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Andrew W Gardner, Polly S Montgomery, Ming Wang
We estimated minimal clinically important differences (MCIDs) for small, moderate, and large changes in measures obtained from a standardized treadmill test, a 6-minute walk test, and patient-based outcomes following supervised and home-based exercise programs in symptomatic patients with peripheral artery disease (PAD). Patients were randomized to either 12 weeks of a supervised exercise program ( n=60), a home-based exercise program ( n=60), or an attention-control group ( n=60). Using the distribution-based method to determine MCIDs, the MCIDs for small, moderate, and large changes in peak walking time (PWT) in the supervised exercise group were 38, 95, and 152 seconds, respectively, and the changes in claudication onset time (COT) were 35, 87, and 138 seconds...
April 1, 2018: Vascular Medicine
Jetan H Badhiwala, Christopher D Witiw, Farshad Nassiri, Muhammad A Akbar, Blessing Jaja, Jefferson R Wilson, Michael G Fehlings
STUDY DESIGN: Post-hoc analysis of 606 patients enrolled in the AOSpine CSM-NA or CSM-I prospective, multi-center cohort studies. OBJECTIVE: To determine the minimum clinically important difference (MCID) in SF-36v2 Physical Component Summary (PCS) and Mental Component Summary (MSC) scores in patients undergoing surgery for degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA: There has been a shift toward focus on patient reported outcomes (PROs) in spine surgery...
April 12, 2018: Spine
Micheal Raad, Brian J Neuman, Amit Jain, Hamid Hassanzadeh, Peter G Passias, Eric Klineberg, Gregory M Mundis, Themistocles S Protopsaltis, Emily K Miller, Justin S Smith, Virginie Lafage, D Kojo Hamilton, Shay Bess, Khaled M Kebaish, Daniel M Sciubba
OBJECTIVE Given the recent shift in health care toward quality reporting requirements and a greater emphasis on a cost-quality approach, patient stratification with respect to long-term outcomes and the use of health care resources is of increasing value. Stratification tools may be effective if they are simple and evidence based. The authors hypothesize that preoperative patient-reported activity levels might independently predict postoperative outcomes in patients with adult spinal deformity. METHODS This is a retrospective cohort...
April 6, 2018: Journal of Neurosurgery. Spine
Lisa Engel, Dorcas E Beaton, Zahi Touma
Clinicians, researchers, and outcome stakeholders have the crucial, albeit difficult, task of quantifying when a person or group experiences important change or difference on any given outcome measure, often in response to a specific intervention. The minimal clinically important difference (MCID) provides this quantified value of change/difference for a measure. There are many methods for MCID derivation, which can result in multiple values for the same measure. Thus, it is important for potential users of MCID values to be aware of the nuances of MCID development and cautions for interpreting values...
May 2018: Rheumatic Diseases Clinics of North America
Michael R Anderson, Jeff R Houck, Charles L Saltzman, Man Hung, Florian Nickisch, Alexej Barg, Timothy Beals, Judith F Baumhauer
BACKGROUND: A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this study was to assess the validation and generalizability of previously published preoperative PROMIS physical function (PF) and pain interference (PI) threshold t scores as predictors of postoperative clinically meaningful improvement in foot and ankle patients from a geographically unique patient population...
April 1, 2018: Foot & Ankle International
Wen-Li Dai, Ze-Ming Lin, Dong-Hong Guo, Zhan-Jun Shi, Jian Wang
The purpose of this study was to use meta-analytic approach to compare the efficacy and safety of intraarticular hylan and hyaluronic acid (HA) for knee osteoarthritis (OA) treatment. We searched PubMed, Embase, and the Cochrane databases through July 2017 to identify Level I randomized controlled trials (RCTs) that evaluated clinical efficacy and safety of hylan compared with HA for knee OA. The primary outcomes were Visual Analogue Scale (VAS) for pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, and WOMAC function scores...
April 4, 2018: Journal of Knee Surgery
Ying-Chih Wang, Bhagwant S Sindhu, Jay Kapellusch, Sheng-Che Yen, Leigh Lehman
BACKGROUND: Global rating of change (GROC) scores provide a means of measuring patients' self-perceived change in health status over time. OBJECTIVES: The purposes of the study were to examine agreement of GROC ratings between the patient (GROCp) and the treating therapist (GROCt), the impact on the minimal clinically important difference (MCID) estimates by reporting resources, and the relationships between the subjective GROC scores and objective outcome measures...
