Statistics In Brief: Minimum Clinically Important Difference—Availability of Reliable Estimates

Excerpt

To enter the era of value-based orthopaedics (“health outcomes per dollar spent”) [2, 19], clinical researchers will have to prove that each treatment produces a meaningful clinical improvement using outcomes that are relevant for patients. The American Association of Hip and Knee Surgeons has recommended the use of patient-reported outcome measures to evaluate the results of knee and hip arthroplasties [16]. Studies have focused on statistically detectable (sometimes called statistically significant) differences [35]; however, it can be possible to detect statistical differences between interventions that are so small as not to be discernible to patients. Such small differences may not justify the cost or risk of the intervention. It seems much more important that treatments should result in clinical improvements big enough for patients to consider clinically important. …