Minimally important difference estimates and methods: a protocol

doi:10.1136/bmjopen-2015-007953

Review

. 2015 Oct 1;5(10):e007953.

doi: 10.1136/bmjopen-2015-007953.

Minimally important difference estimates and methods: a protocol

Affiliations

¹ Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Research Institute, The Hospital For Sick Children, Hospital for Sick Children, Toronto, Ontario, Canada Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
² Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California, USA Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA.
³ Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile.
⁴ Department of Health Promotion and Human Behavior, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁵ Department of Health Services, University of Washington, Seattle, Washington, USA.
⁶ Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁷ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
⁸ Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁹ Nephrology Program, Humber River Regional Hospital, Toronto, Ontario, Canada Division of Nephrology, University of Western Ontario, London, Ontario, Canada Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.

PMID: 26428330
PMCID: PMC4606423
DOI: 10.1136/bmjopen-2015-007953

Review

Minimally important difference estimates and methods: a protocol

Bradley C Johnston et al. BMJ Open. 2015.

. 2015 Oct 1;5(10):e007953.

doi: 10.1136/bmjopen-2015-007953.

Affiliations

¹ Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada Child Health Evaluative Sciences, The Research Institute, The Hospital For Sick Children, Hospital for Sick Children, Toronto, Ontario, Canada Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
² Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California, USA Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA.
³ Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile.
⁴ Department of Health Promotion and Human Behavior, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁵ Department of Health Services, University of Washington, Seattle, Washington, USA.
⁶ Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁷ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
⁸ Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁹ Nephrology Program, Humber River Regional Hospital, Toronto, Ontario, Canada Division of Nephrology, University of Western Ontario, London, Ontario, Canada Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.

PMID: 26428330
PMCID: PMC4606423
DOI: 10.1136/bmjopen-2015-007953

Abstract

Introduction: Patient-reported outcomes (PROs) are often the outcomes of greatest importance to patients. The minimally important difference (MID) provides a measure of the smallest change in the PRO that patients perceive as important. An anchor-based approach is the most appropriate method for MID determination. No study or database currently exists that provides all anchor-based MIDs associated with PRO instruments; nor are there any accepted standards for appraising the credibility of MID estimates. Our objectives are to complete a systematic survey of the literature to collect and characterise published anchor-based MIDs associated with PRO instruments used in evaluating the effects of interventions on chronic medical and psychiatric conditions and to assess their credibility.

Methods and analysis: We will search MEDLINE, EMBASE and PsycINFO (1989 to present) to identify studies addressing methods to estimate anchor-based MIDs of target PRO instruments or reporting empirical ascertainment of anchor-based MIDs. Teams of two reviewers will screen titles and abstracts, review full texts of citations, and extract relevant data. On the basis of findings from studies addressing methods to estimate anchor-based MIDs, we will summarise the available methods and develop an instrument addressing the credibility of empirically ascertained MIDs. We will evaluate the credibility of all studies reporting on the empirical ascertainment of anchor-based MIDs using the credibility instrument, and assess the instrument's inter-rater reliability. We will separately present reports for adult and paediatric populations.

Ethics and dissemination: No research ethics approval was required as we will be using aggregate data from published studies. Our work will summarise anchor-based methods available to establish MIDs, provide an instrument to assess the credibility of available MIDs, determine the reliability of that instrument, and provide a comprehensive compendium of published anchor-based MIDs associated with PRO instruments which will help improve the interpretability of outcome effects in systematic reviews and practice guidelines.

Keywords: MID; Minimally Important Difference; Patient Reported Outcome; Protocol; Systematic Survey.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PubMed Disclaimer

Figures

**Figure 1**
Number of citations found in PubMed with search terms of patient reported outcome, by 5-year stratum.

**Figure 2**
Number of citations found in PubMed with the search terms of patient reported outcome limited to clinical trials, by 5-year stratum.

**Figure 3**
Number of citations found in PubMed with search terms of patient reported outcome and practice guidelines, by 5-year strata.

**Figure 4**
Number of citations found in PubMed with search terms of minimal (clinically) important difference, by 5-year stratum.

