Establishing the Minimum Clinically Significant Difference in Patients with Rotator Cuff Disease and Shoulder Prosthesis

• Published in: Journal of clinical medicine Vol. 12; no. 4
• Main Authors: Longo, Umile Giuseppe, Papalia, Rocco, De Salvatore, Sergio, Marinozzi, Andrea, Piergentili, Ilaria, Lalli, Alberto, Bandini, Benedetta, Franceschetti, Edoardo, Denaro, Vincenzo
• Format: Journal Article
• Language: English
• Published: MDPI AG 01-02-2023
• Subjects: Anxiety; Care and treatment; Complications and side effects; Depression, Mental; Diagnosis; Health aspects; Mental health surveys; Orthopedic implants; Risk factors; Rotator cuff (Anatomy); Shoulder pain; Italy
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12041540

Insufficiently treated shoulder pain may cause mental disturbances, including depression and anxiety. The Hospital Anxiety and Depression Scale (HADS) is a patient-reported outcome measure (PROM) that aims to identify depression and anxiety in patients in nonpsychiatric wards. The aim of this study was to identify the minimum clinically important difference (MCID) and patient acceptable symptom state (PASS) scores for the HADS in a cohort of individuals with rotator cuff disease. Using the HADS, participants’ degrees of anxiety and depression were assessed at inception and at their final assessment 6 months after surgery. To calculate the MCID and the PASS, distribution and anchor approaches were employed. The MCID from inception to final assessment was 5.7 on the HADS, 3.8 on the HADS-A, and 3.3 on the HADS-D. A 5.7 amelioration on the HADS score, 3.8 on the HADS-A, and 3.3 on the HADS-D, from inception to final assessment, meant that patients had reached a clinically meaningful improvement in their symptom state. The PASS was 7 on the HADS, 3.5 on the HADS-A, and 3.5 on the HADS-D; therefore, for the majority of patients, a score of at least 7 on the HADS, 3.5 on the HADS-A, and 3.5 on the HADS-D at final evaluation was considered a satisfactory symptom state.