Minimal Clinically Important Difference and Substantial Clinical Benefit After Revision Hip Arthroscopy

Nwachukwu, Benedict U.; Chang, Brenda; Rotter, Ben-Zion; Kelly, Bryan T.; Ranawat, Anil S.; Nawabi, Danyal H.

doi:10.1016/j.arthro.2018.01.050

Cited by 84 publications

(56 citation statements)

References 29 publications

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“…In addition to aggregation of PRO scores, patients were administered custom questionnaires for the determination of the MCID, SCB, and PASS using an anchor-based methodology previously validated in the literature. 13,19,20,24 The MCID and SCB were assessed using a single anchor question, with patients being dichotomized into an MCID group and "no change" group, as well as an SCB group (Fig 2). 25,26 Receiver operating characteristic (ROC) and area under the curve (AUC) analysis with the Youden index was used to optimize the specificity and sensitivity of threshold values.…”

Section: Anchor Questions and Statistical Analysismentioning

confidence: 99%

“…[16][17][18] The MCID, SCB, and PASS thresholds are being increasingly defined for a variety of PROMs in specific patient populations. 13,15,[19][20][21] Although the PROMIS PF CAT has shown an acceptable performance relative to legacy PROMs in patients undergoing meniscal surgery, the MCID, SCB, and PASS values have yet to be defined. 9 The purpose of our study was to define the MCID, SCB, and PASS thresholds for the PROMIS PF CAT instrument in patients undergoing arthroscopic meniscal surgery.…”

mentioning

confidence: 99%

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How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?

Okoroha

Nwachukwu

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Anchor Questions and Statistical Analysismentioning

confidence: 99%

mentioning

confidence: 99%

How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?

Okoroha

Nwachukwu

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…1 Clinical researchers are beginning to explore the role and psychometric properties of outcome measures such as minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS). [2][3][4][5][6][7][8] Specifically, within the field of hip preservation surgery, a lot of attention has been paid to defining and understanding these clinical measures. In the study by Kivlan, Martin, Christoforetti, Wolff, Nho, Salvo, Ellis, Van Thiel, Matsuda, and Carreira 9 entitled "The Patient Acceptable Symptomatic State of the 12-Item International Hip Outcome Tool at 1-Year Follow-Up of Hip-Preservation Surgery," the authors sought to determine the PASS for the iHOT-12.…”

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confidence: 99%

Editorial Commentary: PASSing the Test Versus Acing It: Understanding Clinically Significant Outcome Improvement in Arthroscopic Hip Surgery

Nwachukwu

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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There is increasing interest in defining clinically significant outcome after orthopaedic procedures, and the field of hip preservation surgery is leading the way. Minimal clinically important difference, patient acceptable symptomatic state (PASS), and substantial clinical benefit have been established as important measures of clinically significant outcome. The International Hip Outcome Tool 12-question subset, one of the newer hip-specific measures, is being increasingly used. The 12-item version may prove popular among investigators given its decreased questionnaire burden. There still remain opportunities in future work to standardize how we analyze, interpret, and report clinically significant outcome. Specifically, an anchor-based method for calculating PASS may provide a more accurate representation of PASS score for arthroscopic hip surgery patients.

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“…The original iHOT-33 manuscript reported a minimal clinically important difference (MCID) of 6.1 in a general symptomatic hip population [ 66 ]. Since then, three other studies focusing on hip arthroscopy reported MCIDs varying from 10 to 12 [ 67 – 69 ] in time ranges varying from 6 to 12 months. Using a non-central t function with a conservative MCID of 10, an alpha level of 0.05, a power of 0.90, and a loss to follow-up of 15% provides a total sample size of 63 per group (total of 126).…”

Section: Methodsmentioning

confidence: 99%

Periacetabular osteotomy with or without arthroscopic management in patients with hip dysplasia: study protocol for a multicenter randomized controlled trial

Wilkin

Poitras

Clohisy

et al. 2020

Trials

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Background: Hip dysplasia is one of the most common causes of hip arthritis. Its incidence is estimated to be between 3.6 and 12.8% (Canadian Institute for Health Information, Hip and knee replacements in Canada, 2017-2018: Canadian joint replacement registry annual report, 2019; Jacobsen and Sonne-Holm, Rheumatology 44:211-8, 2004). The Periacetabular Osteotomy (PAO) has been used successfully for over 30 years (Gosvig et al., J Bone Joint Surg Am 92:1162-9, 2010), but some patients continue to exhibit symptoms post-surgery (Wyles et al., Clin Orthop Relat Res 475:336-50, 2017). A hip arthroscopy, performed using a small camera, allows surgeons to address torn cartilage inside the hip joint. Although both procedures are considered standard of care treatment options, it is unknown whether the addition of hip arthroscopy improves patient outcomes compared to a PAO alone. To delay or prevent future joint replacement surgeries, joint preservation surgery is recommended for eligible patients. While previous studies found an added cost to perform hip arthroscopies, the cost-effectiveness to Canadian Health care system is not known. Methods: Patients randomized to the experimental group will undergo central compartment hip arthroscopy prior to completion of the PAO. Patients randomized to the control group will undergo isolated PAO. Patient-reported quality of life will be the primary outcome used for comparison between the two treatment groups as measured by The International Hip Outcome Tool (iHOT-33) (Saberi Hosnijeh et al., Arthritis Rheum 69:86-93, 2017). Secondary outcomes will include the four-square step test and sit-to-stand (validated in patients with pre-arthritic hip pain) and hip-specific symptoms and impairment using the HOOS; global health assessment will be compared using the PROMIS Global 10 Score; health status will be assessed using the EQ-5D-5L and EQ VAS questionnaires (Ganz et al., Clin Orthop Relat Res 466:264-72, 2008) pre-and post-operatively. In addition, operative time, hospital length of stay, adverse events, and health services utilization will be collected. A subgroup of patients (26 in each group) will receive a T1rho MRI before and after surgery to study changes in cartilage quality over time. A cost-utility analysis will be performed to compare costs and quality-adjusted life years (QALYs) associated with the intervention.

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Minimal Clinically Important Difference and Substantial Clinical Benefit After Revision Hip Arthroscopy

Cited by 84 publications

References 29 publications

How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?

How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?

Editorial Commentary: PASSing the Test Versus Acing It: Understanding Clinically Significant Outcome Improvement in Arthroscopic Hip Surgery

Periacetabular osteotomy with or without arthroscopic management in patients with hip dysplasia: study protocol for a multicenter randomized controlled trial

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