The anchor-based minimal important change, based on receiver operating characteristic analysis or predictive modeling, may need to be adjusted for the proportion of improved patients

Terluin, Berend; Eekhout, Iris; Terwee, Caroline B.

doi:10.1016/j.jclinepi.2016.12.015

Cited by 106 publications

(166 citation statements)

References 14 publications

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“…Moreover, the magnitude of these estimates sometimes varies widely. Several other researcher groups have made similar observations, stressing the importance of improved understanding of factors influencing the magnitude of MIDs 4662979899. Future research should, therefore, focus on understanding how different methodological and statistical approaches contribute to the variability in MIDs.…”

Section: Discussionmentioning

confidence: 71%

Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study

Devji

Carrasco-Labra

Qasim

et al. 2020

BMJ

156

202

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Objective To develop an instrument to evaluate the credibility of anchor based minimal important differences (MIDs) for outcome measures reported by patients, and to assess the reliability of the instrument. Design Instrument development and reliability study. Data sources Initial criteria were developed for evaluating the credibility of anchor based MIDs based on a literature review (Medline, Embase, CINAHL, and PsycInfo databases) and the experience of the authors in the methodology for estimation of MIDs. Iterative discussions by the team and pilot testing with experts and potential users facilitated the development of the final instrument. Participants With the newly developed instrument, pairs of masters, doctoral, or postdoctoral students with a background in health research methodology independently evaluated the credibility of a sample of MID estimates. Main outcome measures Core credibility criteria applicable to all anchor types, additional criteria for transition rating anchors, and inter-rater reliability coefficients were determined. Results The credibility instrument has five core criteria: the anchor is rated by the patient; the anchor is interpretable and relevant to the patient; the MID estimate is precise; the correlation between the anchor and the outcome measure reported by the patient is satisfactory; and the authors select a threshold on the anchor that reflects a small but important difference. The additional criteria for transition rating anchors are: the time elapsed between baseline and follow-up measurement for estimation of the MID is optimal; and the correlations of the transition rating with the baseline, follow-up, and change score in the patient reported outcome measures are satisfactory. Inter-rater reliability coefficients (ĸ) for the core criteria and for one item from the additional criteria ranged from 0.70 to 0.94. Reporting issues prevented the evaluation of the reliability of the three other additional criteria for the transition rating anchors. Conclusions Researchers, clinicians, and healthcare policy decision makers can consider using this instrument to evaluate the design, conduct, and analysis of studies estimating anchor based minimal important differences.

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Section: Discussionmentioning

confidence: 71%

Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study

Devji

Carrasco-Labra

Qasim

et al. 2020

BMJ

156

202

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“…was used . It has been suggested that if the proportion improved on the anchor does not equal 0·5, an adjusted MIC may need to be calculated . As the proportion improved on the IGA anchor was 0·56 and the P/PGA anchor was 0·53, we have not reported the adjusted MIC here.…”

Section: Methodsmentioning

confidence: 99%

How should minimally important change scores for the Patient-Oriented Eczema Measure be interpreted? A validation using varied methods

et al. 2018

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SummaryBackgroundThe Patient‐Oriented Eczema Measure (POEM), scored 0–28, is the core outcome instrument recommended for measuring patient‐reported atopic eczema symptoms in clinical trials. To date, two published studies have broadly concurred that the minimally important change (MIC) of the POEM is three points. Further assessment of the MIC of POEM in different populations, and using a variety of methods, will improve interpretability of the POEM in research and clinical practice.ObjectivesTo calculate the smallest detectable change in the POEM and estimate the MIC of the POEM using a variety of methods in a trial dataset of children with moderate‐to‐severe atopic eczema.MethodsThis study used distribution‐based and anchor‐based methods to calculate the MIC of the POEM in children with moderate‐to‐severe eczema.ResultsData were collected from 300 children. The smallest detectable change was 2·13. The MIC estimates were 1·07 (using 0·2 SD of baseline POEM scores) and 2·68 (using 0·5 SD of baseline POEM scores) based on distribution‐based methods; were 3·09–6·13 based on patient‐/parent‐reported anchor‐based methods; and were 3·23–5·38 based on investigator‐reported anchor‐based methods.ConclusionsWe recommend the following thresholds be used to interpret changes in POEM scores: ≤ 2, unlikely to be a change beyond measurement error; 2·1–2·9, a small change detected that is likely to be beyond measurement error but may not be clinically important; 3–3·9, probably a clinically important change; ≥ 4, very likely to be a clinically important change.

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“…pain, function and patient satisfaction) might have produced other results. Furthermore, note that alternative methods to derive MCIC estimates do exist [40,41] however we chose to use the ROC curve method to preserve comparability with other studies in the eld and communicability with readers unfamiliar with alternative methods.…”

Section: Discussionmentioning

confidence: 99%

Measurement properties of the Musculoskeletal Health Questionnaire (MSK-HQ): a between country comparison

Christiansen¹,

McCray

Winding

et al. 2020

Preprint

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Background: The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. However, the MSK-HQ needs to be further evaluated across settings and different languages.Objective: The objective of the study was to evaluate and compare measurement properties of the MSK-HQ across Danish (DK) and English (UK) cohorts of patients from primary care physiotherapy services with musculoskeletal pain. Methods: MSK-HQ was translated into Danish according to international guidelines. Measurement invariance was assessed by differential item functioning (DIF) analyses. Test-retest reliability, measurement error, responsiveness and minimal clinically important change (MCIC) were evaluated and compared between DK (n=153) and UK (n=166) cohorts. Results: The Danish version demonstrated acceptable face and construct validity. Out of the 14 MSK-HQ items, three items showed DIF for language (pain/stiffness at night, understanding condition and confidence in managing symptoms) and three items showed DIF for pain location (walking, washing/dressing and physical activity levels). Intraclass Correlation Coefficients for test-retest were 0.86 (95% CI 0.81 to 0.91) for DK cohort and 0.77 (95% CI 0.49 to 0.90) for the UK cohort. The systematic measurement error was 1.6 and 3.9 points for the DK and UK cohorts respectively, with random measurement error being 8.6 and 9.9 points. Receiver operating characteristic (ROC) curves of the change scores against patients’ own judgment at 3 months exceeded 0.70 in both cohorts. Absolute and relative MCIC estimates were 8-10 points and 26% for the DK cohort and 6-8 points and 29% for the UK cohort.Conclusions: The measurement properties of MSK-HQ were acceptable across countries, but seem more suited for group than individual level evaluation. Researchers and clinicians should be aware that some discrepancy exits and should take the observed measurement error into account when evaluating change in scores over time.

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The anchor-based minimal important change, based on receiver operating characteristic analysis or predictive modeling, may need to be adjusted for the proportion of improved patients

Cited by 106 publications

References 14 publications

Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study

Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study

How should minimally important change scores for the Patient-Oriented Eczema Measure be interpreted? A validation using varied methods

Measurement properties of the Musculoskeletal Health Questionnaire (MSK-HQ): a between country comparison

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