Minimum clinically important differences in the Minnesota Living with Heart Failure questionnaire: from a study of heart failure patients treated with integrated Chinese and Western medicine

Yanbo Zhu; Jianni Cong; Lin Lin; Jinhang Du; Liqun Long; Yuan He; Jiaju Ren

doi:10.3389/fcvm.2023.1242216

Minimum clinically important differences in the Minnesota Living with Heart Failure questionnaire: from a study of heart failure patients treated with integrated Chinese and Western medicine

Front Cardiovasc Med. 2023 Nov 27:10:1242216. doi: 10.3389/fcvm.2023.1242216. eCollection 2023.

Authors

Yanbo Zhu^#¹, Jianni Cong^#², Lin Lin³, Jinhang Du⁴, Liqun Long¹, Yuan He⁵, Jiaju Ren¹

Affiliations

¹ School of Management, Beijing University of Chinese Medicine, Beijing, China.
² School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
³ Department of Personnel, China-Japan Friendship Hospital, Beijing, China.
⁴ Cardiology Department of Integrated Traditional Chinese and Western Medicine, China-Japan Friendship Hospital, Beijing, China.
⁵ School of Computer Science and Statistics, Trinity College, Dublin, Ireland.

^# Contributed equally.

Abstract

Objective: The purpose of this study was to estimate the minimum clinically important differences (MCIDs) in the Minnesota Living with Heart Failure questionnaire (MLHFQ), which targeted patients with heart failure treated with integrated Chinese and Western medicine, as a means of helping doctors and patients judge the effectiveness of intervention.

Methods: A total of 194 patients with chronic heart failure were recruited from three general hospitals in Beijing. Anchor-based and distribution-based approaches were used to estimate MCID. The anchor was SF-36 item 2 (HT, Health Transition), and the calculation methods included the mean change method, receiver operating characteristic (ROC) curve analysis, and linear regression model. For the distribution-based approaches, 0.2, 0.5, and 0.8 standardized response mean (SRM) values and standard error of measurement (SEM) value of 1 were used.

Results: The correlation coefficients of the MLHFQ scale information and HT were 0.346-0.583. Different MCIDs were obtained by the mean change method, ROC curve, and linear regression model. The minimum MCID in the physical domain, emotional domain, and total scores were 3.6, 2.0, and 7.4, respectively; the maximum estimates were 9.5, 2.5, and 13.0, respectively; and the average estimates were 5.7, 2.2, and 10.0, respectively. The average estimates were close to the result of the 0.5 SRM or 1 SEM.

Conclusion: We established MCIDs in the MLHFQ using anchor-based and distribution-based approaches. It was recommended to round the average estimates of anchor-based approaches up to the nearest whole number for the MCIDs of the MLHFQ physical domain, emotional domain, and total scores. The results were 6.0, 2.0, and 10.0, respectively.

Keywords: Minnesota Living with Heart Failure questionnaire; heart failure; integrated Chinese and Western medicine; minimum clinically important difference; quality of life.

Grants and funding

This work was supported by General Program of Beijing Natural Science (No.7222282); Open bidding for selecting the best candidates Project of Beijing University of Chinese Medicine (2022-JYB-JBZR-036); the National Natural Science Foundation of China (no. 30873256). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.