Minimal clinically important decline in physical function over one year: EPOSA study

Paola Siviero, Federica Limongi, Antonella Gesmundo, Sabina Zambon, Cyrus Cooper, Elaine M. Dennison, Mark H. Edwards, Erik J. Timmermans, Suzan van der Pas, Laura A. Schaap, Natasja M. van Schoor, Michael D. Denkinger, Florian Herbolsheimer, Richard Peter, Maria Victoria Castell, Ángel Otero, Rocio Queipo, Nancy L. Pedersen, Dorly J. H. Deeg, Stefania Maggi & 24 others T. Nikolaus, R. Peter, M. D. Denkinger, F. Herbolsheimer, S. Maggi, S. Zambon, F. Limongi, M. Noale, P. Siviero, D. J. Deeg, S. van der Pas, L. A. Schaap, N. M. van Schoor, E. J. Timmermans, A. Otero, M. V. Castell, M. Sanchez-Martinez, R. Quieipo, N. L. Pedersen, R. Broumandi, E. M. Dennison, C. Cooper, M. H. Edwards, C. Parsons

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities knee and hip Osteoarthritis Index (WOMAC) are the most commonly used clinical tools to manage and monitor osteoarthritis (OA). Few studies have as yet reported longitudinal changes in the AUSCAN index regarding the hand. While there are published data regarding WOMAC assessments of the hip and the knee, the two sites have always evaluated separately. The current study therefore sought to determine the minimal clinically important difference (MCID) in decline in the AUSCAN hand and WOMAC hip/knee physical function scores over 1 year using anchor-based and distribution-based methods. Methods: The study analysed data collected by the European Project on Osteoarthritis, a prospective observational study investigating six adult cohorts with and without OA by evaluating changes in the AUSCAN and WOMAC physical function scores at baseline and 12-18 months later. Pain and stiffness scores, the performance-based grip strength and walking speed and health-related quality of life measures were used as the study's anchors. Receiver operating characteristic curves and distribution-based methods were used to estimate the MCID in the AUSCAN and WOMAC physical function scores; only the data of those participants who possessed paired (baseline and follow up-measures) AUSCAN and WOMAC scores were included in the analysis. Results: Out of the 1866 participants who were evaluated, 1842 had paired AUSCAN scores and 1845 had paired WOMAC scores. The changes in the AUSCAN physical function score correlated significantly with those in the AUSCAN pain score (r = 0.31). Anchor- A nd distribution-based approaches converged identifying 4 as the MCID for decline in the AUSCAN hand physical function. Changes in the WOMAC hip/knee physical function score were significantly correlated with changes in both the WOMAC pain score (r = 0.47) and the WOMAC stiffness score (r = 0.35). The different approaches converged identifying two as the MCID for decline in the WOMAC hip/knee physical function. Conclusions: The most reliable MCID estimates of decline over 1 year in the AUSCAN hand and WOMAC hip/knee physical function scores were 4 and 2 points, respectively.
Original languageEnglish
Article number227
JournalBMC Musculoskeletal Disorders
Volume20
Issue number1
DOIs
Publication statusPublished - 17 May 2019

