Minimum important difference between patients with rheumatoid arthritis : the patient's perspective

Wells, G.A., Tugwell, P., Kraag, G.R., Baker, P.R., Groh, J., & Redelmeier, D.A. (1993) Minimum important difference between patients with rheumatoid arthritis : the patient's perspective. Journal of Rheumatology, 20(3), pp. 557-560.

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Abstract

OBJECTIVE: To determine the point at which differences in clinical assessment scores on physical ability, pain and overall condition are sufficiently large to correspond to a subjective perception of a meaningful difference from the perspective of the patient.

METHODS: Forty patients with a diagnosis of rheumatoid arthritis participated in an evening of clinical assessment and one-on-one conversations with each other regarding their arthritic condition. The assessments included tender and swollen joint counts, clinician and patient global assessments, participant assessment of pain and the Health Assessment Questionnaire (HAQ) on physical ability. After each conversation, participants rated themselves relative to their conversational partner on physical ability, pain and overall condition. These subjective comparative ratings were compared to the differences of the individual clinical assessments.

RESULTS: In total there were 120 conversations. Generally participants judged themselves as less disabled than others. They rated themselves as "somewhat better" than their conversation partner when they had a (mean) 7% better score on the HAQ, 6% less pain, and 9% better global assessment. In contrast, they rated themselves as "somewhat worse" when they had a (mean) 16% worse score on the HAQ, 16% more pain, and 29% worse global assessment.

CONCLUSIONS: Patients view clinically important differences in an asymmetric manner. These results can provide guidance in interpreting results and planning clinical trials.

Impact and interest:

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ID Code: 55768
Item Type: Journal Article
Refereed: Yes
Additional Information: Cited By (since 1996): 284
Export Date: 13 December 2012
Source: Scopus
Keywords: clinical importance, clinical trials, outcome measures, rheumatoid arthritis, subjective assessments
ISSN: 0315-162X
Subjects: Australian and New Zealand Standard Research Classification > MATHEMATICAL SCIENCES (010000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Epidemiology (111706)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Public Health & Social Work
Deposited On: 12 Mar 2013 07:23
Last Modified: 13 Mar 2013 03:59

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