Variability of MCID, SCB, and PASS Thresholds in Studies Assessing Patient-Reported Outcomes After Rotator Cuff...

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine
• Clinical Outcomes Research

Background:

• Patient-reported outcomes (PROs) are increasingly vital in evaluating rotator cuff repair (RCR) success.
• Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS) are key thresholds for assessing RCR outcomes.
• This review synthesizes reported thresholds for these measures in RCR literature.

Approach:

• A systematic review of PubMed, Embase, Ovid, Cochrane, and Google Scholar databases was conducted.
• Included studies published between January 2000 and May 2022, reporting MCID, SCB, and PASS for RCR with ≥12 months follow-up.
• Extracted data included reported thresholds and their calculation methodologies.

Key Points:

• 41 studies (6331 shoulders) met inclusion criteria, with 90% reporting MCID, 39% PASS, and 27% SCB.
• Anchor-based methods were used by 12 studies for threshold calculation, while 6 used distribution-based methods.
• The reporting and use of MCID, SCB, and PASS in RCR research have notably increased, particularly in recent years.

Conclusions:

• Significant variability exists in reported MCID, SCB, and PASS threshold values following rotator cuff repair.
• Prioritizing studies using anchor-based methods and critically evaluating anchor questions is recommended.
• Standardization of these outcome thresholds and calculation methods is essential for reliable PRO assessment in RCR.