Advertisement

Minimal Clinically Important Difference for PROMIS Physical Function in Patients With Distal Radius Fractures

Published:April 03, 2019DOI:https://doi.org/10.1016/j.jhsa.2019.02.015

      Purpose

      This study was conducted to determine the minimal clinically important difference (MCID) of the Patient-Reported Outcomes Information System (PROMIS) Physical Function computer adaptive test (CAT) after distal radius fracture.

      Methods

      This study retrospectively analyzed data from 187 adults receiving nonsurgical care for a unilateral distal radius fracture at a single institution between February 2016 and November 2017. All patients completed the PROMIS Physical Function v1.2/2.0 CAT at each visit. At follow-up, patients also completed 2 multiple-choice clinical anchor questions querying their overall response to treatment. The MCID estimate was then calculated with an anchor-based method as the mean PROMIS Physical Function score change for the group reporting mild improvement and with a distribution-based method considering effect sizes of change and the minimum detectable change (MDC). The MCID estimate was examined for the influence of patient age, follow-up interval, and initial PROMIS score.

      Results

      Change in PROMIS Physical Function scores between visits was significantly different between patients reporting no change, mild improvement, and much improvement on the anchor questions. The anchor-based MCID estimate for PROMIS Physical Function was 3.6 points (SD, 8.4). Among patients reporting mild improvement, individual changes in PROMIS Physical Function were not correlated with patient age or time between visits but were moderately negatively correlated with the initial absolute PROMIS Physical Function score. Applying the effect size parameters to our data when patients indicated minimal change, the distribution-based MCID estimate was 4.6 (SD, 1.8). Both the anchor-based and the distribution-based MCID estimates were judged sufficient because they exceeded the MDC value of 2.3.

      Conclusions

      The MCID value for PROMIS Physical Function is estimated between 3.6 and 4.6 in patients treated nonsurgically for distal radius fractures. Clinical improvement is associated with smaller magnitudes of change on PROMIS Physical Function when patients present with better reported function.

