Skip to main content
Top
Published in: Journal of Foot and Ankle Research 1/2010

Open Access 01-12-2010 | Research

Minimal Important Difference (MID) of two commonly used outcome measures for foot problems

Authors: Karl B Landorf, Joel A Radford, Susie Hudson

Published in: Journal of Foot and Ankle Research | Issue 1/2010

Login to get access

Abstract

Background

The Visual Analogue Scale (VAS) and the Foot Health Status Questionnaire (FHSQ) are two commonly used outcome measures for evaluating foot health. This study aimed to calculate the Minimal Important Difference (MID) of the VAS and the FHSQ.

Methods

184 participants with plantar heel pain were recruited from the general public to take part in two randomised trials (92 participants in each trial) that studied the effectiveness of two conservative interventions for plantar heel pain. Data from these participants were used to calculate the MIDs of the VAS and the FHSQ. An anchor-based method was used to calculate the MIDs. Two distinct types of pain were investigated for the VAS: average pain and first-step pain. All four domains of the FHSQ were investigated: foot pain, foot function, footwear and general foot health.

Results

The MID for the VAS using the anchor-based approach was -8 mm (95% CI: -12 to -4) for average pain and -19 mm (95% CI: -25 to -13) for first-step pain on the 100 mm VAS. The MID for the FHSQ was 13 points (95% CI: 6 to 19) for pain and 7 points (95% CI: 1 to 13) for function. The MID for the footwear domain of the FHSQ was -2 points (95% CI: -8 to 4) and 0 points (95% CI: -7 to 6) for the general foot health domain of the FHSQ.

