journal article Oct 27, 2012

Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study

Arthritis Care & Research Vol. 64 No. 11 pp. 1699-1707 · Wiley
View at Publisher Save 10.1002/acr.21747
Abstract
AbstractObjectiveTo estimate the minimum clinically important improvement (MCII) and patient acceptable symptom state (PASS) values for 4 generic outcomes in 5 rheumatic diseases and 7 countries.MethodsWe conducted a multinational (Australia, France, Italy, Lebanon, Morocco, Spain, and The Netherlands) 4‐week cohort study involving 1,532 patients who were prescribed nonsteroidal antiinflammatory drugs for ankylosing spondylitis, chronic back pain, hand osteoarthritis, hip and/or knee osteoarthritis, or rheumatoid arthritis. The MCII and PASS values were estimated with the 75th percentile approach for 4 generic outcomes: pain, patient global assessment, functional disability, and physician global assessment, all normalized to a 0–100 score.ResultsFor the whole sample, the estimated MCII values for absolute change at 4 weeks were −17 (95% confidence interval [95% CI] −18, −15) for pain; −15 (95% CI −16, −14) for patient global assessment; −12 (95% CI −13, −11) for functional disability assessment; and −14 (95% CI −15, −14) for physician global assessment. For the whole sample, the estimated PASS values were 42 (95% CI 40, 44) for pain; 43 (95% CI 41, 45) for patient global assessment; 43 (95% CI 41, 44) for functional disability assessment; and 39 (95% CI 37, 40) for physician global assessment. Estimates were consistent across diseases and countries (for subgroups ≥20 patients).ConclusionThis work allows for promoting the use of values of MCII (15 of 100 for absolute improvement, 20% for relative improvement) and PASS (40 of 100) in reporting the results of trials of any of the 5 involved rheumatic diseases with pain, patient global assessment, physical function, or physician global assessment used as outcome criteria.
Topics

No keywords indexed for this article. Browse by subject →

References
43
[2]
Bellamy N "Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis: consensus development at OMERACT III" J Rheumatol (1997)
[11]
Measurement of health status

Roman Jaeschke, Joel Singer, Gordon H. Guyatt

Controlled Clinical Trials 10.1016/0197-2456(89)90005-6
[16]
The cost of dichotomising continuous variables

Douglas G Altman, Patrick Royston

BMJ 10.1136/bmj.332.7549.1080
[18]
Core outcome measures for chronic pain clinical trials: IMMPACT recommendations

Robert H. Dworkin, Dennis C. Turk, John T. Farrar et al.

Pain 10.1016/j.pain.2004.09.012
[19]
Tubach F "Minimal clinically important improvement and patient acceptable symptom state for subjective outcome measures in rheumatic disorders" J Rheumatol (2007)
[20]
Tubach F "Minimal clinically important difference, low disease activity state, and patient acceptable symptom state: methodological issues" J Rheumatol (2005)
[27]
The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis

Frank C. Arnett, Steven M. Edworthy, Daniel A. Bloch et al.

Arthritis & Rheumatism 10.1002/art.1780310302
[28]
Evaluation of Diagnostic Criteria for Ankylosing Spondylitis

Sjef Van Der Linden, Hans A. Valkenburg, Arnold Cats

Arthritis & Rheumatism 10.1002/art.1780270401
[33]
Garrett S "A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index" J Rheumatol (1994)
[34]
Calin A "A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index" J Rheumatol (1994)
[36]
Bellamy N "Validation of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthitis of the hip or knee" J Rheumatol (1995)
[38]
Wells G "Minimal clinically important difference module: summary, recommendations, and research agenda" J Rheumatol (2001)
[39]
Wells G "MCID/low disease activity state workshop: low disease activity state in rheumatoid arthritis" J Rheumatol (2003)
[42]
Bellamy N "Comparison of transformed visual analogue and native numerical rating scaled patient responses to the WOMAC Index" Int Med J (2011)
[43]
Wells G "MCID/low disease activity state workshop: summary, recommendations, and research agenda" J Rheumatol (2003)
Cited By
345
Cryotherapy following total knee replacement

Ashwin Aggarwal, Sam Adie · 2025

Cochrane Database of Systematic Rev...
Metrics
345
Citations
43
References
Details
Published
Oct 27, 2012
Vol/Issue
64(11)
Pages
1699-1707
License
View
Cite This Article
F. Tubach, P. Ravaud, E. Martin‐Mola, et al. (2012). Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study. Arthritis Care & Research, 64(11), 1699-1707. https://doi.org/10.1002/acr.21747