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Minimal important change and difference in health outcome: An overview of approaches, concepts, and methods.

Authors
  • Dekker, Joost1
  • de Boer, Michiel2
  • Ostelo, Raymond3
  • 1 Department of Rehabilitation Medicine, Amsterdam UMC, Location Vrij Universiteit, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC Location Vrije Universiteit, Amsterdam, the Netherlands. Electronic address: [email protected]. , (Netherlands)
  • 2 Department of Primary and Long-Term Care, UMCG, Groningen, the Netherlands. Electronic address: [email protected]. , (Netherlands)
  • 3 Department of Health Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology and Data Science, Amsterdam Movement Sciences, Amsterdam UMC, Location Vrije Universiteit, Amsterdam, the Netherlands. Electronic address: [email protected]. , (Netherlands)
Type
Published Article
Journal
Osteoarthritis and Cartilage
Publisher
Elsevier
Publication Date
Jan 01, 2024
Volume
32
Issue
1
Pages
8–17
Identifiers
DOI: 10.1016/j.joca.2023.09.002
PMID: 37714259
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To provide an overview of approaches, concepts, and methods used to define and assess minimal important change and difference in health outcome. A narrative review of the literature, guided by a conceptual framework. We distinguish between (i) interpretation of health outcome in individuals versus groups, (ii) change within individuals or groups versus difference between change within individuals or groups; and (iii) the responder approach (based on the proportion of patients that obtain a defined response) versus the group average approach (based on the average amount of change in a group). We review approaches, concepts, and methods. By bringing together and juxtaposing various approaches, concepts, and methods, we set a precursory step in the direction of consensus building in the field concerned with defining and assessing minimal important change and difference in health outcome. We emphasize the need for conceptual clarification and terminological standardization. We argue that assessing minimal importance of change and difference in health outcome is essentially a value judgment involving a range of considerations and perspectives. Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

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