Changes and thresholds in the Forgotten Joint Score after total hip arthroplasty MINIMAL CLINICALLY IMPORTANT DIFFERENCE, MINIMAL IMPORTANT AND DETECTABLE CHANGES, AND PATIENT-ACCEPTABLE SYMPTOM STATE
Changes and thresholds in the Forgotten Joint Score after total hip arthroplasty MINIMAL CLINICALLY IMPORTANT DIFFERENCE, MINIMAL IMPORTANT AND DETECTABLE CHANGES, AND PATIENT-ACCEPTABLE SYMPTOM STATE
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DOI：
10.1302/0301-620x.103b12.bjj-2021-0384.r1
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发表时间：
2021-12-01
影响因子：
4.6
通讯作者：
Clement, N. D.
中科院分区：
文献类型：
--
作者：
Robinson, P. G.;MacDonald, D. J.;Clement, N. D.
本研究的目的是根据英国人群全髋关节置换术（THA）后6个月的患者满意度，确定遗忘关节评分（FJS）中最小临床重要差异（MCID）、最小重要变化（MIC）、最小可检测变化（MDC）和患者可接受症状状态（PASS）。方法：在一年的时间里，461例患者接受了原发性THA，并完成了术前和6个月的FJS，平均年龄为67.2岁（22 - 93岁）。在六个月时，患者满意度被记录为非常满意、满意、一般、不满意或非常不满意。中性（n = 31）和满意（n = 101）患者的差异被用来定义MCID。一个队列的MIC被定义为那些宣布其结果满意的患者FJS的变化，而接受者工作特征曲线分析用于确定个体的MIC和PASS。采用基于分布的方法计算MDC。结果以满意度为锚点，FJS的MCID为8.1(95%置信区间（CI） 3.7 ~ 15.9；P = 0.040)，在校正混杂因素后证实了这一点。队列患者FJS的MIC为17.7 (95% CI 13.7 - 21.7)，单个患者的MIC为18。FJS的MDC90为8分，这意味着90%得分高于8分的患者将经历超出测量误差的真正变化。FJS的PASS阈值定义为29。结论MCID和MIC可以分别用于评估两组之间是否存在临床差异，或者一个队列或患者的FJS是否有意义的改变。两个值都大于测量误差（MDC90），表明确实发生了变化。术后FJS的PASS阈值可作为THA术后患者满意度的标志。
AimsThe aim of this study was to identify the minimal clinically important difference (MCID), minimal important change (MIC), minimal detectable change (MDC), and patient-acceptable symptom state (PASS) in the Forgotten Joint Score (FJS) according to patient satisfaction six months following total hip arthroplasty (THA) in a UK population.MethodsDuring a one-year period, 461 patients underwent a primary THA and completed preoperative and six-month FJS, with a mean age of 67.2 years (22 to 93). At six months, patient satisfaction was recorded as very satisfied, satisfied, neutral, dissatisfied, or very dissatisfied. The difference between patients recording neutral (n = 31) and satisfied (n = 101) was used to define the MCID. MIC for a cohort was defined as the change in the FJS for those patients declaring their outcome as satisfied, whereas receiver operating characteristic curve analysis was used to determine the MIC for an individual and the PASS. Distribution-based methodology was used to calculate the MDC.ResultsUsing satisfaction as the anchor, the MCID for the FJS was 8.1 (95% confidence interval (CI) 3.7 to 15.9; p = 0.040), which was affirmed when adjusting for confounding. The MIC for the FJS for a cohort of patients was 17.7 (95% CI 13.7 to 21.7) and for an individual patient was 18. The MDC90 for the FJS was eight, meaning that 90% of patients scoring more than this will have experienced a real change that is beyond measurement error. The PASS threshold for the FJS was defined as 29.ConclusionThe MCID and MIC can be used respectively to assess whether there is a clinical difference between two groups, or whether a cohort or patient has had a meaningful change in their FJS. Both values were greater than measurement error (MDC90), suggesting a real change. The PASS threshold for the postoperative FJS can be used as a marker of achieving patient satisfaction following THA.