See this image and copyright information in PMC

Cited by

Minimum clinically important differences in the Minnesota Living with Heart Failure questionnaire: from a study of heart failure patients treated with integrated Chinese and Western medicine.
Zhu Y, Cong J, Lin L, Du J, Long L, He Y, Ren J. Zhu Y, et al. Front Cardiovasc Med. 2023 Nov 27;10:1242216. doi: 10.3389/fcvm.2023.1242216. eCollection 2023. Front Cardiovasc Med. 2023. PMID: 38089764 Free PMC article.
Minimal important difference of the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in persons with chronic low back pain.
Wong JJ, Hogg-Johnson S, De Groote W, Ćwirlej-Sozańska A, Garin O, Ferrer M, Acuña ÀP, Côté P. Wong JJ, et al. Chiropr Man Therap. 2023 Dec 5;31(1):49. doi: 10.1186/s12998-023-00521-0. Chiropr Man Therap. 2023. PMID: 38053118 Free PMC article.
Evaluation of the MOVE online exercise programme for young people aged 13-30.
Barnes E, Hillier-Moses G, Murray H, Stevinson C, Franks HA, Gossage L. Barnes E, et al. Support Care Cancer. 2023 Jun 5;31(7):377. doi: 10.1007/s00520-023-07758-8. Support Care Cancer. 2023. PMID: 37273014 Free PMC article.
Evaluation of the EQ-5D-5L, EQ-VAS stand-alone component and Oxford knee score in the Australian knee arthroplasty population utilising minimally important difference, concurrent validity, predictive validity and responsiveness.
Lin DY, Cheok TS, Kaambwa B, Samson AJ, Morrison C, Chan T, Kroon HM, Jaarsma RL. Lin DY, et al. Health Qual Life Outcomes. 2023 May 10;21(1):41. doi: 10.1186/s12955-023-02126-w. Health Qual Life Outcomes. 2023. PMID: 37165364 Free PMC article.
Saturated fat and human health: a protocol for a methodologically innovative systematic review and meta-analysis to inform public health nutrition guidelines.
Johnston BC, Zeraatkar D, Steen J, de Jauregui DRF, Zhu H, Sun M, Cooper M, Maraj M, Prokop-Dorner A, Reyes BC, Valli C, Storman D, Karam G, Zajac J, Ge L, Swierz MJ, Ghosh N, Vernooij RWM, Chang Y, Zhao Y, Thabane L, Guyatt GH, Alonso-Coello P, Hooper L, Bala MM. Johnston BC, et al. Syst Rev. 2023 Mar 14;12(1):39. doi: 10.1186/s13643-023-02209-1. Syst Rev. 2023. PMID: 36918997 Free PMC article.

See all "Cited by" articles

References

1. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–83. 10.1097/00005650-199206000-00002 - DOI - PubMed
1. Beck AT, Ward CH, Mendelson M et al. . An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–71. 10.1001/archpsyc.1961.01710120031004 - DOI - PubMed
1. Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989;10:407–15. 10.1016/0197-2456(89)90005-6 - DOI - PubMed
1. Johnston BC, Thorlund K, Schunemann HJ et al. . Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference units. Health Qual Life Outcomes 2010;8:116 10.1186/1477-7525-8-116 - DOI - PMC - PubMed
1. Schunemann HJ, Guyatt GH. Commentary–goodbye M(C)ID! Hello MID, where do you come from? Health Serv Res 2005;40:593–7. 10.1111/j.1475-6773.2005.0k375.x - DOI - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Miscellaneous
- NCI CPTAC Assay Portal

[1] Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–83. 10.1097/00005650-199206000-00002 - DOI - PubMed

[2] Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–83. 10.1097/00005650-199206000-00002 - DOI - PubMed

[3] Beck AT, Ward CH, Mendelson M et al. . An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–71. 10.1001/archpsyc.1961.01710120031004 - DOI - PubMed

[4] Beck AT, Ward CH, Mendelson M et al. . An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–71. 10.1001/archpsyc.1961.01710120031004 - DOI - PubMed

[5] Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989;10:407–15. 10.1016/0197-2456(89)90005-6 - DOI - PubMed

[6] Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989;10:407–15. 10.1016/0197-2456(89)90005-6 - DOI - PubMed

[7] Johnston BC, Thorlund K, Schunemann HJ et al. . Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference units. Health Qual Life Outcomes 2010;8:116 10.1186/1477-7525-8-116 - DOI - PMC - PubMed

[8] Johnston BC, Thorlund K, Schunemann HJ et al. . Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference units. Health Qual Life Outcomes 2010;8:116 10.1186/1477-7525-8-116 - DOI - PMC - PubMed

[9] Schunemann HJ, Guyatt GH. Commentary–goodbye M(C)ID! Hello MID, where do you come from? Health Serv Res 2005;40:593–7. 10.1111/j.1475-6773.2005.0k375.x - DOI - PMC - PubMed

[10] Schunemann HJ, Guyatt GH. Commentary–goodbye M(C)ID! Hello MID, where do you come from? Health Serv Res 2005;40:593–7. 10.1111/j.1475-6773.2005.0k375.x - DOI - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Minimally important difference estimates and methods: a protocol

Affiliations

Minimally important difference estimates and methods: a protocol

Authors

Affiliations

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous