Determining the clinical importance of treatment benefits for interventions for XXXX .

@entity1 @entity922 @entity158
UNASSIGNED: The overarching goals of treatments for orthopedic conditions are generally to improve or restore function and alleviate @entity158 . Results of clinical trials are generally used to determine whether a treatment is efficacious; however, a statistically significant improvement may not actually be @entity922 , i.e., meaningful to the @entity1 . To determine whether an intervention has produced @entity922 benefits requires a two-step process: first, determining the magnitude of change considered @entity922 for a particular measure in the relevant population and, second, applying this yardstick to a @entity1 's data to determine whether s/he has benefited from treatment. Several metrics have been devised to quantify @entity922 differences, including the @entity922 ( @entity922 ) and @entity922 ( @entity922 ). Herein, we review the methods to generate the @entity922 and other metrics and their use and interpretation in clinical trials and practice. We particularly highlight the many pitfalls associated with the generation and utilization of these metrics that can impair their correct use. These pitfalls include the fact that different @entity158 measures yield different MCIDs, that efficacy in clinical trials is impacted by various factors (population characteristics, trial design), that the @entity922 value is impacted by the method used to calculate it (anchor, distribution), by the type of anchor chosen and by the definition (threshold) of improvement. The @entity922 is also dependent on the population characteristics such as disease type and severity, sex, age, etc. For appropriate use, the @entity922 should be applied to changes in individual subjects, not to group changes. The @entity922 and @entity922 are useful tools to define general guidelines to determine whether a treatment produces clinically meaningful effects. However, the many pitfalls associated with these metrics require a detailed understanding of the methods to calculate them and their context of use. Orthopedic surgeons that will use these metrics need to carefully understand them and be aware of their pitfalls.
