Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders

Jaemin Son; Eun-San Kim; Yoon Jae Lee; Nam-Woo Lee; In-Hyuk Ha

doi:10.1111/joor.13717

Minimum clinically important difference and substantial clinical benefit in patients with chronic temporomandibular disorders

J Oral Rehabil. 2024 May 5. doi: 10.1111/joor.13717. Online ahead of print.

Authors

Jaemin Son¹, Eun-San Kim², Yoon Jae Lee², Nam-Woo Lee³, In-Hyuk Ha²

Affiliations

¹ Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea.
² Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
³ Department of Korean Rehabilitation Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.

PMID: 38706163
DOI: 10.1111/joor.13717

Abstract

Background: Research on temporomandibular disorder (TMD) responsiveness is scarce and limited regarding patients' representativeness.

Objective(s): This study aimed to estimate minimum clinically important difference (MCID) and substantial clinical benefit (SCB) among a large and diverse patient population regarding sex and age.

Methods: In this study, 162 patients participated from five hospitals. MCID and SCB in pain, functional disability and quality of life were examined with anchor-based methods. Patients' global impression of change was used as the anchor. Area under the curve (AUC) values were determined for testing accuracy. Changes from baseline and coefficient of variation by responsiveness status were calculated to explain the results of accuracy.

Results: SCB was estimated to be 2.18 for the numeric rating scale (NRS) for pain (AUC: 0.80 [95% CI: 0.72-0.88]) in all patients and 2.50 in women (AUC: 0.81 [95% CI: 0.71-0.89]). The estimated SCB of NRS for discomfort (1.50) and Jaw Functional Limitation Scale for mastication (1.35) had wide CIs for AUCs. Likewise, the estimated MCIDs of NRS for pain (0.80) and NRS for discomfort (1.50) had wide CIs for AUCs. Among non-responders who did not achieve the MCID of NRS for pain, the coefficient of variation was very high for all outcomes other than the NRS for pain.

Conclusion: This study investigated the responsiveness of patients with TMD using a large and diverse patient sample. SCB in pain decrease can be used to assess the responsiveness of patients with TMD. Composite outcomes should be developed to estimate MCID.

Keywords: chronic pain; clinical relevance; minimal clinically important difference; patient reported outcome measures; secondary data analysis; temporomandibular disorder.