Conclusion

The results of this study provide additional evidence for MID values of the VAS and the FHSQ for plantar heel pain. This is important for clinicians and researchers as it provides a greater understanding of how much improvement is required by a patient before a minimal, worthwhile change is experienced. The calculated MIDs will also assist researchers with prospective sample size calculations.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fayers PM, Machin D: Quality of Life: Assessment, Analysis and Interpretation of Patient-reported Outcomes. 2007, Chichester: Wiley, 2CrossRef Fayers PM, Machin D: Quality of Life: Assessment, Analysis and Interpretation of Patient-reported Outcomes. 2007, Chichester: Wiley, 2CrossRef
2.
go back to reference Bowling A: Measuring Health: A review of quality of life measurement scales. 2005, Maidenhead: Open University Press, 3 Bowling A: Measuring Health: A review of quality of life measurement scales. 2005, Maidenhead: Open University Press, 3
3.
go back to reference Carr AJ, Higginson IJ: Measuring Quality of Life: Are quality of life measures patient centred?. Br Med J. 2001, 322: 1357-1360. 10.1136/bmj.322.7298.1357.CrossRef Carr AJ, Higginson IJ: Measuring Quality of Life: Are quality of life measures patient centred?. Br Med J. 2001, 322: 1357-1360. 10.1136/bmj.322.7298.1357.CrossRef
4.
go back to reference Morris LA, Miller DW: The Regulation of Patient-Reported Outcome Claims: Need for a Flexible Standard. Value Health. 2002, 5: 372-381. 10.1046/j.1524-4733.2002.54073.x.CrossRefPubMed Morris LA, Miller DW: The Regulation of Patient-Reported Outcome Claims: Need for a Flexible Standard. Value Health. 2002, 5: 372-381. 10.1046/j.1524-4733.2002.54073.x.CrossRefPubMed
5.
go back to reference Haywood KL: Patient-reported outcome I: Measuring what matters in musculoskeletal care. Musculoskeletal Care. 2006, 4: 187-203. 10.1002/msc.94.CrossRefPubMed Haywood KL: Patient-reported outcome I: Measuring what matters in musculoskeletal care. Musculoskeletal Care. 2006, 4: 187-203. 10.1002/msc.94.CrossRefPubMed
6.
go back to reference Jaeschke R, Singer J, Guyatt GH: Ascertaining the Minimal Clinically Important Difference. Control Clin Trials. 1989, 10: 407-415. 10.1016/0197-2456(89)90005-6.CrossRefPubMed Jaeschke R, Singer J, Guyatt GH: Ascertaining the Minimal Clinically Important Difference. Control Clin Trials. 1989, 10: 407-415. 10.1016/0197-2456(89)90005-6.CrossRefPubMed
7.
go back to reference Schunemann HJ, Guyatt GH: Commentary-Goodbye M(C)ID! Hello MID, Where Do You Come From?. Health Serv Res. 2005, 40: 593-597. 10.1111/j.1475-6773.2005.0k375.x.CrossRefPubMedPubMedCentral Schunemann HJ, Guyatt GH: Commentary-Goodbye M(C)ID! Hello MID, Where Do You Come From?. Health Serv Res. 2005, 40: 593-597. 10.1111/j.1475-6773.2005.0k375.x.CrossRefPubMedPubMedCentral
8.
go back to reference Revicki D, Hays RD, Cella D, Sloan J: Recommended methods for determining responsiveness and minimally important difference for patient reported outcomes. J Clin Epidemiol. 2008, 61: 102-109. 10.1016/j.jclinepi.2007.03.012.CrossRefPubMed Revicki D, Hays RD, Cella D, Sloan J: Recommended methods for determining responsiveness and minimally important difference for patient reported outcomes. J Clin Epidemiol. 2008, 61: 102-109. 10.1016/j.jclinepi.2007.03.012.CrossRefPubMed
9.
go back to reference Martin RL, Irrgang JJ: A survey of Self-reported Outcome Instruments for the Foot and Ankle. J Orthop Sports Phys Ther. 2007, 37: 72-84. 10.2519/jospt.2007.2403.CrossRefPubMed Martin RL, Irrgang JJ: A survey of Self-reported Outcome Instruments for the Foot and Ankle. J Orthop Sports Phys Ther. 2007, 37: 72-84. 10.2519/jospt.2007.2403.CrossRefPubMed
10.
go back to reference Landorf KB, Burns J: Health Outcome Assessment. Merriman's Assessment of the Lower Limb. Edited by: Yates B. 2009, Edinburgh: Elsevier, 33-51. 3 Landorf KB, Burns J: Health Outcome Assessment. Merriman's Assessment of the Lower Limb. Edited by: Yates B. 2009, Edinburgh: Elsevier, 33-51. 3
11.
go back to reference Bennett PJ, Patterson C: The Foot Health Status Questionnaire (FSHQ): a new instrument for measuring outcomes of footcare. Australas J Podiatr Med. 1998, 32: 87-92. Bennett PJ, Patterson C: The Foot Health Status Questionnaire (FSHQ): a new instrument for measuring outcomes of footcare. Australas J Podiatr Med. 1998, 32: 87-92.
12.
