Trial reportNeurocritical care2026
Minimal Clinically Important Difference of the Functional Status Scale in Pediatric Neurocritical Care Patients: Post Hoc Analysis of a Randomized Controlled Trial.
Trial report in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundThe Functional Status Scale (FSS) is a validated tool that provides a more comprehensive and multidimensional assessment of functional impairment in neurocritical children compared with the Pediatric Cerebral Performance Category (PCPC) score.
methodsThis study is a secondary post hoc analysis of a randomized controlled trial, which evaluated the efficacy and safety of early protocolized rehabilitation in neurocritical children. An anchor-based approach was used to calculate the minimal clinically important difference (MCID) for FSS, with PCPC serving as the anchor variable. Participants were dichotomized on the basis of PCPC scores into two groups: those who demonstrated improvement between 12 and 24 weeks (defined as a reduction of ≥ 1 point in PCPC score) and those who did not (no change or worsening). Receiver operating characteristic (ROC) curve analysis was performed to identify the optimal FSS change score corresponding to the MCID. Sensitivity, specificity, and Youden's index were calculated.
resultsData from 188 participants were analyzed. On the basis of PCPC, 125 participants improved significantly between 12 and 24 weeks. At 24 weeks, the reduction in FSS scores was significantly greater in the improved group compared with the stable/not improved group (2.9 ± 0.7 vs. 1.9 ± 0.5, p < 0.001). The optimal MCID cutoff for FSS was 3 points, with an AUC of 0.86 (95% CI: 0.81-0.91), and sensitivity, specificity, accuracy, and a Youden index of 79.2%, 87.3%, 81.9%, and 0.66, respectively. A total of 26 participants (20%) in the "improved" group were misclassified as "stable/not improved", and 8 participants (12%) in the "stable/not improved" group were misclassified as "improved."
conclusionsThe minimal clinically important difference (MCID) for the Functional Status Scale (FSS) in our study was determined to be 3 points. This, however, needs to be externally validated in future studies.
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