature from 1991 to 2020 was conducted.
• The review examined intervention studies utilizing the COPM as an outcome measure, analyzing intervention types and associated change scores.

Key Points:

• One hundred studies were identified, assessing the effectiveness of eight types of occupational therapy interventions.
• The widely held belief that a 2-point change in COPM scores signifies clinical significance was not empirically supported by the reviewed literature.

Conclusions:

• Further research is required to establish robust methods for determining clinical significance or a minimal clinically important difference for the COPM.
• Alternative approaches to asserting clinical significance need to be investigated to validate COPM's impact on patient outcomes.