Cite this

Siviero, Paola ; Limongi, Federica ; Gesmundo, Antonella ; Zambon, Sabina ; Cooper, Cyrus ; Dennison, Elaine M. ; Edwards, Mark H. ; Timmermans, Erik J. ; van der Pas, Suzan ; Schaap, Laura A. ; van Schoor, Natasja M. ; Denkinger, Michael D. ; Herbolsheimer, Florian ; Peter, Richard ; Castell, Maria Victoria ; Otero, Ángel ; Queipo, Rocio ; Pedersen, Nancy L. ; Deeg, Dorly J. H. ; Maggi, Stefania ; Nikolaus, T. ; Peter, R. ; Denkinger, M. D. ; Herbolsheimer, F. ; Maggi, S. ; Zambon, S. ; Limongi, F. ; Noale, M. ; Siviero, P. ; Deeg, D. J. ; van der Pas, S. ; Schaap, L. A. ; van Schoor, N. M. ; Timmermans, E. J. ; Otero, A. ; Castell, M. V. ; Sanchez-Martinez, M. ; Quieipo, R. ; Pedersen, N. L. ; Broumandi, R. ; Dennison, E. M. ; Cooper, C. ; Edwards, M. H. ; Parsons, C. / Minimal clinically important decline in physical function over one year: EPOSA study. In: BMC Musculoskeletal Disorders. 2019 ; Vol. 20, No. 1.
@article{d9a85d7d42734dd2b27e5ef028a08da8,
title = "Minimal clinically important decline in physical function over one year: EPOSA study",
abstract = "Background: The Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities knee and hip Osteoarthritis Index (WOMAC) are the most commonly used clinical tools to manage and monitor osteoarthritis (OA). Few studies have as yet reported longitudinal changes in the AUSCAN index regarding the hand. While there are published data regarding WOMAC assessments of the hip and the knee, the two sites have always evaluated separately. The current study therefore sought to determine the minimal clinically important difference (MCID) in decline in the AUSCAN hand and WOMAC hip/knee physical function scores over 1 year using anchor-based and distribution-based methods. Methods: The study analysed data collected by the European Project on Osteoarthritis, a prospective observational study investigating six adult cohorts with and without OA by evaluating changes in the AUSCAN and WOMAC physical function scores at baseline and 12-18 months later. Pain and stiffness scores, the performance-based grip strength and walking speed and health-related quality of life measures were used as the study's anchors. Receiver operating characteristic curves and distribution-based methods were used to estimate the MCID in the AUSCAN and WOMAC physical function scores; only the data of those participants who possessed paired (baseline and follow up-measures) AUSCAN and WOMAC scores were included in the analysis. Results: Out of the 1866 participants who were evaluated, 1842 had paired AUSCAN scores and 1845 had paired WOMAC scores. The changes in the AUSCAN physical function score correlated significantly with those in the AUSCAN pain score (r = 0.31). Anchor- A nd distribution-based approaches converged identifying 4 as the MCID for decline in the AUSCAN hand physical function. Changes in the WOMAC hip/knee physical function score were significantly correlated with changes in both the WOMAC pain score (r = 0.47) and the WOMAC stiffness score (r = 0.35). The different approaches converged identifying two as the MCID for decline in the WOMAC hip/knee physical function. Conclusions: The most reliable MCID estimates of decline over 1 year in the AUSCAN hand and WOMAC hip/knee physical function scores were 4 and 2 points, respectively.",
keywords = "AUSCAN, Functional decline, Hand, Hip/knee, MCID, Osteoarthritis, WOMAC",
author = "Paola Siviero and Federica Limongi and Antonella Gesmundo and Sabina Zambon and Cyrus Cooper and Dennison, {Elaine M.} and Edwards, {Mark H.} and Timmermans, {Erik J.} and {van der Pas}, Suzan and Schaap, {Laura A.} and {van Schoor}, {Natasja M.} and Denkinger, {Michael D.} and Florian Herbolsheimer and Richard Peter and Castell, {Maria Victoria} and {\'A}ngel Otero and Rocio Queipo and Pedersen, {Nancy L.} and Deeg, {Dorly J. H.} and Stefania Maggi and T. Nikolaus and R. Peter and Denkinger, {M. D.} and F. Herbolsheimer and S. Maggi and S. Zambon and F. Limongi and M. Noale and P. Siviero and Deeg, {D. J.} and {van der Pas}, S. and Schaap, {L. A.} and {van Schoor}, {N. M.} and Timmermans, {E. J.} and A. Otero and Castell, {M. V.} and M. Sanchez-Martinez and R. Quieipo and Pedersen, {N. L.} and R. Broumandi and Dennison, {E. M.} and C. Cooper and Edwards, {M. H.} and C. Parsons",
year = "2019",
month = "5",
day = "17",
doi = "10.1186/s12891-019-2593-1",
language = "English",
volume = "20",
journal = "BMC Musculoskeletal Disorders",
issn = "1471-2474",
publisher = "BioMed Central",
number = "1",

