Changes and thresholds in the Oxford Shoulder Score following shoulder arthroplasty: Minimal clinically important difference, minimal important and detectable changes, and patient-acceptable symptom state
Year: 2023
Type: article
Study design: Observational Study
Abstract: Background The minimal clinically important difference, minimal important change, minimal detectable change and patient-acceptable symptom state are poorly defined for the Oxford Shoulder Score following shoulder arthroplasty. The study's aim was to calculate their values. Methods One hundred patients underwent shoulder arthroplasty and completed pre and 1-year postoperative Oxford Shoulder Score. Patient satisfaction was assessed at 1-year using a visual analogue scale from 0 to 100: ‘very satisfied’ (>80), ‘satisfied’ (>60–80), and ‘unsatisfied’ (≤60). The difference between patients recording ‘unsatisfied’ ( n = 11) and ‘satisfied’ ( n = 16) was used to define the minimal clinically important difference. MIC cohort was calculated as the change in Oxford Shoulder Score for those satisfied (>60). Receiver-operating characteristic curve analysis was used to determine the MIC individual and patient-acceptable symptom state. Distribution-based methodology was used for the minimal detectable change. Results The minimal clinically important difference was 6.9 (95% confidence interval 0.7–13.1, p = 0.039). The MIC cohort was 11.6 (95% confidence interval 6.8–16.4) and MIC individual 13. The minimal detectable change was 6.6 and the patient-acceptable symptom state was defined as ≥29. Discussion The minimal clinically important difference and minimal important change can assess whether there is a clinical difference between two groups and whether a cohort/patient has had a meaningful change in their Oxford Shoulder Score, respectively. These were greater than measurement error (minimal detectable change), suggesting a real change. The patient-acceptable symptom state can be used as a marker of achieving satisfaction.
Source: Shoulder & Elbow
Authors: Perry Liu, Irrum Afzal, Vipin Asopa, Nick D Clement, Vipul Patel
Institution: Edinburgh Royal Infirmary
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4377023973