Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research
Background: Minimum clinically important difference (MCID) is the smallest change in an outcome measure that is considered clinically meaningful. Using validated MCID thresholds for outcomes powers trials adequately to detect meaningful treatment effects, aids in their interpretation and guides deve...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024025106 |
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| author | Biswamohan Mishra Pachipala Sudheer Roopa Rajan Ayush Agarwal M V Padma Srivastava Nilima Nilima Venugopalan Y. Vishnu |
| author_facet | Biswamohan Mishra Pachipala Sudheer Roopa Rajan Ayush Agarwal M V Padma Srivastava Nilima Nilima Venugopalan Y. Vishnu |
| author_sort | Biswamohan Mishra |
| collection | DOAJ |
| description | Background: Minimum clinically important difference (MCID) is the smallest change in an outcome measure that is considered clinically meaningful. Using validated MCID thresholds for outcomes powers trials adequately to detect meaningful treatment effects, aids in their interpretation and guides development of new outcome measures. Objectives: To provide a comprehensive summary of MCID thresholds of various symptom severity scales reported in movement disorder. Methods: We conducted systematic review of the literature and included studies of one or more movement disorders, and reporting MCID scales. Results: 2763 reports were screened. Final review included 32 studies. Risk of bias (RoB) assessment showed most studies were of good quality. Most commonly evaluated scale was Unified Parkinson's Disease Rating Scale (UPDRS) (11 out of 32). Four studies assessing MDS-UPDRS had assessed its different sub-parts, reporting a change of 2.64,3.05,3.25 and 0.9 points to detect clinically meaningful improvement and 2.45,2.51,4.63 and 0.8 points to detect clinically meaningful worsening, for the Part I, II, III and IV, respectively. For Parts II + III, I + II + III and I + II + III + IV, MCID thresholds reported for clinically meaningful improvement were 5.73, 4.9, 6.7 and 7.1 points respectively; while those for clinically meaningful worsening were 4.7, 4.2, 5.2 and 6.3 points, respectively. MCID thresholds reported for other scales included Abnormal Involuntary Movement Scale (AIMS), Toronto Western Spasmodic Torticollis Rating Scale (TWSRS), and Burke-Fahn-Marsden Dystonia Scale (BFMD). Conclusion: This review summarizes all the MCID thresholds currently reported in Movement disorders research and provides a comprehensive resource for future trials, highlighting the need for standardized and validated MCID scales in movement disorder research. |
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| format | Article |
| id | doaj.art-b9f6800bd64349a1a787b959b4c05506 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-24T23:16:32Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-b9f6800bd64349a1a787b959b4c055062024-03-17T07:55:33ZengElsevierHeliyon2405-84402024-03-01105e26479Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders researchBiswamohan Mishra0Pachipala Sudheer1Roopa Rajan2Ayush Agarwal3M V Padma Srivastava4Nilima Nilima5Venugopalan Y. Vishnu6Department of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neurology, All India Institute of Medical Sciences, New Delhi, India; Corresponding author. CNC, AIIMS, Room No. 704, Ansari East, Delhi, New Delhi, 110029, India.Background: Minimum clinically important difference (MCID) is the smallest change in an outcome measure that is considered clinically meaningful. Using validated MCID thresholds for outcomes powers trials adequately to detect meaningful treatment effects, aids in their interpretation and guides development of new outcome measures. Objectives: To provide a comprehensive summary of MCID thresholds of various symptom severity scales reported in movement disorder. Methods: We conducted systematic review of the literature and included studies of one or more movement disorders, and reporting MCID scales. Results: 2763 reports were screened. Final review included 32 studies. Risk of bias (RoB) assessment showed most studies were of good quality. Most commonly evaluated scale was Unified Parkinson's Disease Rating Scale (UPDRS) (11 out of 32). Four studies assessing MDS-UPDRS had assessed its different sub-parts, reporting a change of 2.64,3.05,3.25 and 0.9 points to detect clinically meaningful improvement and 2.45,2.51,4.63 and 0.8 points to detect clinically meaningful worsening, for the Part I, II, III and IV, respectively. For Parts II + III, I + II + III and I + II + III + IV, MCID thresholds reported for clinically meaningful improvement were 5.73, 4.9, 6.7 and 7.1 points respectively; while those for clinically meaningful worsening were 4.7, 4.2, 5.2 and 6.3 points, respectively. MCID thresholds reported for other scales included Abnormal Involuntary Movement Scale (AIMS), Toronto Western Spasmodic Torticollis Rating Scale (TWSRS), and Burke-Fahn-Marsden Dystonia Scale (BFMD). Conclusion: This review summarizes all the MCID thresholds currently reported in Movement disorders research and provides a comprehensive resource for future trials, highlighting the need for standardized and validated MCID scales in movement disorder research.http://www.sciencedirect.com/science/article/pii/S2405844024025106ParkinsonismDystoniaTremorTardive dyskinesiaAtaxiaMovement disorders |
| spellingShingle | Biswamohan Mishra Pachipala Sudheer Roopa Rajan Ayush Agarwal M V Padma Srivastava Nilima Nilima Venugopalan Y. Vishnu Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research Heliyon Parkinsonism Dystonia Tremor Tardive dyskinesia Ataxia Movement disorders |
| title | Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research |
| title_full | Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research |
| title_fullStr | Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research |
| title_full_unstemmed | Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research |
| title_short | Bridging the gap between statistical significance and clinical relevance: A systematic review of minimum clinically important difference (MCID) thresholds of scales reported in movement disorders research |
| title_sort | bridging the gap between statistical significance and clinical relevance a systematic review of minimum clinically important difference mcid thresholds of scales reported in movement disorders research |
| topic | Parkinsonism Dystonia Tremor Tardive dyskinesia Ataxia Movement disorders |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024025106 |
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