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Minimally important change, measurement error, and responsiveness for the Self-Reported Foot and Ankle Score
Department of Orthopedics and Clinical Sciences, SUS Malmö, Malmö, Sweden.
Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Clinical Physiology, Kalmar Hospital, Kalmar, Sweden & Department of Medicine and Health Sciences, Linköping University Hospital, Linköping, Sweden.
Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden.ORCID iD: 0000-0002-8081-579X
2017 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 88, no 3, p. 300-304Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Patient-reported outcome measures (PROMs) are increasingly used to evaluate results in orthopedic surgery. To enhance good responsiveness with a PROM, the minimally important change (MIC) should be established. MIC reflects the smallest measured change in score that is perceived as being relevant by the patients. We assessed MIC for the Self-reported Foot and Ankle Score (SEFAS) used in Swedish national registries. Patients and methods - Patients with forefoot disorders (n = 83) or hindfoot/ankle disorders (n = 80) completed the SEFAS before surgery and 6 months after surgery. At 6 months also, a patient global assessment (PGA) scale-as external criterion-was completed. Measurement error was expressed as the standard error of a single determination. MIC was calculated by (1) median change scores in improved patients on the PGA scale, and (2) the best cutoff point (BCP) and area under the curve (AUC) using analysis of receiver operating characteristic curves (ROCs). Results - The change in mean summary score was the same, 9 (SD 9), in patients with forefoot disorders and in patients with hindfoot/ankle disorders. MIC for SEFAS in the total sample was 5 score points (IQR: 2-8) and the measurement error was 2.4. BCP was 5 and AUC was 0.8 (95% CI: 0.7-0.9). Interpretation - As previously shown, SEFAS has good responsiveness. The score change in SEFAS 6 months after surgery should exceed 5 score points in both forefoot patients and hindfoot/ankle patients to be considered as being clinically relevant. © 2017 The Author(s).

Place, publisher, year, edition, pages
Abingdon: Taylor & Francis, 2017. Vol. 88, no 3, p. 300-304
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:hh:diva-34972DOI: 10.1080/17453674.2017.1293445ISI: 000400742500011PubMedID: 28464751Scopus ID: 2-s2.0-85013054854OAI: oai:DiVA.org:hh-34972DiVA, id: diva2:1209532
Funder
Medical Research Council of Southeast Sweden (FORSS)Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2018-05-24Bibliographically approved

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