title: Use of the patient acceptable symptom state and the minimal clinically important difference to evaluate the outcomes of cataract extraction.
abstract: OBJECTIVE
  To determine the minimal clinically important difference and the patient acceptable symptom state for visual acuity and visual function, 2 key visual outcomes for patients undergoing cataract extraction, as an aid for evaluating the outcome of cataract extraction.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  
  
  
  METHODS
  Multicenter study of 17 hospitals.
  
  
  METHODS
  A total of 4335 consecutive patients advised to undergo cataract extraction.
  
  
  METHODS
  Sociodemographic and clinical data, including visual acuity (VA), patient satisfaction, and responses to the Visual Function Index 14 (VF-14) and transitional questions were collected before and after cataract extraction. The patient acceptable symptom state and minimal clinically important difference were estimated for the entire sample and for subgroups by preintervention status and presence of ocular comorbidities.
  
  
  RESULTS
  Among patients with simple cataract, postintervention patient acceptable symptom state values for VA ranged from 0.67 to 0.80, depending on preintervention VA, while VF-14 scores ranged from 88 to 90. For patients with any additional ocular comorbidity, VA ranged from 0.63 to 0.75, depending on preintervention VA, while VF-14 scores ranged from 86 to 92. For the entire sample, postintervention patient acceptable symptom state values were 0.75 for VA and 86.1 for VF-14 scores. Minimal clinically important difference for patients who reported being a little better ranged from 0.17 to 0.5 in VA and 0.41 to 37.46 in VF-14 scores, depending on preintervention status and presence of ocular comorbidities.
  
  
  CONCLUSIONS
  The minimal clinically important difference and patient acceptable symptom state values are complementary parameters that may help in the clinical decision-making process by providing more meaningful estimates of the impact of cataract extraction on 2 important outcomes, visual acuity and visual function.
authors.affiliation: Research Unit, Hospital Galdakao-Usansolo - CIBER Epidemiología y Salud Pública, Galdakao, Vizcaya, Spain. josemaria.quintanalopez@osakidetza.net
authors.forename: Jose M
authors.initials: JM
authors.lastname: Quintana
authors.forename: Urko
authors.initials: U
authors.lastname: Aguirre
authors.forename: Carlota
authors.initials: C
authors.lastname: Las-Hayas
authors.forename: Nerea
authors.initials: N
authors.lastname: Gonzalez
authors.forename: Susana
authors.initials: S
authors.lastname: Garcia
authors.forename: Antonio
authors.initials: A
authors.lastname: Escobar
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011446:Prospective Studies; D011788:Quality of Life; D012372:ROC Curve; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014786:Vision Disorders / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*