Defining Significant Changes with Patient-Acceptable Symptom State Score and Minimal Clinically Important Difference...

Japanese International Hip Outcome Tool 12 (iHOT12J) and Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ) have been used in patients with hip labral injuries. However, patient-acceptable symptom state (PASS) and minimal clinically important difference (MCID) from iHOT12J and JHEQ have not been investigated. We analyzed PASS score and MCID between iHOT12J and JHEQ preoperatively and at 2 years postoperatively in patients underwent hip arthroscopy.

PASS score and MCID were calculated using pre- and two years post hip arthroscopy iHOT12J and JHEQ data from 99 patients. Anchor-based method was used to calculate PASS, which involved dividing patients into two groups based on their JHEQ satisfaction visual analog scale as well as performing receiver operating characteristic (ROC) curve analyses. ROC curve and PASS score were computed using obtained values and Youden index, respectively. Value with the greatest sensitivity and specificity was target value. MCID was calculated with 0.5 standard deviation (SD) method by dividing the mean of iHOT12J and JHEQ values, obtained from pre- and at two years post-surgery, by 0.5.

PASS scores were 74.2 for iHOT12J and 62.0 for JHEQ. SD was 24.8% for iHOT12J and 19.4 for JHEQ. MCID was 12.4 for iHOT12J and 9.7 for JHEQ. Achievement rates of PASS and MCID were 73/99 (73.7%) for iHOT12J and 89/99 (89.9%) for JHEQ.

PASS score and MCID could serve as measurable benchmarks to define significance in patient-reported outcome measure values for clinical outcomes or variables of postoperative hip arthroscopy.