Patient-reported questionnaires in MS rehabilitation: responsiveness and minimal important difference of the multiple sclerosis questionnaire for physiotherapists (MSQPT)

Abstract

BackgroundThe Multiple Sclerosis Questionnaire for Physical Therapists (MSQPT) is a patient-rated outcome questionnaire for evaluating the rehabilitation of persons with multiple sclerosis (MS). Responsiveness was evaluated, and minimal important difference (MID) estimates were calculated to provide thresholds for clinical change for four items, three sections and the total score of the MSQPT.MethodsThis multicentre study used a combined distribution- and anchor-based approach with multiple anchors and multiple rating of change questions. Responsiveness was evaluated using effect size, standardized response mean (SRM), modified SRM and relative efficiency. For distribution-based MID estimates, 0.2 and 0.33 standard deviations (SD), standard error of measurement (SEM) and minimal detectable change were used. Triangulation of anchor- and distribution-based MID estimates provided a range of MID values for each of the four items, the three sections and the total score of the MSQPT. The MID values were tested for their sensitivity and specificity for amelioration and deterioration for each of the four items, the three sections and the total score of the MSQPT. The MID values of each item and section and of the total score with the best sensitivity and specificity were selected as thresholds for clinical change.The outcome measures were the MSQPT, Hamburg Quality of Life Questionnaire for Multiple Sclerosis (HAQUAMS), rating of change questionnaires, Expanded Disability Status Scale, 6-metre timed walking test, Berg Balance Scale and 6-minute walking test.ResultsThe effect size ranged from 0.46 to 1.49. The SRM data showed comparable results. The modified SRM ranged from 0.00 to 0.60. Anchor-based MID estimates were very low and were comparable with SD- and SEM-based estimates. The MSQPT was more responsive than the HAQUAMS in detecting improvement but less responsive in finding deterioration. The best MID estimates of the items, sections and total score, expressed in percentage of their maximum score, were between 5.4% (activity) and 22% (item 10) change for improvement and between 5.7% (total score) and 22% (item 10) change for deterioration.ConclusionsThe MSQPT is a responsive questionnaire with an adequate MID that may be used as threshold for change during rehabilitation of MS patients.Trial registrationThis trial was retrospectively (01/24/2015) registered in ClinicalTrials.gov as NCT02346279.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-017-0834-1) contains supplementary material, which is available to authorized users.

The disease burden of Multiple Sclerosis from the individual and population perspective: Which symptoms matter most?

“…Data on sex and region of residence (German-, French-, and Italian-speaking regions of Switzerland) stem from the participants' contact information. The entry survey collects information on HRQoL, frequency of symptoms (never/once/recurrent/permanent), age, disease duration (years since MS diagnosis), MS form, use of disease-modifying treatment (DMT), health professionals visited in the previous year, confirmed MS diagnosis in parents, siblings or offspring, mobility (Ferchichi and van der Maas, 2015;van der Maas, 2017), lifestyle factors, and socioeconomic status. As Expanded Disability Status Scale (EDSS) was rarely reported, a proxy measure was derived from available mobility data (Appendix) (Ferchichi and van der Maas, 2015;van der Maas, 2017).…”

Validation of the Indonesian Version of the Foot and Ankle Outcome Score in Patients with Chronic Lateral Ankle Instability

“…Among the ve FAOS subscales, pain was the most responsive, possibly because pain is the most common problem of CLAI patients and often is the main reason for a clinical visit [1]. Moreover, most effect sizes of the FAOS subscales in improvement of the SF-36's "change" were larger than those in deterioration of the SF-36's "change", indicating that FAOS items were more sensitive to positive changes in the health status [34]. Anchor-based responsiveness depends on external measures, and here, it was determined by the strength of the association of the FAOS subscale with the SF-36's "change".…”

Validation of the Indonesian version of the foot and ankle score in patients with chronic lateral ankle instability

“…Among the five FAOS subscales, pain was the most responsive, possibly because pain is the most common problem of CLAI patients and often is the main reason for a clinical visit [ 1 , 2 ]. Moreover, most effect sizes of the FAOS subscales in improvement of the SF-36’s “change” were larger than those in deterioration of the SF-36’s “change”, indicating that FAOS items were more sensitive to positive changes in the health status [ 39 ]. Anchor-based responsiveness depends on external measures, and here, it was determined by the strength of the association of the FAOS subscale with the SF-36’s “change”.…”