April 2, 2018: Physiotherapy Theory and Practice
Jonathan R Danoff, Rahul Goel, Ryan Sutton, Mitchell G Maltenfort, Matthew S Austin
BACKGROUND: The ability to detect changes in patient-perceived pain after total joint arthroplasty (TJA) is critical to manage postoperative pain. The minimal clinically important difference (MCID) for visual analog scale for pain (VAS-P) has not been investigated in this population. This study investigated the MCID for VAS-P in the TJA population. METHODS: Postoperative pain scores were collected on 139 total hip arthroplasty (THA) and 165 total knee arthroplasty (TKA) patients...
February 22, 2018: Journal of Arthroplasty
Domingo Orozco-Beltrán, Sara Artola, Margarida Jansà, Martin Lopez de la Torre-Casares, Eva Fuster
BACKGROUND: Hypoglycemia is a limiting factor to achieving optimal glycemic control in patients with type-2 diabetes mellitus (T2DM), increasing risk of death and complications, reducing health-related quality of life (HRQoL) and work productivity and increasing healthcare costs. The study's primary objective was to develop and validate a specific questionnaire to assess the impact of hypoglycemia on the HRQoL of T2DM patients (QoLHYPO© questionnaire). METHODS: A two-phase multicenter prospective, longitudinal, observational, epidemiologic study of consecutively enrolled patients, not involving any drug, was conducted: In phase 1 (questionnaire development), patients who had given their written informed consent, who were at least 30 years of age, had been diagnosed with T2DM at least 5 years prior, had an HbA1c test in the previous 3 months, and a hypoglycemic episode in the previous 6 months were included...
March 23, 2018: Health and Quality of Life Outcomes
Man Hung, Jerry Bounsanga, Maren W Voss, Charles L Saltzman
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...
March 18, 2018: World Journal of Orthopedics
Brian W Carey, James Harty
BACKGROUND: The ATTUNE Knee by DePuy Synthes was introduced in 2013. It is designed to provide better range of motion and address patient-reported instability. The PFC Sigma Knee, an earlier prosthesis by DePuy Synthes, is a common knee replacement with a strong clinical track record. Our aim is to compare the outcomes after primary total knee replacement for end-stage knee osteoarthritis of the PFC and ATTUNE knee systems in 21 patients who each have prosthesis in opposite knees using WOMAC, Oxford Knee and SF-12 scores and evaluation of range of motion...
March 15, 2018: Journal of Orthopaedic Surgery and Research
Darren de Sa, Ajaykumar Shanmugaraj, Melissa Weidman, Devin C Peterson, Nicole Simunovic, Volker Musahl, Olufemi R Ayeni
The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive, technique with the potential for more rapid recovery. This systematic review aims to critically assess components of the technique, its safety profile, outcomes, and complications. PUBMED, EMBASE, and MEDLINE were searched for studies discussing primary ACLR using the AIT. Article screening, quality assessment, and data abstraction were completed in duplicate, and a minimal clinically important difference (MCID) was used to frame the descriptive results in a clinically significant context...
February 8, 2018: Journal of Knee Surgery
P Elkan, T Lagerbäck, H Möller, Paul Gerdhem
PURPOSE: Quality registers give unique possibilities to achieve information from large groups of patients, but outcome must be interpreted carefully due to less stringent data collection and lower follow-up rates than in research projects. We tried to quantify any outcome differences between a national spine quality register and a prospective observational study. METHODS: Adult patients treated with lumbar discectomy between 2004 and 2010 were retrieved from the Swedish Spine register (Swespine) (n = 7791) and from the single center lumbar disc herniation study (LDHS) in Stockholm (n = 177)...
March 9, 2018: European Spine Journal
Sylvie Lambert, Nicholas Hulbert-Williams, Eric Belzile, Antonio Ciampi, Afaf Girgis
OBJECTIVE: Caregiver research has relied on composite measures (e.g., count) of unmet supportive care needs to determine relationships with anxiety and depression. Such composite measures assume that all unmet needs have a similar impact on outcomes. The purpose of this study is to identify individual unmet needs most associated with caregivers' anxiety and depression. METHODS: 219 Caregivers completed the 44-item Supportive Care Needs Survey and the Hospital Anxiety and Depression scale [minimal clinically important difference (MCID)=1...
