Minimal important changes in the Constant-Murley score in patients with subacromial pain
Minimal important changes in the Constant-Murley score in patients with subacromial pain
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DOI：
10.1016/j.jse.2014.01.014
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发表时间：
2014-08-01
影响因子：
3
通讯作者：
Johansson, Kajsa
中科院分区：
文献类型：
--
作者：
Holmgren, Theresa;Oberg, Birgitta;Johansson, Kajsa
目的：研究长期肩峰下疼痛患者和肩峰下疼痛伴或不伴肩袖断裂患者的Constant-Murley评分改善的最小重要变化(MIC)。方法：采用锚定MIC分布法，结合锚定和分布的方法：接收者工作曲线的最佳截止点(MICC)和95%的极限截止点(MIC95%(LIMIT))来估计MIC。研究人群由93名患者组成，随机临床试验评估特定运动策略的效果。结果：在Constant-Murley评分中发现微循环的平均变化为17分，灵敏度为91%，特异度为79%。最低抑菌浓度(MIC95%)为24点。在亚组分析中，在肩袖完好的患者中，微循环的平均变化为19点，最低抑菌浓度极限为18点。在肩袖破裂患者中，MIC平均变化15分，MIC95%限值为30分。结论：对于肩袖完整的长期肩峰下疼痛患者，Constant-Murley评分能够检测到MIC。估计的MIC值可以作为临床实践中Constant-Murley评分的相关变化的一个指标，并指导临床医生如何解释特定治疗的结果。(C)2014年《肩肘外科杂志》董事会。
Objective: The purpose of this study was to determine the minimal important change (MIC) of improvement in the Constant-Murley score in patients with long-standing subacromial pain and in subgroups patients with subacromial pain with and without rotator cuff ruptures.Method: The MIC was estimated by the anchor-based MIC distribution method, which integrates anchor- and distribution-based approach: the optimal cutoff point of the receiver operating curve (MICROC) and the 95% limit cutoff point (MIC95% (limit)). The study population consisted of 93 patients included in a randomized clinical trial evaluating the effect of a specific exercise strategy.Results: The MICROC was found at a mean change of 17 points in the Constant-Murley score, which responds to a sensitivity of 91% and a specificity of 79%. The MIC95% (limit) was found at a mean change 24 points. In the subgroup analysis, the MICROC was found at a mean change of 19 points and the MIClimit at 18 points in patients with an intact rotator cuff. In patients with rotator cuff ruptures, the MICROC was found at a mean change of 15 points and the MIC95% limit at 30 points.Conclusion: The Constant-Murley score is able to detect the MIC in individual patients with long-standing subacromial pain when the rotator cuff is intact. The estimated MIC values could be used as an for relevant changes in the Constant-Murley score in clinical practice and guide the clinician in how interpret the results of specific treatments. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.