title: Minimum important difference between patients with rheumatoid arthritis: the patient's perspective.
abstract: OBJECTIVE
  To determine the point at which differences in clinical assessment scores on physical ability, pain and overall condition are sufficiently large to correspond to a subjective perception of a meaningful difference from the perspective of the patient.
  
  
  METHODS
  Forty patients with a diagnosis of rheumatoid arthritis participated in an evening of clinical assessment and one-on-one conversations with each other regarding their arthritic condition. The assessments included tender and swollen joint counts, clinician and patient global assessments, participant assessment of pain and the Health Assessment Questionnaire (HAQ) on physical ability. After each conversation, participants rated themselves relative to their conversational partner on physical ability, pain and overall condition. These subjective comparative ratings were compared to the differences of the individual clinical assessments.
  
  
  RESULTS
  In total there were 120 conversations. Generally participants judged themselves as less disabled than others. They rated themselves as "somewhat better" than their conversation partner when they had a (mean) 7% better score on the HAQ, 6% less pain, and 9% better global assessment. In contrast, they rated themselves as "somewhat worse" when they had a (mean) 16% worse score on the HAQ, 16% more pain, and 29% worse global assessment.
  
  
  CONCLUSIONS
  Patients view clinically important differences in an asymmetric manner. These results can provide guidance in interpreting results and planning clinical trials.
authors: Department of Medicine, Ottawa General Hospital, ON, Canada.
authors: G A
authors: GA
authors: Wells
authors: P
authors: P
authors: Tugwell
authors: G R
authors: GR
authors: Kraag
authors: P R
authors: PR
authors: Baker
authors: J
authors: J
authors: Groh
authors: D A
authors: DA
authors: Redelmeier
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D002986:Clinical Trials as Topic; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain; D010361:Patients / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome