Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods

The concept of the minimal clinically important difference (MCID) emerged from the recognition that statistical significance alone is not enough to determine the clinical relevance of treatment effects in clinical research. In many cases, statistically significant changes in outcomes may not be mean...

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Main Authors: Biswamohan Mishra, Pachipala Sudheer, Ayush Agarwal, M Vasantha Padma Srivastava, Nilima, Venugopalan Y Vishnu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Annals of Indian Academy of Neurology
Subjects:
Online Access:http://www.annalsofian.org/article.asp?issn=0972-2327;year=2023;volume=26;issue=4;spage=334;epage=343;aulast=Mishra
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author Biswamohan Mishra
Pachipala Sudheer
Ayush Agarwal
M Vasantha Padma Srivastava
Nilima
Venugopalan Y Vishnu
author_facet Biswamohan Mishra
Pachipala Sudheer
Ayush Agarwal
M Vasantha Padma Srivastava
Nilima
Venugopalan Y Vishnu
author_sort Biswamohan Mishra
collection DOAJ
description The concept of the minimal clinically important difference (MCID) emerged from the recognition that statistical significance alone is not enough to determine the clinical relevance of treatment effects in clinical research. In many cases, statistically significant changes in outcomes may not be meaningful to patients or may not result in any tangible improvements in their health. This has led to a growing emphasis on the importance of measuring patient-reported outcome measures (PROMs) in clinical trials and other research studies, in order to capture the patient perspective on treatment effectiveness. MCID is defined as the smallest change in scores that is considered meaningful or important to patients. MCID is particularly important in fields such as neurology, where many of the outcomes of interest are subjective or based on patient-reported symptoms. This review discusses the challenges associated with interpreting outcomes of clinical trials based solely on statistical significance, highlighting the importance of considering clinical relevance and patient perception of change. There are two main approaches to estimating MCID: anchor-based and distribution-based. Anchor-based approaches compare change scores using an external anchor, while distribution-based approaches estimate MCID values based on statistical characteristics of scores within a sample. MCID is dynamic and context-specific, and there is no single 'gold standard' method for estimating it. A range of MCID thresholds should be defined using multiple methods for a disease under targeted intervention, rather than relying on a single absolute value. The use of MCID thresholds can be an important tool for researchers, neurophysicians and patients in evaluating the effectiveness of treatments and interventions, and in making informed decisions about care.
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spelling doaj.art-2f016cb81cd84cb5bb2de60ea6d0994e2023-10-26T05:44:41ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492023-01-0126433434310.4103/aian.aian_207_23Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methodsBiswamohan MishraPachipala SudheerAyush AgarwalM Vasantha Padma SrivastavaNilimaVenugopalan Y VishnuThe concept of the minimal clinically important difference (MCID) emerged from the recognition that statistical significance alone is not enough to determine the clinical relevance of treatment effects in clinical research. In many cases, statistically significant changes in outcomes may not be meaningful to patients or may not result in any tangible improvements in their health. This has led to a growing emphasis on the importance of measuring patient-reported outcome measures (PROMs) in clinical trials and other research studies, in order to capture the patient perspective on treatment effectiveness. MCID is defined as the smallest change in scores that is considered meaningful or important to patients. MCID is particularly important in fields such as neurology, where many of the outcomes of interest are subjective or based on patient-reported symptoms. This review discusses the challenges associated with interpreting outcomes of clinical trials based solely on statistical significance, highlighting the importance of considering clinical relevance and patient perception of change. There are two main approaches to estimating MCID: anchor-based and distribution-based. Anchor-based approaches compare change scores using an external anchor, while distribution-based approaches estimate MCID values based on statistical characteristics of scores within a sample. MCID is dynamic and context-specific, and there is no single 'gold standard' method for estimating it. A range of MCID thresholds should be defined using multiple methods for a disease under targeted intervention, rather than relying on a single absolute value. The use of MCID thresholds can be an important tool for researchers, neurophysicians and patients in evaluating the effectiveness of treatments and interventions, and in making informed decisions about care.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2023;volume=26;issue=4;spage=334;epage=343;aulast=Mishraanchor-based methodsclinical relevancedistribution-based methodsminimal clinical important difference (mcid)minimal clinically important changeneurologypatient-reported outcome measures (proms)rasch model
spellingShingle Biswamohan Mishra
Pachipala Sudheer
Ayush Agarwal
M Vasantha Padma Srivastava
Nilima
Venugopalan Y Vishnu
Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods
Annals of Indian Academy of Neurology
anchor-based methods
clinical relevance
distribution-based methods
minimal clinical important difference (mcid)
minimal clinically important change
neurology
patient-reported outcome measures (proms)
rasch model
title Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods
title_full Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods
title_fullStr Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods
title_full_unstemmed Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods
title_short Minimal clinically important difference (MCID) in patient-reported outcome measures for neurological conditions: Review of concept and methods
title_sort minimal clinically important difference mcid in patient reported outcome measures for neurological conditions review of concept and methods
topic anchor-based methods
clinical relevance
distribution-based methods
minimal clinical important difference (mcid)
minimal clinically important change
neurology
patient-reported outcome measures (proms)
rasch model
url http://www.annalsofian.org/article.asp?issn=0972-2327;year=2023;volume=26;issue=4;spage=334;epage=343;aulast=Mishra
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