Tashjian, J Bone Joint Surg Am 2010 - Minimal Clinically Important Differences in ASES and Simple Shoulder Test Scores after Nonoperative Treatment of Rotator Cuff Disease - Article Summary

Minimal Clinically Important Differences in ASES and Simple Shoulder Test Scores after Nonoperative Treatment of Rotator Cuff Disease

Tashjian, Powell, et al.·J Bone Joint Surg Am·2010·352 citations·Prospective cohort

Background

The minimal clinically important difference is the smallest difference in an outcome score that a patient perceives as beneficial. The purpose of this study was to determine the minimal clinically important difference in the American Shoulder and Elbow Surgeons (ASES) score and in the Simple Shoulder Test (SST) score for patients treated nonoperatively for rotator cuff disease.

Methods

81 patients with tendinitis or a tear of the rotator cuff were treated with nonoperative modalities.
Evaluation with the ASES score and the SST was performed at baseline and at a minimum of 6 weeks after treatment.
At the follow-up evaluation, the minimal clinically important difference was estimated for the 2 scores with use of an anchor-based approach involving 15-item (pain and function) and 4-item improvement questions.

Results

The 15-item function and 4-item assessments indicated, respectively, that a 2.05-point (p = 0.02) and 2.33-point (p = 0.0009) change in the SST score from baseline represented a minimal clinically important difference.
The 15-item function, 15-item pain, and 4-item assessments indicated that a 12.01-point (p = 0.03), 16.92-point (p = 0.004), and 16.72-point (p < 0.0001) change in the ASES score from baseline represented a minimal clinically important difference.
Age, sex, initial baseline scores, and hand dominance had no effect on the minimal clinically important differences (p > 0.05).
A longer duration of follow-up after treatment was associated with a greater minimal clinically important difference in the ASES score (p < 0.05), although the duration of follow-up had no effect on the minimal clinically important difference in the SST score.

Conclusions

Patients with rotator cuff disease who are treated without surgery and have a 2-point change in the SST score or a 12 to 17-point change in the ASES score experience a clinically important change in self-assessed outcome. These minimal clinically important differences can provide the basis for determining if significant differences in outcomes after treatment are clinically relevant.

Reference

Minimal Clinically Important Differences in ASES and Simple Shoulder Test Scores after Nonoperative Treatment of Rotator Cuff Disease.

Tashjian, Powell, et al.J Bone Joint Surg Am2010352 citationsProspective cohort