March 6, 2018: Psycho-oncology
Guillaume Chevance, Nelly Héraud, Alain Varray, Julie Boiché
The aim of this study was to examine the role of explicit and implicit attitudes in the improvement of exercise capacity during a 5-week pulmonary rehabilitation (PR). A total of 105 patients performed walking tests at baseline and at the end of PR. Change between performances was computed at the end of PR, and Minimal-Clinically-Important-Difference (MCID) were used to categorize patients as responders (i.e. change above MCID, N = 54) or non-responders (i.e. change below MCID, N = 51). At baseline, implicit attitudes were measured through a physical activity versus sedentary behavior Implicit Association Test; explicit attitudes toward physical activity and sedentary behavior were measured by questionnaires...
March 5, 2018: Psychology, Health & Medicine
Deborah A Hall, Rajnikant L Mehta, Heike Argstatter
OBJECTIVE: Reporting of clinical significance is recommended because findings can be statistically significant without being relevant to patients. For aiding clinical interpretation of the Tinnitus Questionnaire (TQ), many investigators use a 5-point change cut-off as a minimal clinically important difference (MCID). But there are shortcomings in how this value was originally determined. DESIGN: The MCID was evaluated by analysing retrospective clinical data on the TQ (German version)...
February 28, 2018: International Journal of Audiology
Micaela Gobeille, Alexis Malkin, Richard Jamara, Nicole C Ross
PURPOSE: This prospective cohort study examined clinical outcomes of low vision rehabilitation (LVR) delivered by a mobile clinic. METHODS: Participants were recruited from those scheduled for mobile clinic LVR and met the United States definition of legal blindness. Participants completed the Massof Activity Inventory (AI) before LVR, 3 months post-LVR, and 1 year post-LVR. Change scores and measures of clinical effect (i.e. Cohen's effect size and minimum clinically important difference, MCID) were calculated for each time point and compared...
March 2018: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
Dawn P Andrews, Kari B Odland-Wolf, James May, Russell Baker, Alan Nasypany
Background and Purpose: Secondary impingement syndrome (SIS) is a common complaint in the sporting population particularly among athletes engaging in overhead activities. While symptoms may be present at the shoulder with patients complaining of SIS, spinal alignment or dysfunction can influence scapular positioning and overall shoulder girdle function. As an adjunct therapy to traditional interventions for SIS, thoracic high-velocity low-amplitude (HVLA) thrusts have been utilized and correlated with patient reported decreases in pain...
February 2018: International Journal of Sports Physical Therapy
Mike H Bao, Benjamin J Keeney, Wayne E Moschetti, Nicholas G Paddock, David S Jevsevar
BACKGROUND: Approximately one-half of all US surgical procedures, and one-third of orthopaedic procedures, are performed at teaching hospitals. However, the effect of resident participation and their level of training on patient care for TKA postoperative physical function, operative time, length of stay, and facility discharge are unclear. QUESTIONS/PURPOSES: (1) Are resident participation, postgraduate year (PGY) training level, and number of residents associated with absolute postoperative Patient-Reported Outcomes Measurement Information System (PROMIS-10) global physical function score (PCS), and achieving minimum clinically important difference (MCID) PCS improvement, after TKA? (2) Are resident participation, PGY, and number of residents associated with increased TKA operative time? (3) Are resident participation, PGY, and number of residents associated with increased length of stay after TKA? (4) Are resident participation, PGY, and number of residents associated with higher odds of patients being discharged to another inpatient facility, rather than to their home (facility discharge)? METHODS: We performed a retrospective study using a longitudinally maintained institutional registry of TKAs that included 1626 patients at a single tertiary academic institution from April 2011 through July 2016...
February 14, 2018: Clinical Orthopaedics and related Research
Ritsaart F Westenberg, Emily L Zale, Tessa J Heinhuis, Sezai Özkan, Adam Nazzal, Sang-Gil Lee, Neal C Chen, Ana-Maria Vranceanu
BACKGROUND: Mindfulness-based interventions are useful in reducing psychologic distress and pain intensity in patients with chronic pain. However, most mindfulness-based interventions are resource-intensive, lengthy, and not feasible for busy orthopaedic surgical practices. QUESTIONS/PURPOSES: The purpose of this study was to determine if a 60-second personalized mindfulness-based video exercise is (1) associated with improved pain intensity, emotional distress, and state anxiety compared with an attention placebo control (a time-matched educational pamphlet about pain and stress); and (2) feasible and acceptable for patients with upper extremity injury in an orthopaedic practice...
February 14, 2018: Clinical Orthopaedics and related Research
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