How should minimally important change (MIC) scores for the Patient Oriented Eczema Measure (POEM) be interpreted?: a validation using varied methods

Howells, Laura; Ratib, Sonia; Chalmers, J.R.; Bradshaw, Lucy; Thomas, K.S.

Abstract

Background

The Patient Oriented Eczema Measure (POEM), scored 0-28, is the core outcome instrument recommended for measuring patient-reported atopic eczema symptoms in clinical trials. To date, two published studies have broadly concurred that the MIC of the POEM is 3 points. Further assessment of the minimally important change (MIC) of POEM in different populations, and using a variety of methods, will improve interpretability of the POEM in research and clinical practice.

Objectives

To calculate the smallest detectable change in the POEM and estimate the MIC of the POEM using a variety of methods in a trial dataset of children with moderate to severe atopic eczema.

Methods

This study used distribution-based and anchor-based methods to calculate the MIC of the POEM in children with moderate to severe eczema.

Results

Data was collected from 300 children. The smallest detectable change was 2.12. The MIC estimates were 1.07 (0.2 SD) and 2.68 (0.5 SD) based on distribution-based methods, were 3.09 to 6.13 based on patient-reported anchor-based methods, and were 3.23 to 5.38 based on investigator-reported anchor-based methods.

Conclusions

We recommend the following thresholds are used to interpret changes in POEM scores: ≤ 2, unlikely to be a change beyond measurement error; 2.1 to 2.9, a small change detected that is likely to be beyond measurement error but may not be clinically important; 3 to 3.9, probably a clinically important change; 4+, very likely to be a clinically important change.

Citation

Howells, L., Ratib, S., Chalmers, J., Bradshaw, L., & Thomas, K. (2018). How should minimally important change (MIC) scores for the Patient Oriented Eczema Measure (POEM) be interpreted?: a validation using varied methods. British Journal of Dermatology, 178(5), https://doi.org/10.1111/bjd.16367

• Journal Article Type: Article
• Acceptance Date: Jan 11, 2018
• Online Publication Date: Jan 21, 2018
• Publication Date: May 31, 2018
• Deposit Date: Mar 2, 2018
• Publicly Available Date: Mar 2, 2018
• Journal: British Journal of Dermatology
• Print ISSN: 0007-0963
• Electronic ISSN: 1365-2133
• Publisher: Oxford University Press (OUP)
• Peer Reviewed: Peer Reviewed
• Volume: 178
• Issue: 5
• DOI: https://doi.org/10.1111/bjd.16367
• Keywords: Minimally important change; Minimum clinically important difference; Smallest detectable change; Atopic eczema; Patient-Oriented Eczema Measure
• Public URL: https://nottingham-repository.worktribe.com/output/935848
• Publisher URL: https://doi.org/10.1111/bjd.16367
• Contract Date: Mar 2, 2018