Minimal important difference estimates for patient-reported outcomes: A systematic survey

Alonso Carrasco-Labra¹, Tahira Devji², Anila Qasim², Mark R Phillips², Yuting Wang², Bradley C Johnston³, Niveditha Devasenapathy⁴, Dena Zeraatkar², Meha Bhatt², Xuejing Jin⁵, Romina Brignardello-Petersen², Olivia Urquhart⁶, Farid Foroutan⁷, Stefan Schandelmaier⁸, Hector Pardo-Hernandez⁹, Qiukui Hao¹⁰, Vanessa Wong², Zhikang Ye², Liam Yao², Robin W M Vernooij¹¹, Hsiaomin Huang¹², Linan Zeng¹³, Yamna Rizwan¹⁴, Reed Siemieniuk², Lyubov Lytvyn², Donald L Patrick¹⁵, Shanil Ebrahim², Toshi A Furukawa¹⁶, Gihad Nesrallah¹⁷, Holger J Schünemann¹⁸, Mohit Bhandari¹⁹, Lehana Thabane², Gordon H Guyatt¹⁸

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Oral and Craniofacial Health Science, School of Dentistry, University of North Carolina at Chapel Hill, 385 S Columbia St, Chapel Hill, NC 27599, USA. Electronic address: alonsocarrascolabra@gmail.com.
² Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada.
³ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Nutrition, Texas A&M University, College of Agriculture and Life Sciences, College Station, TX B3H 1V7, USA.
⁴ Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
⁵ Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Public Health, University of Alberta, 85 Avenue, Edmonton, Alberta AB T6G 2R3, Canada.
⁶ Department of Evidence Synthesis & Translation Research, ADA Science & Research Institute, American Dental Association, 211 E Chicago Avenue, Chicago, Illinois, USA.
⁷ Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada.
⁸ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University of Basel, Basel, Switzerland.
⁹ Iberoamerican Cochrane Centre, Biomedical Research Institute (IIB Sant Pau), CIBERESP, Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni M. Claret 167 Pavelló 18 planta 0, 08025 Barcelona, Spain.
¹⁰ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
¹¹ Department of Nephrology & Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
¹² Department of Orthopaedic Surgery, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
¹³ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Pharmacy Department/Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
¹⁴ Department of Psychology, University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada.
¹⁵ Department of Health Services, University of Washington, 1705 NE Pacific St, Seattle, WA 98195, USA.
¹⁶ Department of Health Promotion and Human Behavior, Department of Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Yoshidakonoecho, Sakyo Ward, Kyoto 606-8501, Japan.
¹⁷ Nephrology Program, Humber River Regional Hospital, 1235 Wilson Avenue, Toronto, Ontario M3M 0B2, Canada; Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada.
¹⁸ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Medicine, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada.
¹⁹ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Surgery, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada.

PMID: 33321175
DOI: 10.1016/j.jclinepi.2020.11.024

Minimal important difference estimates for patient-reported outcomes: A systematic survey

Alonso Carrasco-Labra et al. J Clin Epidemiol. 2021 May.

. 2021 May:133:61-71.

doi: 10.1016/j.jclinepi.2020.11.024. Epub 2020 Dec 13.

Authors

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Oral and Craniofacial Health Science, School of Dentistry, University of North Carolina at Chapel Hill, 385 S Columbia St, Chapel Hill, NC 27599, USA. Electronic address: alonsocarrascolabra@gmail.com.
² Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada.
³ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Nutrition, Texas A&M University, College of Agriculture and Life Sciences, College Station, TX B3H 1V7, USA.
⁴ Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
⁵ Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Public Health, University of Alberta, 85 Avenue, Edmonton, Alberta AB T6G 2R3, Canada.
⁶ Department of Evidence Synthesis & Translation Research, ADA Science & Research Institute, American Dental Association, 211 E Chicago Avenue, Chicago, Illinois, USA.
⁷ Ted Rogers Centre for Heart Research, University Health Network, Toronto, Ontario, Canada.
⁸ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University of Basel, Basel, Switzerland.
⁹ Iberoamerican Cochrane Centre, Biomedical Research Institute (IIB Sant Pau), CIBERESP, Hospital de la Santa Creu i Sant Pau, C/ Sant Antoni M. Claret 167 Pavelló 18 planta 0, 08025 Barcelona, Spain.
¹⁰ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
¹¹ Department of Nephrology & Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
¹² Department of Orthopaedic Surgery, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109, USA.
¹³ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Pharmacy Department/Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
¹⁴ Department of Psychology, University of Guelph, 50 Stone Road E, Guelph, Ontario N1G 2W1, Canada.
¹⁵ Department of Health Services, University of Washington, 1705 NE Pacific St, Seattle, WA 98195, USA.
¹⁶ Department of Health Promotion and Human Behavior, Department of Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Yoshidakonoecho, Sakyo Ward, Kyoto 606-8501, Japan.
¹⁷ Nephrology Program, Humber River Regional Hospital, 1235 Wilson Avenue, Toronto, Ontario M3M 0B2, Canada; Faculty of Medicine, University of Toronto, 1 King's College Cir, Toronto, Ontario M5S 1A8, Canada.
¹⁸ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Medicine, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada.
¹⁹ Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada; Department of Surgery, McMaster University, 1280 Main St East, Hamilton, Ontario L8S 4L8, Canada.

PMID: 33321175
DOI: 10.1016/j.jclinepi.2020.11.024

Abstract

Objectives: The objective of the study was to develop an inventory summarizing all anchor-based minimal important difference (MID) estimates for patient-reported outcome measures (PROMs) available in the medical literature.

Study design and setting: We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and the Patient-Reported Outcome and Quality of Life Instruments Database internal library (January 1989-October 2018). We included primary studies empirically calculating an anchor-based MID estimate for any PROM in adults and adolescents. Pairs of reviewers independently screened and selected studies, extracted data, and evaluated the credibility of the MIDs.

Results: We identified 585 eligible studies, the majority conducted in Europe (n = 211) and North America (n = 179), reporting 5,324 MID estimates for 526 distinct PROMs. Investigators conducted their studies in the context of patients receiving surgical (n = 105, 18%), pharmacological (n = 85, 15%), rehabilitation (n = 65, 11%), or a combination of interventions (n = 194, 33%). Of all MID estimates, 59% (n = 3,131) used a global rating of change anchor. Major credibility limitations included weak correlation (n = 1,246, 23%) or no information regarding the correlation (n = 3,498, 66%) between the PROM and anchor and imprecision in the MID estimate (n = 2,513, 47%).

Conclusion: A large number of MIDs for assisting in the interpretation of PROMs exist. The MID inventory will facilitate the use of MID estimates to inform the interpretation of the magnitude of treatment effects in clinical research and guideline development.

Keywords: Minimal important difference; Patient-reported outcome measure.

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Commentary: Online Platform of Minimal Important Difference estimates for patient reported outcomes: potential and challenges.
Beaton DE, Maxwell LJ. Beaton DE, et al. J Clin Epidemiol. 2021 May;133:172-174. doi: 10.1016/j.jclinepi.2021.02.013. Epub 2021 Feb 16. J Clin Epidemiol. 2021. PMID: 33600950 No abstract available.

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Minimal important difference estimates for patient-reported outcomes: A systematic survey

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Minimal important difference estimates for patient-reported outcomes: A systematic survey

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Abstract

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Full Text Sources

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Medical