}

Siviero, P, Limongi, F, Gesmundo, A, Zambon, S, Cooper, C, Dennison, EM, Edwards, MH, Timmermans, EJ, van der Pas, S, Schaap, LA, van Schoor, NM, Denkinger, MD, Herbolsheimer, F, Peter, R, Castell, MV, Otero, Á, Queipo, R, Pedersen, NL, Deeg, DJH, Maggi, S, Nikolaus, T, Peter, R, Denkinger, MD, Herbolsheimer, F, Maggi, S, Zambon, S, Limongi, F, Noale, M, Siviero, P, Deeg, DJ, van der Pas, S, Schaap, LA, van Schoor, NM, Timmermans, EJ, Otero, A, Castell, MV, Sanchez-Martinez, M, Quieipo, R, Pedersen, NL, Broumandi, R, Dennison, EM, Cooper, C, Edwards, MH & Parsons, C 2019, 'Minimal clinically important decline in physical function over one year: EPOSA study' BMC Musculoskeletal Disorders, vol. 20, no. 1, 227. https://doi.org/10.1186/s12891-019-2593-1, https://doi.org/10.1186/s12891-019-2593-1

Minimal clinically important decline in physical function over one year: EPOSA study. / Siviero, Paola; Limongi, Federica; Gesmundo, Antonella; Zambon, Sabina; Cooper, Cyrus; Dennison, Elaine M.; Edwards, Mark H.; Timmermans, Erik J.; van der Pas, Suzan; Schaap, Laura A.; van Schoor, Natasja M.; Denkinger, Michael D.; Herbolsheimer, Florian; Peter, Richard; Castell, Maria Victoria; Otero, Ángel; Queipo, Rocio; Pedersen, Nancy L.; Deeg, Dorly J. H.; Maggi, Stefania; Nikolaus, T.; Peter, R.; Denkinger, M. D.; Herbolsheimer, F.; Maggi, S.; Zambon, S.; Limongi, F.; Noale, M.; Siviero, P.; Deeg, D. J.; van der Pas, S.; Schaap, L. A.; van Schoor, N. M.; Timmermans, E. J.; Otero, A.; Castell, M. V.; Sanchez-Martinez, M.; Quieipo, R.; Pedersen, N. L.; Broumandi, R.; Dennison, E. M.; Cooper, C.; Edwards, M. H.; Parsons, C.

In: BMC Musculoskeletal Disorders, Vol. 20, No. 1, 227, 17.05.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Minimal clinically important decline in physical function over one year: EPOSA study

AU - Siviero, Paola

AU - Limongi, Federica

AU - Gesmundo, Antonella

AU - Zambon, Sabina

AU - Cooper, Cyrus

AU - Dennison, Elaine M.

AU - Edwards, Mark H.

AU - Timmermans, Erik J.

AU - van der Pas, Suzan

AU - Schaap, Laura A.

AU - van Schoor, Natasja M.

AU - Denkinger, Michael D.

AU - Herbolsheimer, Florian

AU - Peter, Richard

AU - Castell, Maria Victoria

AU - Otero, Ángel

AU - Queipo, Rocio

AU - Pedersen, Nancy L.

AU - Deeg, Dorly J. H.

AU - Maggi, Stefania

AU - Nikolaus, T.

AU - Peter, R.

AU - Denkinger, M. D.

AU - Herbolsheimer, F.

AU - Maggi, S.

AU - Zambon, S.

AU - Limongi, F.

AU - Noale, M.

AU - Siviero, P.

AU - Deeg, D. J.

AU - van der Pas, S.

AU - Schaap, L. A.

AU - van Schoor, N. M.

AU - Timmermans, E. J.

AU - Otero, A.

AU - Castell, M. V.

AU - Sanchez-Martinez, M.

AU - Quieipo, R.

AU - Pedersen, N. L.

AU - Broumandi, R.

AU - Dennison, E. M.

AU - Cooper, C.

AU - Edwards, M. H.

AU - Parsons, C.

