Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review

Abstract Background Many outcomes relevant to rheumatoid arthritis are measured as continuous variables. Judging whether the results of those measurements are clinically significant requires determining the minimal important difference (MID) estimate. Therefore, valid MID estimate(s) are essential f...

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Main Authors: Sally Yaacoub, Anas El Zouhbi, Michella Abi Zeid Daou, Vicky Nahra, Abir Mokbel, Layal Hneiny, Liana Fraenkel, Bradley C. Johnston, Elie A. Akl
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Rheumatology
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Online Access:https://doi.org/10.1186/s41927-025-00524-9
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author Sally Yaacoub
Anas El Zouhbi
Michella Abi Zeid Daou
Vicky Nahra
Abir Mokbel
Layal Hneiny
Liana Fraenkel
Bradley C. Johnston
Elie A. Akl
author_facet Sally Yaacoub
Anas El Zouhbi
Michella Abi Zeid Daou
Vicky Nahra
Abir Mokbel
Layal Hneiny
Liana Fraenkel
Bradley C. Johnston
Elie A. Akl
author_sort Sally Yaacoub
collection DOAJ
description Abstract Background Many outcomes relevant to rheumatoid arthritis are measured as continuous variables. Judging whether the results of those measurements are clinically significant requires determining the minimal important difference (MID) estimate. Therefore, valid MID estimate(s) are essential for the purposes of clinical decision-making and developing clinical recommendations. Our objective is to present the MID estimates for instruments used to measure outcomes in rheumatoid arthritis studies. Methods We conducted a scoping review. We included original research reports on MID of instruments used to measure outcomes in rheumatoid arthritis, using distribution- or anchor-based methods. We excluded conference abstracts. We searched MEDLINE (OVID) and EMBASE (OVID) databases on January 6, 2025 and scanned the reference lists of included studies and of identified relevant systematic reviews. Reviewers screened the titles and abstracts and full-texts, then abstracted data in duplicate and independently. They resolved disagreements by discussion or by consulting a third reviewer. We summarized the data narratively and in tabular formats. Results We identified 35 eligible studies reporting on a total of 144 MID estimates for 72 instruments used in rheumatoid arthritis. The most common constructs measured were physical function (26%), disease activity (18%), health status (17%) and fatigue (14%). The majority of measurement instruments were generic (60%). The most common instrument with MID estimates was the Health Assessment Questionnaire Disability Index (7%). The majority of MID estimates were calculated using anchor-based methods (72%). We did not critically appraise the included studies. Conclusions We identified the MID estimates for a substantive number of measurement instruments used in rheumatoid arthritis. There was considerable variability in the findings for the same instrument within and across studies.
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spelling doaj-art-269a6aae173047ce84b51143700bab132025-08-20T03:06:43ZengBMCBMC Rheumatology2520-10262025-07-019111310.1186/s41927-025-00524-9Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping reviewSally Yaacoub0Anas El Zouhbi1Michella Abi Zeid Daou2Vicky Nahra3Abir Mokbel4Layal Hneiny5Liana Fraenkel6Bradley C. Johnston7Elie A. Akl8Clinical Research Institute, American University of Beirut Medical CenterFaculty of Medicine, American University of BeirutDepartment of Internal Medicine, American University of Beirut Medical CenterDivision of Rheumatology, Case Western Reserve University Hospitals, American University of BeirutDepartment of Health Research Methods, Evidence, and Impact, McMaster UniversitySaab Medical Library, University Libraries, American University of BeirutDepartment of Internal Medicine, Yale UniversityDepartment of Nutrition, College of Agriculture and Life Sciences, College StationDepartment of Internal Medicine, American University of BeirutAbstract Background Many outcomes relevant to rheumatoid arthritis are measured as continuous variables. Judging whether the results of those measurements are clinically significant requires determining the minimal important difference (MID) estimate. Therefore, valid MID estimate(s) are essential for the purposes of clinical decision-making and developing clinical recommendations. Our objective is to present the MID estimates for instruments used to measure outcomes in rheumatoid arthritis studies. Methods We conducted a scoping review. We included original research reports on MID of instruments used to measure outcomes in rheumatoid arthritis, using distribution- or anchor-based methods. We excluded conference abstracts. We searched MEDLINE (OVID) and EMBASE (OVID) databases on January 6, 2025 and scanned the reference lists of included studies and of identified relevant systematic reviews. Reviewers screened the titles and abstracts and full-texts, then abstracted data in duplicate and independently. They resolved disagreements by discussion or by consulting a third reviewer. We summarized the data narratively and in tabular formats. Results We identified 35 eligible studies reporting on a total of 144 MID estimates for 72 instruments used in rheumatoid arthritis. The most common constructs measured were physical function (26%), disease activity (18%), health status (17%) and fatigue (14%). The majority of measurement instruments were generic (60%). The most common instrument with MID estimates was the Health Assessment Questionnaire Disability Index (7%). The majority of MID estimates were calculated using anchor-based methods (72%). We did not critically appraise the included studies. Conclusions We identified the MID estimates for a substantive number of measurement instruments used in rheumatoid arthritis. There was considerable variability in the findings for the same instrument within and across studies.https://doi.org/10.1186/s41927-025-00524-9Minimal clinically important differenceClinical significance
spellingShingle Sally Yaacoub
Anas El Zouhbi
Michella Abi Zeid Daou
Vicky Nahra
Abir Mokbel
Layal Hneiny
Liana Fraenkel
Bradley C. Johnston
Elie A. Akl
Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
BMC Rheumatology
Minimal clinically important difference
Clinical significance
title Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
title_full Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
title_fullStr Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
title_full_unstemmed Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
title_short Minimal important differences of measurement instruments used in rheumatoid arthritis: a scoping review
title_sort minimal important differences of measurement instruments used in rheumatoid arthritis a scoping review
topic Minimal clinically important difference
Clinical significance
url https://doi.org/10.1186/s41927-025-00524-9
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