Although patient-reported outcome measures (PROMs) have become a regularly used metric, there is little consensus on the methodology used to determine clinically relevant postoperative outcomes. We systematically reviewed the literature for studies that have identified metrics of clinical efficacy after total hip arthroplasty (THA) including minimal clinically important difference (MCID), patient acceptable symptom state (PASS), minimal detectable change (MDC), and substantial clinical benefit (SCB). A systematic review examining quantitative metrics for assessing clinical improvement with PROMs following THA was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the MEDLINE database from 2008 to 2020. Inclusion criteria included full texts, English language, primary THA with minimum 1-year follow-up, use of metrics for assessing clinical outcomes with PROMs, and primary derivations of those metrics. Sixteen studies (24,487 THA patients) met inclusion criteria and 11 different PROMs were reported. MCIDs were calculated using distribution methods in 7 studies (44%), anchor methods in 2 studies (13%), and both methods in 2 studies (13%). MDC was calculated in 2 studies, PASS was reported in 1 study using anchor-based method, and SCB was calculated in 1 study using anchor-based method. There is a lack of consistency in the literature regarding the use and interpretation of PROMs to assess patient satisfaction. MCID was the most frequently reported measure, while MDC, SCB, and PASS were used relatively infrequently. Method of derivation varied based on the PROM used; distribution method was more frequently used for MCID.

中文翻译：

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全髋关节置换术临床重要变化的指标：系统评价

尽管患者报告的结果测量（PROM）已成为常用的指标，但对于用于确定临床相关术后结果的方法几乎没有达成共识。我们系统地回顾了研究文献，这些研究确定了全髋关节置换术（THA）后的临床疗效指标，包括最小临床重要差异（MCID）、患者可接受的症状状态（PASS）、最小可检测变化（MDC）和实质性临床获益（ SCB）。根据系统评价和荟萃分析指南的首选报告项目，使用 2008 年至 2020 年的 MEDLINE 数据库，对评估 THA 后 PROM 临床改善的定量指标进行了系统评价。纳入标准包括全文、英语、主要 THA至少 1 年随访、使用 PROM 评估临床结果的指标以及这些指标的主要推导。 16 项研究（24,487 名 THA 患者）符合纳入标准，报告了 11 种不同的 PROM。 7 项研究 (44%) 中使用分布方法计算 MCID，2 项研究 (13%) 中使用锚定方法，2 项研究 (13%) 中两种方法均使用。 2 项研究中计算了 MDC，1 项研究中使用基于锚定的方法报告了 PASS，1 项研究中使用基于锚定的方法计算了 SCB。关于使用和解释 PROM 来评估患者满意度的文献缺乏一致性。 MCID 是最常报告的衡量标准，而 MDC、SCB 和 PASS 的使用相对较少。推导方法根据所使用的 PROM 的不同而不同；分布法更常用于MCID。