‘Minimal Clinically Important Difference (MCID) of the Patient Rated Wrist Evaluation (PRWE) questionnaire in patients recovering from distal radius fractures’.

Vos, L.M. (2014) ‘Minimal Clinically Important Difference (MCID) of the Patient Rated Wrist Evaluation (PRWE) questionnaire in patients recovering from distal radius fractures’. thesis, Medicine.

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Abstract

Background: The Patient Rated Wrist Evaluation (PRWE) questionnaire is a commonly used standardized outcome tool for the assessment of treatment success in patients with distal radius fractures (DRF). However, interpretation of (changes in) scores on these questionnaires remains difficult. To aid in this process, the Minimal Clinically Important Difference (MCID) has been created. The MCID is the smallest change in outcome score that patients perceive as important. Calculating the MCID of the PRWE can be very useful for future research, because it can act as a basis in adequate sample size calculation and for improving the interpretation of study results. The MCID of the PRWE for patients with distal radius fractures has not been determined before. Purpose: Calculating the Minimal Clinically Important Difference of the Patient Rated Wrist Evaluation questionnaire in patients recovering from distal radius fractures. Methods: Data from 2 randomized controlled trials was used. The combination of anchor and distribution based methods were used for calculating the MCID. The MCID was calculated for 39 patient, through an anchor-based (AB) method in which longitudinal change in the PRWE was related to an external criteria for meaningful change, being global rating of change by patients. The MCID was defined as the 95% limit cut-off point, and as the best ROC cut-off point. Supportive information on the MCID was obtained from 172 subjects by providing distribution-based indices like the Standard error of Measurement (SEM) and the Minimal Detectable Change (MDC). The influence of initial PRWE score and follow up duration on the MCID was also assessed. Results: Four different statistical approaches yielded 4 different MCID estimates. The MCID estimate for the PRWE questionnaire was –19 points based on the 95% cut-off point and –17,50 points based on the ROC cut-off point. The SEM for the PRWE was – 5.50 points. The MDC was – 15 point. According to this study a longitudinal change of 18 points in score represents a justifiable estimate of the MCID for the PRWE in patients recovering from distal radius fractures. Follow up duration and baseline scores are likely to influence the magnitude of the MCID. Conclusion: the small range of MCID values presented in this study provides valuable information for future research in the field of distal radius fractures. This range is recommended to be applied for group-level analysis in interpreting study results as opposed to the application for individual patients. This MCID range is recommended to be used in future sample size calculation.

Item Type:	Thesis (Thesis)
Supervisor name:	Muinck Keizer, Drs. R.J. de PhD candidate Trauma unit and Goslings, Prof. dr. C.J. and AMC Amsterdam, the Netherlands and Karthaus, Dr. A.J.M. and Deventer Hospital, the Netherlands
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:54
Last Modified:	25 Jun 2020 10:54
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1533

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