Purpose
To determine the minimal clinically important difference (MCID) using Patient-Reported
Outcome Measurement Information System (PROMIS) computer-adaptive testing assessments
in patients undergoing arthroscopic partial meniscectomy. The secondary purpose was
to identify which preoperative patient factors are associated with MCID achievement.
Methods
Three PROMIS computer-adaptive testing assessments (Physical Function [PF], Pain Interference
[PI], and Depression [D]) were administered to all patients presenting to 1 of 2 board-certified,
sports medicine orthopaedic surgeons. Patients with Current Procedural Terminology
codes of 29880 or 29881 were chart reviewed for a host clinical and demographic factors.
PROMIS scores were assessed for improvement and patient characteristics were assessed
for influence on any improvement. MCID was calculated according to the distribution
methodology and receiver operating characteristics were used to assess preoperative
scores predictive ability.
Results
In total, 166 patients met inclusion criteria (58 exclusions). Postoperative PROMIS-PF
(45.6), PROMIS-PI (54.6), and PROMIS-D (44.1) significantly improved at least 3 months
after surgery when compared with baseline (P = .002). MCID values for PROMIS-PF, PROMIS-PI, and PROMIS-D were 3.5, 3.3, and 4.4,
respectively. Individuals with PROMIS-PF scores below 34.9 yielded an 82% probability
of achieving MCID, while PROMIS-PI scores above 67.5 yielded an 86% probability of
achieving MCID and a cutoff of 58.9 for PROMIS-D yielded a 60% probability of achieving
MCID, with 90% specificity.
Conclusions
PROMIS scores, obtained preoperatively, were shown to be valid predictors of postoperative
clinical improvement in patients undergoing meniscectomy. Our findings suggest that
patients with physical function scores of 34.9 or less have an increased probability
of reaching a minimal clinically important difference. Similarly, patients with pain
interference scores of 67.5 and above have increased probability of reaching MCID
for pain interference. These cutoffs may be used by physicians to aid in the counseling
of patients considering arthroscopic meniscectomy.
Level of Evidence
IV, Case Series.
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Article info
Publication history
Published online: October 31, 2020
Accepted:
October 16,
2020
Received:
January 21,
2020
Footnotes
See commentary on page 972
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2020 Published by Elsevier on behalf of the Arthroscopy Association of North America
