AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
Health-related quality of life(HRQOL)and daily functioning are central considerations for older adults with cancer.Attention to symptom burden,daily functioning,and HRQOL is imperative in this patient population to id...Health-related quality of life(HRQOL)and daily functioning are central considerations for older adults with cancer.Attention to symptom burden,daily functioning,and HRQOL is imperative in this patient population to identify relevant research endpoints and outcomes and to provide care that matches individual needs.Patient-reported outcomes(PROs)are an indispensable source of information about the effects of disease and treatment on patient wellbeing.Integrating PROs with comprehensive geriatric assessment(CGA),which targets medical,psychosocial,and functional-impairment vulnerabilities,is key to identifying patients who need supportive measures.However,patient-related factors(e.g.,decline,survival,satisfaction with life,coping,and intervention effects)present measurement challenges,with implications for research and practice.As patients age,the severity of age-related impairments will undoubtedly increase,profoundly and negatively affecting HRQOL and physical functioning.Because HRQOL in the elderly is a complex concept,measuring it can be challenging.Existing measures typically assess HRQOL as functional health,adverse symptoms,and global quality of life-capturing only a portion of this complex concept,with potentially less consideration of the effects of age-related deterioration on functioning dimensions.Moreover,older adults with cancer are underrepresented in randomized clinical trials,and the completeness of PRO reporting by older adults is often suboptimal.Further studies are thus needed to validate PROs and CGA in this population and define the minimum clinically important difference to use in RCTs for these patients.Future efforts should focus on maximizing the use of CGA and appropriate PROs among aged patients to improve geriatric oncology care and to establish clinical benefit in anticancer trials in these patients.展开更多
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
文摘Health-related quality of life(HRQOL)and daily functioning are central considerations for older adults with cancer.Attention to symptom burden,daily functioning,and HRQOL is imperative in this patient population to identify relevant research endpoints and outcomes and to provide care that matches individual needs.Patient-reported outcomes(PROs)are an indispensable source of information about the effects of disease and treatment on patient wellbeing.Integrating PROs with comprehensive geriatric assessment(CGA),which targets medical,psychosocial,and functional-impairment vulnerabilities,is key to identifying patients who need supportive measures.However,patient-related factors(e.g.,decline,survival,satisfaction with life,coping,and intervention effects)present measurement challenges,with implications for research and practice.As patients age,the severity of age-related impairments will undoubtedly increase,profoundly and negatively affecting HRQOL and physical functioning.Because HRQOL in the elderly is a complex concept,measuring it can be challenging.Existing measures typically assess HRQOL as functional health,adverse symptoms,and global quality of life-capturing only a portion of this complex concept,with potentially less consideration of the effects of age-related deterioration on functioning dimensions.Moreover,older adults with cancer are underrepresented in randomized clinical trials,and the completeness of PRO reporting by older adults is often suboptimal.Further studies are thus needed to validate PROs and CGA in this population and define the minimum clinically important difference to use in RCTs for these patients.Future efforts should focus on maximizing the use of CGA and appropriate PROs among aged patients to improve geriatric oncology care and to establish clinical benefit in anticancer trials in these patients.
