关节整形术结果测量的最小临床重要差异 (MCID) 根据计算方法大大不同
Matthew J Solomito1, Robert Carangelo1,2, Heeren Makanji1,2
1Hartford HealthCare Bone and Joint Institute, Hartford, Connecticut.
The Journal of bone and joint surgery. American volume
|March 20, 2025
概括
关节置换手术的最小临床重要差异 (MCID) 根据计算方法有很大差异,影响了手术成功和患者结果的评估. 这种模糊性质疑其在评估关节整形术有效性的有用性.
科学领域:
- 整形外科 整形外科 整形外科
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 转向以价值为基础的医疗保健强调了患者报告的结果.
- 最小临床重要差异 (MCID) 对于评估感知到的手术益处至关重要.
- 在MCID计算方法的模糊性影响了手术成功的解释.
研究的目的:
- 评估不同统计方法对全膝关节整形术 (TKA) 和全关节整形术 (THA) 的MCID值的影响.
- 评估MCID计算的变化如何影响在关节置换后实现有意义改善的患者数量.
主要方法:
- 审查了1113名接受TKA或THA治疗的患者,以及1年的术后PRO (KOOS JR,HOOS JR).
- 使用16种不同的统计方法确定了MCID.
- 应用计算的MCID值来评估患者报告的结果,并比较各种方法的结果.
主要成果:
- 在评估的16种方法中,MCID值差异很大 (KOOS JR: 0.5-36.6;HOOS JR: 0.6-34.3).
- 基于分布的方法产生了更小,更可变的MCID值.
- 基于的方法产生了更大,更一致的MCID值.
结论:
- 不同的MCID计算的统计方法导致值的显著变化.
- 这些变化会影响确定患有MCID的患者,影响对手术效益的评估.
- 这项研究强调了MCID的模两可,并提出了对其在评估关节整形术结果的可靠性的问题.
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