ArticleJournal of athletic training2021
Anchored Minimal Clinically Important Difference Metrics: Considerations for Bias and Regression to the Mean.
Article in Journal of athletic training, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- Investigation of Minimal Clinically Important Difference of the Extended Barthel Index in Inpatients With Acute to Subacute Stroke in China.Hong Kong journal of occupational therapy : HKJOT · 2026Article
- Lower limb joint kinetics during level walking in patients two years after anterior cruciate ligament reconstruction.Sports medicine and health science · 2026Article
- Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Minimal Clinically Important Difference Estimates Are Biased by Adjusting for Baseline Severity, Not by Regression to the Mean.Journal of athletic training · 2022Article
- Patient-reported outcome measures as an outcome variable in sports medicine research.Frontiers in sports and active living · 2022Review
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Minimal clinically important differences (MCIDs) are used to understand clinical relevance. However, repeated observations produce biased analyses unless one accounts for baseline observation, known as regression to the mean (RTM). Using an International Knee Documentation Committee (IKDC) survey dataset, we can demonstrate the effect of RTM on MCID values by (1) MCID-estimate dependence on baseline observation and (2) MCID-estimate bias being higher when the posttest-pretest data correlation is lower. We created 10 IKDC datasets with 5000 patients and a specific correlation under both equal and unequal variances. For each 10-point increase in baseline IKDC, MCID decreased by 3.5, 2.7, 1.9, 1.2, and 0.7 points when posttest-pretest correlations were 0.10, 0.25, 0.50, 0.75, and 0.90, respectively, under equal variances. Not accounting for RTM resulted in a static 20-point MCID. Minimal clinically important difference estimates may be unreliable. Minimal clinically important difference calculations should include the correlation and variances between posttest and pretest data, and researchers should consider using a baseline covariate-adjusted receiver operating characteristic curve analysis to calculate MCID.
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