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- Title
Examining the Minimal Important Difference of Patient-reported Outcome Measures for Individuals with Knee Osteoarthritis: A Model Using the Knee Injury and Osteoarthritis Outcome Score.
- Authors
Mills, Kathryn A. G.; Naylor, Justine M.; Eyles, Jillian P.; Roos, Ewa M.; Hunter, David J.
- Abstract
<bold>Objective: </bold>To examine the influence of different analytical methods, baseline covariates, followup periods, and anchor questions when establishing a minimal important difference (MID) for individuals with knee osteoarthritis (OA). Second, to propose MID for improving and worsening on the Knee injury and Osteoarthritis Outcome Score (KOOS).<bold>Methods: </bold>Retrospective analysis of prospectively collected data from 272 patients with knee OA undergoing a multidisciplinary nonsurgical management strategy. The magnitude and rate of change as well as the influence of baseline covariates were examined for 5 KOOS subscales over 52 weeks. The MID for improving and worsening were investigated using 4 anchor-based methods.<bold>Results: </bold>Waitlisted for joint replacement and exhibiting unilateral/bilateral symptoms influenced change in KOOS over time. Generally, low correlations between anchors and KOOS change scores limited calculations of MID; thus, they were only proposed for the pain, activities of daily living, and quality of life subscales. The method used to calculate the MID influenced the cutpoint; however, the type of anchor question only influenced the MID when analyzed with a particular mean change method. Depending on patient and clinical characteristics, the subscale, and the analytical approach used, the MID for KOOS improvement ranged from an absolute change of -1.5 to 20.6 points and worsening ranged from -19.17 to 8.5 points.<bold>Conclusion: </bold>MID vary with patient and clinical characteristics, KOOS subscale, and analytical approach. Provided the anchor question is relevant to the patient-reported outcome and baseline status is considered, the anchor does not appear to influence the MID for improvement or worsening when using some anchor-based methods.
- Subjects
KNEE surgery; FUNCTIONAL assessment; KNEE diseases; OSTEOARTHRITIS; HEALTH outcome assessment; QUALITY of life; TOTAL knee replacement; ACTIVITIES of daily living; TREATMENT effectiveness; RETROSPECTIVE studies
- Publication
Journal of Rheumatology, 2016, Vol 43, Issue 2, p395
- ISSN
0315-162X
- Publication type
journal article
- DOI
10.3899/jrheum.150398