PY - 2019/5/17

Y1 - 2019/5/17

N2 - Background: The Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities knee and hip Osteoarthritis Index (WOMAC) are the most commonly used clinical tools to manage and monitor osteoarthritis (OA). Few studies have as yet reported longitudinal changes in the AUSCAN index regarding the hand. While there are published data regarding WOMAC assessments of the hip and the knee, the two sites have always evaluated separately. The current study therefore sought to determine the minimal clinically important difference (MCID) in decline in the AUSCAN hand and WOMAC hip/knee physical function scores over 1 year using anchor-based and distribution-based methods. Methods: The study analysed data collected by the European Project on Osteoarthritis, a prospective observational study investigating six adult cohorts with and without OA by evaluating changes in the AUSCAN and WOMAC physical function scores at baseline and 12-18 months later. Pain and stiffness scores, the performance-based grip strength and walking speed and health-related quality of life measures were used as the study's anchors. Receiver operating characteristic curves and distribution-based methods were used to estimate the MCID in the AUSCAN and WOMAC physical function scores; only the data of those participants who possessed paired (baseline and follow up-measures) AUSCAN and WOMAC scores were included in the analysis. Results: Out of the 1866 participants who were evaluated, 1842 had paired AUSCAN scores and 1845 had paired WOMAC scores. The changes in the AUSCAN physical function score correlated significantly with those in the AUSCAN pain score (r = 0.31). Anchor- A nd distribution-based approaches converged identifying 4 as the MCID for decline in the AUSCAN hand physical function. Changes in the WOMAC hip/knee physical function score were significantly correlated with changes in both the WOMAC pain score (r = 0.47) and the WOMAC stiffness score (r = 0.35). The different approaches converged identifying two as the MCID for decline in the WOMAC hip/knee physical function. Conclusions: The most reliable MCID estimates of decline over 1 year in the AUSCAN hand and WOMAC hip/knee physical function scores were 4 and 2 points, respectively.

AB - Background: The Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities knee and hip Osteoarthritis Index (WOMAC) are the most commonly used clinical tools to manage and monitor osteoarthritis (OA). Few studies have as yet reported longitudinal changes in the AUSCAN index regarding the hand. While there are published data regarding WOMAC assessments of the hip and the knee, the two sites have always evaluated separately. The current study therefore sought to determine the minimal clinically important difference (MCID) in decline in the AUSCAN hand and WOMAC hip/knee physical function scores over 1 year using anchor-based and distribution-based methods. Methods: The study analysed data collected by the European Project on Osteoarthritis, a prospective observational study investigating six adult cohorts with and without OA by evaluating changes in the AUSCAN and WOMAC physical function scores at baseline and 12-18 months later. Pain and stiffness scores, the performance-based grip strength and walking speed and health-related quality of life measures were used as the study's anchors. Receiver operating characteristic curves and distribution-based methods were used to estimate the MCID in the AUSCAN and WOMAC physical function scores; only the data of those participants who possessed paired (baseline and follow up-measures) AUSCAN and WOMAC scores were included in the analysis. Results: Out of the 1866 participants who were evaluated, 1842 had paired AUSCAN scores and 1845 had paired WOMAC scores. The changes in the AUSCAN physical function score correlated significantly with those in the AUSCAN pain score (r = 0.31). Anchor- A nd distribution-based approaches converged identifying 4 as the MCID for decline in the AUSCAN hand physical function. Changes in the WOMAC hip/knee physical function score were significantly correlated with changes in both the WOMAC pain score (r = 0.47) and the WOMAC stiffness score (r = 0.35). The different approaches converged identifying two as the MCID for decline in the WOMAC hip/knee physical function. Conclusions: The most reliable MCID estimates of decline over 1 year in the AUSCAN hand and WOMAC hip/knee physical function scores were 4 and 2 points, respectively.

KW - AUSCAN

KW - Functional decline

KW - Hand

KW - Hip/knee

KW - MCID

KW - Osteoarthritis

KW - WOMAC

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85065916134&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31101033

U2 - 10.1186/s12891-019-2593-1

DO - 10.1186/s12891-019-2593-1

M3 - Article

VL - 20

JO - BMC Musculoskeletal Disorders

JF - BMC Musculoskeletal Disorders

SN - 1471-2474

IS - 1

M1 - 227

ER -