Minimal clinically important differences in SF‐36 global score: Current value in orthopedic oncology

Abstract

The SF-36 is widely used to evaluate the health-related quality of life (HRQoL) of patients with musculoskeletal tumors. Instead of typical methods, calculating the SF-36 Global Score has recently become an increasingly common reporting approach. However, numerical changes lack clear clinical relevance. The minimal clinically important difference (MCID) is useful for interpreting changes in functional scores by defining the smallest change patients may perceive as clinically meaningful.The aim of this study is to determine the MCID of the SF-36 Global Score in orthopedic oncology patients, which has not been reported to date. Three-hundred ten patients who underwent surgery and completed two surveys during postoperative follow-up were reviewed. The two most common methods for calculating the SF-36 Global Score were used: (1) anchor-based methods and receiver operating characteristic analysis based on one-half of the SD of change score and standard error of measurement at baseline and; (2) distribution-based methods. Using anchor-based methods, the MCIDs of SF-36 Global Scores #1 and #2 were 2.7 (area under the curve [AUC] = 0.85) and 2.5 (AUC = 0.79) for improvement, and −1.5 (AUC = 0.81) and −0.6 (AUC = 0.83) for deterioration, respectively. Using distribution-based methods, the MCIDs of SF-36 Global Scores #1 and #2 were 4.1 and 4.4 by half SD, and 4.1 and 4.5 by standard error of measurement, respectively. Our findings provide benchmark values, which can serve as a reference for future studies in musculoskeletal tumor patients using the SF-36 Global Score as a single measure for HRQoL. K E Y W O R D S anchor-based method, distribution-based method, health-related quality of life (HRQoL), minimal clinically important difference (MCID), sarcoma, SF-36 Global Score 1 | BACKGROUND Patient-derived outcome assessments are essential determinants of health-related quality of life (HRQoL) in oncology and help inform treatment decisions for future musculoskeletal oncology patients. There has been a burgeoning of publications regarding HRQoL. 1 More generic instruments, such as SF-36 or Patient Reported Outcomes Measurement Information System, are validated internationally for general orthopedic conditions. 2,3 However, these have not been evaluated critically in musculoskeletal oncology, although

The anchor design of anchor-based method to determine the minimal clinically important difference: a systematic review

“…(2018) [ 28 ] Degenerative Cervical Myelopathy Neck Disability Index (NDI) Yes ROC 3.93 3.16 Yuksel, S.(2018) [ 29 ] Adult spinal deformity Patient’s rating of change (15-point Likert scales) No Linear regression 7.33 4.37 Brigden, A. (2018) [ 30 ] Chronic Fatigue Syndrome (CFS)/Myalgic encephalomyelitis (ME) in Children and Adolescents Patient’s rating of change (7-point Likert scales) No Mean change (within group) 8.8 - Kato, S.(2019) [ 31 ] Cervical laminoplasty Patient’s rating of change or patient satisfaction (7-point Likert scales) No ROC 3.9 - Carton, P(2020) [ 32 ] Arthroscopic Correction of Sports-Related Femoroacetabular Impingement Patient’s rating of change (5-point Likert scales) No Mean change(between groups)、ROC - - Ogura, K.(2020) [ 33 ] Orthopedic oncology Patient’s rating of change (5-point Likert scales) Yes ROC - - Yao, M.(2020) [ 34 ] lumbar disc herniation Patient’s rating of change (7-point Likert scales) No Mean change (between groups) 4.57 3.59 ...…”

Exploring the Relationship Between Childhood Adversity and Adult Autoimmune Symptoms

“…However, Ogura et al (2021) conducted a minimal clinically important difference analysis to investigate its validity for measuring HRQoL. Their results provided support for use of a global SF-36 score that represents a single measure for HRQoL (Ogura et al, 2021). Furthermore, global scores obtained from the SF-36 have been used in other literature (e.g., Pellegrini et al, 2015, Queen et al, 2014, Tidermark et al, 2003.…”

“…28 Using the SF-36 to obtain a global score representing health-related quality of life (HRQoL) has been criticized, as it was suggested to be scored using the eight-subscales (Lins & Carvalho, 2016). However, Ogura et al (2021) conducted a minimal clinically important difference analysis to investigate its validity for measuring HRQoL. Their results provided support for use of a global SF-36 score that represents a single measure for HRQoL (Ogura et al, 2021).…”

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