• Anesthesiology · Jul 2016

    Observational Study

    Minimal Clinically Important Difference for Three Quality of Recovery Scales.

    • Paul S Myles, Daniel B Myles, Wendy Galagher, Colleen Chew, Neil MacDonald, and Alicia Dennis.
    • From the Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Monash University, Melbourne, Victoria, Australia (P.S.M.); Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (D.B.M.); Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Melbourne, Victoria, Australia (W.G., C.C.); Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, and Royal Women's Hospital, Carlton, Melbourne, Victoria, Australia (N.M.); and Department of Anaesthesia, Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia (A.D.).
    • Anesthesiology. 2016 Jul 1; 125 (1): 39-45.

    BackgroundSeveral quality of recovery (QoR) health status scales have been developed to quantify the patient's experience after anesthesia and surgery, but to date, it is unclear what constitutes the minimal clinically important difference (MCID). That is, what minimal change in score would indicate a meaningful change in a patient's health status?MethodsThe authors enrolled a sequential, unselected cohort of patients recovering from surgery and used three QoR scales (the 9-item QoR score, the 15-item QoR-15, and the 40-item QoR-40) to quantify a patient's recovery after surgery and anesthesia. The authors compared changes in patient QoR scores with a global rating of change questionnaire using an anchor-based method and three distribution-based methods (0.3 SD, standard error of the measurement, and 5% range). The authors then averaged the change estimates to determine the MCID for each QoR scale.ResultsThe authors enrolled 204 patients at the first postoperative visit, and 199 were available for a second interview; a further 24 patients were available at the third interview. The QoR scores improved significantly between the first two interviews. Triangulation of distribution- and anchor-based methods results in an MCID of 0.92, 8.0, and 6.3 for the QoR score, QoR-15, and QoR-40, respectively.ConclusionPerioperative interventions that result in a change of 0.9 for the QoR score, 8.0 for the QoR-15, or 6.3 for the QoR-40 signify a clinically important improvement or deterioration.

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