Evaluating Measures of Clinical Meaningfulness for Patient-Reported Outcome Measures in Total Joint Arthroplasty: A Systematic Review.
Carissa L Finley, Chancellor F Gray, Hari K Parvataneni et al.
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In 30 seconds
This systematic review examined how studies derived thresholds for clinically meaningful change in the HOOS JR and KOOS JR after primary total joint arthroplasty. It included 17 studies involving 44,935 patients. Thresholds varied substantially by instrument and derivation method: for example, HOOS JR anchor-based MCIDs ranged from 14.8 to 38.1 points, compared with distribution-based MCIDs of 3.9 to 11.0 points. The authors concluded that methods and use of MCID, SCB, and PASS thresholds need standardization to improve interpretation of patient-reported outcomes.
Key findings
- Across 10 HOOS JR studies, distribution-based MCIDs ranged from 3.9 to 11.0 points; anchor-based MCIDs ranged from 14.8 to 38.1 points.
- For KOOS JR, distribution-based MCIDs ranged from 4.0 to 8.7 points, while anchor-based MCIDs ranged from 14.0 to 30.7 points.
- HOOS JR PASS thresholds ranged from 73.5 to 81.0; KOOS JR PASS thresholds ranged from 63.7 to 71.0.
Why it matters
PROM thresholds help clinicians and researchers interpret whether score changes after joint arthroplasty may be meaningful to patients. The wide variation identified across calculation methods means that the same score change could be classified differently depending on the threshold selected, complicating comparisons across studies and interpretation of outcomes.
What to keep in mind
The review included only English-language studies deriving these metrics for primary total joint arthroplasty, limiting the scope of the evidence summarized.