Suus van Bruggen (Amsterdam / NL), Floortje Opperman (Amsterdam / NL), Ilse Jansma (Amsterdam / NL), Charlotte Lameijer (Amsterdam / NL), Frank Bloemers (Amsterdam / NL), Caroline Terwee (Amsterdam / NL)
Abstract text (incl. references and figure legends)
Introduction. Upper extremity injury (UEI) occurs frequently and results in high burden for patients. Rehabilitation should be optimized and progress can be objectified by PROMs. However, the clinical relevance of PROMs, measured by the Minimal Important Change (MIC), should be described more accurate. The aim of this review was to analyze the MIC of PROMs in patients with UEI and to determine possible influencing factors on the MIC.
Materials & Methods. A literature search according to the PRISMA guidelines was performed. Studies that estimated the MIC for the following PROMs were included: DASH, Q-DASH, MHQ, PRWE and PROMIS-UE v1.2/v2.0 item bank, Short-Form and CAT. Credibility of the studies was examined with a MIC credibility instrument.1
Results. Thirty-three studies were included. Estimated MICs were heterogenous. Patient characteristics, time between baseline and follow-up measurement, type of injury (acute (UEI) and/or chronic upper extremity disorders (UED)), localisation of injury and methods to estimate the MIC varied a lot between studies. The following MIC thresholds and ranges were found: DASH 12.4 (4.3 – 25.4), Q-DASH 11.3 (3.5 – 19.0), PRWE 17.0 (7.8 – 42.6), MHQ 18.0 (1.4 – 18.0) and PROMIS-UE v1.2 2.1 (2.1 – 8.0).
Conclusion. This systematic review presents an overview of MICs for five frequently used PROMs in patients with UEI/UED. Clinicians should be aware of a clinically relevant change when change scores of respectively 10 for the DASH, 6.8 for the Q-DASH, 10.7 for the PRWE, 8.4 for the MHQ and 2.1 for the PROMIS UE v1.2 or higher are found. More research regarding the clinical relevance of PROMs in patients with UEI/UED and the methods to estimate the MIC is recommended to propose reference values and a golden standard MIC method.
1 Devji, T., et al., Evaluating the credibility of anchor based estimates of minimal important differences for patient reported outcomes: instrument development and reliability study. BMJ, 2020
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