Reliability and Clinically Important Improvement Thresholds for Osteoarthritis Pain and Function Scales: A Multicenter Study

Abstract

Objective To assess the reliability and clinically meaningful thresholds of intermittent and constant osteoarthritis pain (ICOAP) score, the Knee injury and Osteoarthritis Outcome Score Physical function Short-form (KOOS-PS), the Hip disability and Osteoarthritis Outcome Score Physical function Short-form (HOOS-PS), and the Quality of life subscales of HOOS/KOOS (HOOS-QOL/KOOS-QOL) in patients with knee or hip arthritis. Methods 195 patients (141 knee, 54 hip) seen at two orthopedic outpatient clinics with a diagnosis of knee or hip osteoarthritis completed patient-reported questionnaires (ICOAP pain scale, KOOS-PS, HOOS-PS, KOOS-QOL, HOOS-QOL) at baseline and 2-week follow-up. Reliability was assessed using Intraclass correlation coefficients (ICC). We calculated minimally clinically important difference (MCID) and moderate improvement in the subgroup that reported change in their status of their affected joint. Results The reliability as assessed by ICCs was as follows: ICOAP pain scale, 0.63 (0.48, 0.74) in patients with knee arthritis, and 0.86 (0.73, 0.93) for hip arthritis; KOOS-PS, 0.66 (0.52, 0.77); HOOS-PS, 0.82 (0.66, 0.91); KOOS-QOL, 0.79 (0.69, 0.86); HOOS-QOL, 0.67 (0.42, 0.83). MCID and moderate improvement estimates in patients with knee arthritis were: ICOAP pain scale, 18.5 and 26.7; KOOS-PS, 2.2 and 15.0; and KOOS-QOL, 8.0 and 15.6. A smaller sample in hip arthritis patients precluded MCID and moderate improvement estimates. Conclusions We found that ICOAP pain, and KOOS-PS/HOOS-PS scales were reasonably reliable in patients with hip osteoarthritis. Reliability of these scales was much lower in knee arthritis patients. Thresholds for clinically meaningful change in pain or function on these scales were estimated for patients with knee arthritis.

Randomized Controlled Trial Investigating the Role of Exercise in the Workplace to Improve Work Ability, Performance, and Patient-Reported Symptoms Among Older Workers With Osteoarthritis

“…These large effect sizes likely reflect the small sample. 44 In the current study, improvements in overall, constant, and intermittent pain in the exercise group all exceeded the MCID (23.8, 20.6, 26.4, respectively), with intermittent pain exceeding the moderate improvement threshold. 42 Further, differences in each of these outcome measures can also be considered clinically meaningful.…”

The association of pre-operative body pain diagram scores with pain outcomes following total knee arthroplasty

“…We chose an estimate of the MCID as the measure of improvement because the MCID is generally regarded as a clinically relevant metric. 29 We note, though, that the MCID was derived using data from Escobar and Riddle 22 and not from our subjects. Thus, we cannot state with certainty that the individual subjects who achieved the MCID in our cohort regarded their improvement as clinically important.…”

Association between MRI-defined osteoarthritis, pain, function and strength 3–10 years following knee joint injury in youth sport

“…To ensure adequate adjustment for multiple comparisons, a significance level of α=0.004 was used (α=0.05/12 comparisons=0.004). A minimum clinically important difference (MCID) was considered as 6, 5–8.5, 7–8, 5.8–12 and 7–7.2 points for the KOOS pain, symptoms, function in daily living, function in sport and quality-of-life subscales, respectively,22 and 18.5 points for the ICOAP 23. MCID values for the triple-hop (per cent leg length), YBT (normalised to leg length) and knee extensor and flexor strength (Nm/kg) were not available.…”