Authors: Monique M J Walenkamp RobertJan de Muinck Keizer J Carel Goslings Lara M Vos Melvin P Rosenwasser Niels W L Schep
Publish Date: 2015/06/04
Volume: 473, Issue: 10, Pages: 3235-3241
Abstract
The Patientrated Wrist Evaluation PRWE is a commonly used instrument in upper extremity surgery and in research However to recognize a treatment effect expressed as a change in PRWE it is important to be aware of the minimum clinically important difference MCID and the minimum detectable change MDC The MCID of an outcome tool like the PRWE is defined as the smallest change in a score that is likely to be appreciated by a patient as an important change while the MDC is defined as the smallest amount of change that can be detected by an outcome measure A numerical change in score that is less than the MCID even when statistically significant does not represent a true clinically relevant change To our knowledge the MCID and MDC of the PRWE have not been determined in patients with distal radius fracturesOur prospective cohort study included 102 patients with a distal radius fracture and a median age of 59 years interquartile range IQR 48–66 years All patients completed the PRWE questionnaire during each of two separate visits At the second visit patients were asked to indicate the degree of clinical change they appreciated since the previous visit Accordingly patients were categorized in two groups 1 minimally improved or 2 no change The groups were used to anchor the changes observed in the PRWE score to patients’ perspectives of what was clinically important We determined the MCID using an anchorbased receiver operator characteristic method In this context the change in the PRWE score was considered a diagnostic test and the anchor minimally improved or no change as noted by the patients from visit to visit was the gold standard The optimal receiver operator characteristic cutoff point calculated with the Youden index reflected the value of the MCID
Keywords: