Purpose
A patient-reported outcomes measure (PROM) is responsive if it is sensitive to clinical
status changes. The minimal clinically important difference (MCID) is used to indicate
meaningful change, helpful in designing studies and adding context to some study results,
and is related to instrument responsiveness. Our purpose was to provide MCID estimates
for the brief Michigan Hand Outcomes Questionnaire (bMHQ) and Patient-Reported Outcomes
Measurement Information System (PROMIS) pain interference (PI) in a hand and upper
extremity surgery cohort within the context of varying patient-reported mental health.
Methods
Data were analyzed from 1,262 adult patients who received surgical care at a single
center between January 1, 2018, and December 31, 2019. Patients completed PROMIS PI,
PROMIS Global Health (including global mental health [GMH] component), bMHQ, and a
pain-focused anchor question before each clinic visit. Data were collected 8 ± 2 weeks
before and after surgery. A distribution-based MCID then was calculated for the general
patient population, lowest 10th percentile of GMH scores, and top 10th percentile
of GMH scores.
Results
Minimal clinically important difference estimates were 10.4 for the bMHQ and 4.3 for
PROMIS PI. Analysis of MCID across different GMH score groups showed a mean score
of 11.5 for bMHQ for the lowest 10th percentile of GMH, 9.6 for bMHQ for the top 10th
percentile, 4.5 for PI for the lowest 10th percentile, and 4.9 for PI for the top
10th percentile.
Conclusions
Analysis of subgroups stratified by preoperative patient-reported mental health condition
found that preoperative mental health status, as indicated by GMH score, does not
have a meaningful impact on responsiveness of bMHQ or PROMIS PI.
Clinical Relevance
A patient’s reported mental health condition does not meaningfully change how these
common PRO instruments reflect the patient condition after hand and upper extremity
surgery.
Key words
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Article info
Publication history
Published online: August 05, 2022
Accepted:
June 13,
2022
Received:
December 7,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
