Serious reporting deficiencies exist in minimal important difference studies: current state and suggestions for improvement

Alonso Carrasco-Labra, Tahira Devji, Anila Qasim, Mark Phillips, Bradley C Johnston, Niveditha Devasenapathy, Dena Zeraatkar, Meha Bhatt, Xuejing Jin, Romina Brignardello-Petersen, Olivia Urquhart, Farid Foroutan, Stefan Schandelmaier, Hector Pardo-Hernandez, Robin Wm Vernooij, Hsiaomin Huang, Yamna Rizwan, Reed Siemieniuk, Lyubov Lytvyn, Donald L PatrickShanil Ebrahim, Toshi A Furukawa, Gihad Nesrallah, Holger J Schunemann, Mohit Bhandari, Lehana Thabane, Gordon H Guyatt

Research output: Contribution to journalReview articlepeer-review


BACKGROUND AND OBJECTIVES: To evaluate reporting of minimal important difference (MID) estimates using anchor-based methods for patient-reported outcome measures (PROMs), and the association with reporting deficiencies on their credibility.

METHODS: Systematic survey of primary studies empirically estimating MIDs. We searched Medline, EMBASE, PsycINFO, and the Patient-Reported Outcome and Quality of Life Instruments Database until October 2018. We evaluated study reporting, focusing on participants' demographics, intervention(s), characteristics of PROMs and anchors, and MID estimation method(s). We assessed the impact of reporting issues on credibility of MID estimates.

RESULTS: In 585 studies reporting on 5,324 MID estimates for 526 distinct PROMs, authors frequently failed to adequately report key characteristics of PROMs and MIDs, including minimum and maximum values of PROM scale, measure of variability accompanying the MID estimate and number of participants included in the MID calculation. Across MID estimates (n = 5,324), the most serious reporting issues impacting credibility included infrequent reporting of the correlation between the anchor and PROM (66%), inadequate details to judge precision of MID point estimate (13%), and insufficient information about the threshold used to ascertain MIDs (16%).

CONCLUSION: Serious issues of incomplete reporting in the MID literature threaten the optimal use of MID estimates to inform the magnitude of effects of interventions on PROMs.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalJournal of Clinical Epidemiology
Early online date24 Jun 2022
Publication statusPublished - Oct 2022


  • Anchor-based methods
  • Credibility
  • Minimal important difference
  • Patient-reported outcome
  • Reporting quality
  • Systematic survey


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