Evidence map›Paper›PMID 38954643›Full record

SynthesisThe Journal of bone and joint surgery. American volume2024

Minimal Clinically Important Difference (MCID) for the Short Musculoskeletal Function Assessment (SMFA) in Severe Lower Extremity Trauma: Pooled Data from 7 Multicenter, Prospective Clinical Trials.

Anthony R Carlini, Julie Agel, Michael J Bosse, Katherine P Frey, Elena D Staguhn, Heather A Vallier, William Obremskey, Marc F Swiontkowski, Lisa K Cannada, Paul Tornetta and 7 more

Abstract readMeta-Analysis
In one paragraph

Synthesis in The Journal of bone and joint surgery. American volume, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Anthony R CarliniDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0003-1419-4515
Julie AgelDepartment of Orthopaedics and Sports Medicine, University of Washington Harborview Medical Center, Seattle, Washington.ORCID 0000-0002-4296-7389
Michael J BosseDepartment of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Carolinas Medical Center, Charlotte, North Carolina.ORCID 0000-0001-7484-5282
Katherine P FreyDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0001-5305-1774
Elena D StaguhnDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0003-0620-0276
Heather A VallierDepartment of Orthopaedics, Case Western Reserve University, Cleveland, Ohio.ORCID 0000-0003-3881-6518
William ObremskeyDepartment of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.ORCID 0000-0002-8942-1842
Marc F SwiontkowskiDepartment of Orthopedic Surgery, University of Minnesota Medical School, Minneapolis, Minnesota.ORCID 0000-0001-7036-1782
Lisa K CannadaDepartment of Orthopaedics, Novant Health, University of North Carolina at Charlotte School of Medicine, Charlotte, North Carolina.ORCID 0000-0001-5969-8018
Paul TornettaDepartment of Orthopaedic Surgery, Boston Medical Center, Boston, Massachusetts.ORCID 0000-0002-6448-8864
Ellen J MacKenzieDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Robert V O'TooleDepartment of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.ORCID 0000-0002-5628-6584
Lisa ReiderDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0002-5373-9197
Lauren E AllenDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0002-8097-4555
Susan C CollinsDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0003-4970-2428
Renan C CastilloDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.ORCID 0000-0003-0473-5891
METRC (Major Extremity Trauma Research Consortium)

Funding

Reliability and Responsiveness of PROMIS tools in Orthopaedic Trauma PatientsR01AR064066 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI CASTILLO, RENAN C · 2012 to 2015
$1.4M
NIAMS NIH HHS R01 AR064066
6 · The paper itself

Abstract

backgroundThe Short Musculoskeletal Function Assessment (SMFA) is a well validated, widely used patient-reported outcome (PRO) measure for orthopaedic patients. Despite its widespread use and acceptance, this measure does not have an agreed upon minimal clinically important difference (MCID). The purpose of the present study was to create distributional MCIDs with use of a large cohort of research participants with severe lower extremity fractures.

methodsThree distributional approaches were used to calculate MCIDs for the Dysfunction and Bother Indices of the SMFA as well as all its domains: (1) half of the standard deviation (one-half SD), (2) twice the standard error of measurement (2SEM), and (3) minimal detectable change (MDC). In addition to evaluating by patient characteristics and the timing of assessment, we reviewed these calculations across several injury groups likely to affect functional outcomes.

resultsA total of 4,298 SMFA assessments were collected from 3,185 patients who had undergone surgical treatment of traumatic injuries of the lower extremity at 60 Level-I trauma centers across 7 multicenter, prospective clinical studies. Depending on the statistical approach used, the MCID associated with the overall sample ranged from 7.7 to 10.7 for the SMFA Dysfunction Index and from 11.0 to 16.8 for the SMFA Bother Index. For the Dysfunction Index, the variability across the scores was small (<5%) within the sex and age subgroups but was modest (12% to 18%) across subgroups related to assessment timing.

conclusionsA defensible MCID can be found between 7 and 11 points for the Dysfunction Index and between 11 and 17 points for the Bother Index. The precise choice of MCID may depend on the preferred statistical approach and the population under study. While differences exist between MCID values based on the calculation method, values were consistent across the categories of the various subgroups presented. LEVEL OF EVIDENCE: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Indexed as

Fractures, BoneLeg InjuriesLower ExtremityMinimal Clinically Important DifferencePatient Reported Outcome MeasuresAdolescentAdultAgedFemaleHumansMaleMiddle AgedMulticenter Studies as TopicObservational Studies as TopicProspective StudiesRandomized Controlled Trials as Topic

Identifiers

PMID38954643
PMCPMC11693777

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.