      Clinical relevance

      The MCID estimations are needed to determine the clinical relevance of changes in PROMIS scores and to more accurately calculate sample sizes needed for research incorporating PROMIS.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Smith M.V.
        • Calfee R.P.
        • Baumgarten K.M.
        • Brophy R.H.
        • Wright R.W.
        Upper extremity–specific measures of disability and outcomes in orthopaedic surgery.
        J Bone Joint Surg Am. 2012; 94: 277-285
        • Jaeschke R.
        • Singer J.
        • Guyatt G.H.
        Measurement of health status. Ascertaining the minimal clinically important difference.
        Control Clin Trials. 1989; 10: 407-415
        • Doring A.C.
        • Nota S.P.
        • Hageman M.G.
        • Ring D.C.
        Measurement of upper extremity disability using the Patient-Reported Outcomes Measurement Information System.
        J Hand Surg Am. 2014; 39: 1160-1165
        • Tyser A.R.
        • Beckmann J.
        • Franklin J.D.
        • et al.
        Evaluation of the PROMIS physical function computer adaptive test in the upper extremity.
        J Hand Surg Am. 2014; 39: 2047-2051 e4
        • Overbeek C.L.
        • Nota S.P.
        • Jayakumar P.
        • Hageman M.G.
        • Ring D.
        The PROMIS physical function correlates with the QuickDASH in patients with upper extremity illness.
        Clin Orthop Relat Res. 2015; 473: 311-317
        • American Board of Orthopaedic Surgery I. Certification Examinations
        Part II. Patient Reported Outcomes. 2018.
        (Available at:)
        • Norman G.R.
        • Sloan J.A.
        • Wyrwich K.W.
        Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation.
        Med Care. 2003; 41: 582-592
        • Hung M.
        • Bounsanga J.
        • Voss M.W.
        • Saltzman C.L.
        Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis outcome score for joint reconstruction in orthopaedics.
        World J Orthop. 2018; 9: 41-49
        • Chen R.E.
        • Papuga M.O.
        • Voloshin I.
        • et al.
        Preoperative PROMIS scores predict postoperative outcomes after primary ACL reconstruction.
        Orthop J Sports Med. 2018; 6 (2325967118771286)
        • Ho B.
        • Houck J.R.
        • Flemister A.S.
        • et al.
        Preoperative PROMIS scores predict postoperative success in foot and ankle patients.
        Foot Ankle Int. 2016; 37: 911-918
        • Anderson M.R.
        • Houck J.R.
        • Saltzman C.L.
        • et al.
        Validation and generalizability of preoperative PROMIS scores to predict postoperative success in foot and ankle patients.
        Foot Ankle Int. 2018; 39: 763-770
        • Yost K.J.
        • Eton D.T.
        • Garcia S.F.
        • Cella D.
        Minimally important differences were estimated for six Patient-Reported Outcomes Measurement Information System-cancer scales in advanced-stage cancer patients.
        J Clin Epidemiol. 2011; 64: 507-516
        • Bevans M.
        • Ross A.
        • Cella D.
        Patient-Reported Outcomes Measurement Information System (PROMIS): efficient, standardized tools to measure self-reported health and quality of life.
        Nurs Outlook. 2014; 62: 339-345
      1. Health Measures—Transforming How Health is Measured. 2018.
        (Available at:)
        http://www.healthmeasures.net
        Date accessed: November 5, 2018
        • Juniper E.F.
        • Guyatt G.H.
        • Willan A.
        • Griffith L.E.
        Determining a minimal important change in a disease-specific Quality of Life Questionnaire.
        J Clin Epidemiol. 1994; 47: 81-87
        • Tubach F.
        • Ravaud P.
        • Baron G.
        • et al.
        Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement.
        Ann Rheum Dis. 2005; 64: 29-33
        • Tashjian R.Z.
        • Deloach J.
        • Green A.
        • Porucznik C.A.
        • Powell A.P.
        Minimal clinically important differences in ASES and simple shoulder test scores after nonoperative treatment of rotator cuff disease.
        J Bone Joint Surg Am. 2010; 92: 296-303
        • Schmitt J.S.
        • Di Fabio R.P.
        Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria.
        J Clin Epidemiol. 2004; 57: 1008-1018
        • Amtmann D.
        • Kim J.
        • Chung H.
        • Askew R.L.
        • Park R.
        • Cook K.F.
        Minimally important differences for Patient Reported Outcomes Measurement Information System pain interference for individuals with back pain.
        J Pain Res. 2016; 9: 251-255
        • Hays R.D.
        • Spritzer K.L.
        • Fries J.F.
        • Krishnan E.
        Responsiveness and minimally important difference for the patient-reported outcomes measurement information system (PROMIS) 20-item physical functioning short form in a prospective observational study of rheumatoid arthritis.
        Ann Rheum Dis. 2015; 74: 104-107
        • Lee A.C.
        • Driban J.B.
        • Price L.L.
        • Harvey W.F.
        • Rodday A.M.
        • Wang C.
        Responsiveness and Minimally Important Differences for 4 Patient-Reported Outcomes Measurement Information System Short Forms: Physical Function, Pain Interference, Depression, and Anxiety in knee osteoarthritis.
        J Pain. 2017; 18: 1096-1110
        • London D.A.
        • Stepan J.G.
        • Calfee R.P.
        Determining the Michigan Hand Outcomes Questionnaire minimal clinically important difference by means of three methods.
        Plast Reconstr Surg. 2014; 133: 616-625
        • Beleckas C.M.
        • Prather H.
        • Guattery J.
        • Wright M.
        • Kelly M.
        • Calfee R.P.
        Anxiety in the orthopedic patient: using PROMIS to assess mental health.
        Qual Life Res. 2018; 27: 2275-2282
        • Beleckas C.M.
        • Padovano A.
        • Guattery J.
        • Chamberlain A.M.
        • Keener J.D.
        • Calfee R.P.
        Performance of Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) versus Physical Function (PF) Computer Adaptive Tests (CATs) in upper extremity clinics.
        J Hand Surg Am. 2017; 42: 867-874
        • Kazmers N.H.
        • Hung M.
        • Rane A.A.
        • Bounsanga J.
        • Weng C.
        • Tyser A.R.
        Association of Physical Function, Anxiety, and Pain Interference in nonshoulder upper extremity patients using the PROMIS Platform.
        J Hand Surg Am. 2017; 42: 781-787
        • Thissen D.
        • Liu Y.
        • Magnus B.
        • et al.
        Estimating minimally important difference (MID) in PROMIS pediatric measures using the scale-judgment method.
        Qual Life Res. 2016; 25: 13-23
        • King M.T.
        A point of minimal important difference (MID): a critique of terminology and methods.
        Expert Rev Pharmacoecon Outcomes Res. 2011; 11: 171-184
        • Knox S.A.
        • King M.T.
        Validation and calibration of the SF-36 health transition question against an external criterion of clinical change in health status.
        Qual Life Res. 2009; 18: 637-645
        • Norman G.R.
        • Stratford P.
        • Regehr G.
        Methodological problems in the retrospective computation of responsiveness to change: the lesson of Cronbach.
        J Clin Epidemiol. 1997; 50: 869-879