Responsiveness and Minimal Important Change of the IKDC of Middle-Aged and Older Patients With a Meniscal Tear

Julia C.A. Noorduyn* (Corresponding Author), Victor A. van de Graaf, Lidwine B. Mokkink, Nienke W. Willigenburg, Rudolf W. Poolman, Vanessa A.B. Scholtes, Ise Butter, Eduard L.A.R. Mutsaerts, Julius Wolkenfelt, Matthijs R. Krijnen, Derek F.P. van Deurzen, Dirk Jan F. Moojen, Coen H. Bloembergen, Olivier J.F. Nijland, Arthur de Gast, Thom Snijders, Jelle J. Halma, Daniel B.F. Saris, Nienke Wolterbeek, Camille NeeterGino M.M.J. Kerkhoffs, Rolf W. Peters, Igor C.J.B. van den Brand, Suzanne de Vos-Jakobs, Andy B. Spoor, Taco Gosens, Wahid Rezaie, Dirk Jan Hofstee, Bart J. Burger, Daniel Haverkamp, Anton M.J.S. Vervest, Thijs A. van Rheenen, Anne E. Wijsbek, Ewoud R.A. van Arkel, Bregje J.W. Thomassen, Sheila Sprague, Ben Willem J. Mol, Maurits W. van Tulder,

*Corresponding author for this work

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Abstract

Background: Responsiveness and the minimal important change (MIC) are important measurement properties to evaluate treatment effects and to interpret clinical trial results. The International Knee Documentation Committee (IKDC) Subjective Knee Form is a reliable and valid instrument for measuring patient-reported knee-specific symptoms, functioning, and sports activities in a population with meniscal tears. However, evidence on responsiveness is of limited methodological quality, and the MIC has not yet been established for patients with symptomatic meniscal tears. Purpose: To evaluate the responsiveness and determine the MIC of the IKDC for patients with meniscal tears. Study Design: Cohort study (design); Level of evidence 2. Methods: This study was part of the ESCAPE trial: a noninferiority multicenter randomized controlled trial comparing arthroscopic partial meniscectomy with physical therapy. Patients aged 45 to 70 years who were treated for a meniscal tear by arthroscopic partial meniscectomy or physical therapy completed the IKDC and 3 other questionnaires (RAND 36-Item Health Survey, EuroQol-5D-5L, and visual analog scales for pain) at baseline and 6-month follow-up. Responsiveness was evaluated by testing predefined hypotheses about the relation of the change in IKDC with regard to the change in the other self-reported outcomes. An external anchor question was used to distinguish patients reporting improvement versus no change in daily functioning. The MIC was determined by the optimal cutoff point in the receiver operating characteristic curve, which quantifies the IKDC score that best discriminated between patients with and without improvement in daily function. Results: Data from all 298 patients who completed baseline and 6-month follow-up questionnaires were analyzed. Responsiveness of the IKDC was confirmed in 7 of 10 predefined hypotheses about the change in IKDC score with regard to other patient-reported outcome measures. One hypothesis differed in the expected direction, while 2 hypotheses failed to meet the expected magnitude by 0.02 and 0.01 points. An MIC of 10.9 points was calculated for the IKDC of middle-aged and older patients with meniscal tears. Conclusion: This study showed that the IKDC is responsive to change among patients aged 45 to 70 years with meniscal tears, with an MIC of 10.9 points. This strengthens the value of the IKDC in quantifying treatment effects in this population.

Original languageEnglish
Pages (from-to)364-371
Number of pages8
JournalAmerican journal of sports medicine
Volume47
Issue number2
DOIs
Publication statusPublished - 1 Feb 2019
Externally publishedYes

Keywords

  • clinimetrics
  • IKDC
  • knee
  • measurement properties
  • meniscus

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    Noorduyn, J. C. A., van de Graaf, V. A., Mokkink, L. B., Willigenburg, N. W., Poolman, R. W., Scholtes, V. A. B., ... OLVG (2019). Responsiveness and Minimal Important Change of the IKDC of Middle-Aged and Older Patients With a Meniscal Tear. American journal of sports medicine, 47(2), 364-371. https://doi.org/10.1177/0363546518812880