caa a22 4500 606179089 CHVBK 20210128100759.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s11136-014-0809-2 doi (NATIONALLICENCE)springer-10.1007/s11136-014-0809-2 Individual patient monitoring in daily clinical practice: a critical evaluation of minimal important change [Elektronische Daten] [Jos Hendrikx, Jaap Fransen, Wietske Kievit, Piet van Riel] Purpose: In daily practice, physicians translate knowledge from clinical trials to practice, to improve health in individual patients. To help interpret meaningful change on disease outcome measures, the concept of minimal important change (MIC) was conceived. The objective of this study was to investigate whether MIC values are suited for individual patient monitoring. Methods: Three main elements of the MIC concept were evaluated: (1) MIC values for improvement and deterioration were determined, and the amount of misclassification present in quantifying minimal change was analyzed. (2) Discordance between change categories(improved, unchanged, deteriorated), defined by the MIC values, and patients' satisfaction with their health was inspected. (3) Discordance between change categories, defined by MIC values, and patients' willingness to alter therapy was inspected. Results: MIC value analysis was based on 469 patients with RA seen in daily practice. The chance of falsely classifying health change of an individual patient was high (false-positive range 19-30% and false-negative range 43-72%). Of patients classified as improved, 24% were not satisfied with their health and 69% were not willing to change therapy. Of patients classified as deteriorated, 54% were satisfied with their health and 57% were not willing to change therapy. Conclusions: The misclassification in the quantification of change and high proportions of discordance between change categories defined by MIC cutoff values and patients' satisfaction and willingness to alter therapy indicate that MIC values as such are not suited for individual patient monitoring. Springer International Publishing Switzerland, 2014 Personalized care nationallicence Outcome assessment nationallicence Psychometrics nationallicence Clinimetrics nationallicence Satisfaction nationallicence Rheumatoid arthritis nationallicence Hendrikx Jos Department of Rheumatology (470), Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands aut Fransen Jaap Department of Rheumatology (470), Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands aut Kievit Wietske Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands aut van Riel Piet Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands aut Quality of Life Research Springer International Publishing 24/3(2015-03-01), 607-616 0962-9343 24:3<607 2015 24 11136 https://doi.org/10.1007/s11136-014-0809-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-014-0809-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hendrikx Jos Department of Rheumatology (470), Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Fransen Jaap Department of Rheumatology (470), Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- Kievit Wietske Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands aut NATIONALLICENCE 700 1- van Riel Piet Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/3(2015-03-01), 607-616 0962-9343 24:3<607 2015 24 11136