go back to reference Landorf KB, Radford JA: Minimal important difference: Values for the Foot Health Status Questionnaire, Foot Function Index and Visual Analogue Scale. Foot. 2008, 18: 15-19. 10.1016/j.foot.2007.06.006.CrossRef Landorf KB, Radford JA: Minimal important difference: Values for the Foot Health Status Questionnaire, Foot Function Index and Visual Analogue Scale. Foot. 2008, 18: 15-19. 10.1016/j.foot.2007.06.006.CrossRef
13.
go back to reference Radford JA, Landorf KB, Buchbinder R, Cook C: Effectiveness of low-Dye taping for the short-term treatment of plantar heel pain: a randomised trial. BMC Musculoskelet Disord. 2006, 7: 64-10.1186/1471-2474-7-64.CrossRefPubMedPubMedCentral Radford JA, Landorf KB, Buchbinder R, Cook C: Effectiveness of low-Dye taping for the short-term treatment of plantar heel pain: a randomised trial. BMC Musculoskelet Disord. 2006, 7: 64-10.1186/1471-2474-7-64.CrossRefPubMedPubMedCentral
14.
go back to reference Radford JA, Landorf KB, Buchbinder R, Cook C: Effectiveness of calf muscle stretching for the short-term treatment of plantar heel pain: a randomised trial. BMC Musculoskelet Disord. 2007, 8: 36-10.1186/1471-2474-8-36.CrossRefPubMedPubMedCentral Radford JA, Landorf KB, Buchbinder R, Cook C: Effectiveness of calf muscle stretching for the short-term treatment of plantar heel pain: a randomised trial. BMC Musculoskelet Disord. 2007, 8: 36-10.1186/1471-2474-8-36.CrossRefPubMedPubMedCentral
15.
go back to reference Revill SI, Robinson JO, Rosen M, Hogg MIJ: The reliability of a linear analogue for evaluating pain. Anaesthesia. 1976, 31: 1191-1198. 10.1111/j.1365-2044.1976.tb11971.x.CrossRefPubMed Revill SI, Robinson JO, Rosen M, Hogg MIJ: The reliability of a linear analogue for evaluating pain. Anaesthesia. 1976, 31: 1191-1198. 10.1111/j.1365-2044.1976.tb11971.x.CrossRefPubMed
16.
go back to reference Scott J, Huskisson EC: Graphic representation of pain. Pain. 1976, 2: 175-184. 10.1016/0304-3959(76)90113-5.CrossRefPubMed Scott J, Huskisson EC: Graphic representation of pain. Pain. 1976, 2: 175-184. 10.1016/0304-3959(76)90113-5.CrossRefPubMed
17.
go back to reference Bennett PJ, Patterson C, Wearing S, Baglioni T: Development and Validation of a Questionnaire Designed to Measure Foot-Health Status. J Am Podiatr Med Assoc. 1998, 83: 419-428.CrossRef Bennett PJ, Patterson C, Wearing S, Baglioni T: Development and Validation of a Questionnaire Designed to Measure Foot-Health Status. J Am Podiatr Med Assoc. 1998, 83: 419-428.CrossRef
18.
go back to reference McDowell I: Measuring Health: A Guide to Rating Scales and Questionnaires. 2006, New York: Oxford University PressCrossRef McDowell I: Measuring Health: A Guide to Rating Scales and Questionnaires. 2006, New York: Oxford University PressCrossRef
19.
go back to reference Todd KH, Funk KG, Funk JP, R B: Clinical Significance of Reported Changes in Pain Severity. Ann Emerg Med. 1996, 27: 485-489. 10.1016/S0196-0644(96)70238-X.CrossRefPubMed Todd KH, Funk KG, Funk JP, R B: Clinical Significance of Reported Changes in Pain Severity. Ann Emerg Med. 1996, 27: 485-489. 10.1016/S0196-0644(96)70238-X.CrossRefPubMed
20.
go back to reference Kelly AM: Does the Clinically Significant Difference in Visual Analogue Scale Pain Scores Vary with Gender, Age, or Cause of Pain. Emerg Med. 1998, 5: 1086-1090. Kelly AM: Does the Clinically Significant Difference in Visual Analogue Scale Pain Scores Vary with Gender, Age, or Cause of Pain. Emerg Med. 1998, 5: 1086-1090.
21.
go back to reference Kelly AM: The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001, 18: 205-207. 10.1136/emj.18.3.205.CrossRefPubMedPubMedCentral Kelly AM: The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain. Emerg Med J. 2001, 18: 205-207. 10.1136/emj.18.3.205.CrossRefPubMedPubMedCentral
22.
go back to reference Landorf KB, Keenan A-M: An evaluation of two foot-specific, health-related quality-of-life measuring instruments. Foot Ankle Int. 2002, 23: 538-546.PubMed Landorf KB, Keenan A-M: An evaluation of two foot-specific, health-related quality-of-life measuring instruments. Foot Ankle Int. 2002, 23: 538-546.PubMed
23.
go back to reference Friedman LM, Furberg CD, DeMets DL: Fundamentals of clinical trials. 1998, New York: SpringerCrossRef Friedman LM, Furberg CD, DeMets DL: Fundamentals of clinical trials. 1998, New York: SpringerCrossRef
Metadata
Title
Minimal Important Difference (MID) of two commonly used outcome measures for foot problems
Authors
Karl B Landorf
Joel A Radford
Susie Hudson
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2010
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/1757-1146-3-7

Other articles of this Issue 1/2010

Journal of Foot and Ankle Research 1/2010 Go to the issue