Examining minimal important change of the Canadian Occupational Performance Measure for subacute rehabilitation hospital inpatients

Kanta Ohno; Kounosuke Tomori; Tatsunori Sawada; Ryuji Kobayashi

doi:10.1186/s41687-021-00405-y

Examining minimal important change of the Canadian Occupational Performance Measure for subacute rehabilitation hospital inpatients

J Patient Rep Outcomes. 2021 Dec 20;5(1):133. doi: 10.1186/s41687-021-00405-y.

Authors

Kanta Ohno^{1

2}, Kounosuke Tomori³, Tatsunori Sawada³, Ryuji Kobayashi⁴

Affiliations

¹ Major of Occupational Therapy, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-City, Tokyo, 144-8535, Japan. ohnoknt@stf.teu.ac.jp.
² Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan. ohnoknt@stf.teu.ac.jp.
³ Major of Occupational Therapy, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-City, Tokyo, 144-8535, Japan.
⁴ Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.

Abstract

Background: The Canadian Occupational Performance Measure (COPM) is an individualized patient-reported outcome designed to evaluate the self-perceptions of a patient's occupational performance. Our study aimed to examine the minimal important change (MIC) in inpatients undergoing subacute rehabilitation. The MIC values were calculated using the three different anchor-based analyses with the transition index as an external criterion; the mean change method (MIC_MeanChange), the receiver operating characteristic (MIC_ROC) analysis, and the predictive modeling method adjusted for the proportion of improved patients (MIC_adjust). In this study, the MIC_adjust value was considered as the most valid statistical method. We recruited 100 inpatients with various health conditions from subacute rehabilitation hospitals. Data were collected twice: an initial assessment and a reassessment one month later. The systematic interview format (Five Ws and How) was used for both the initial and second assessments to prevent information bias (response shift).

Results: Three patients who indicated deterioration on the transition index were excluded from all analyses, and 97 patients were analyzed in this study. The MIC_adjust values were 2.20 points (95% confidence interval 1.80-2.59) for the COPM performance score and 2.06 points (95% confidence interval 1.73-2.39) for the COPM satisfaction score. The MIC_MeanChange and MIC_ROC values were considered less reasonable to interpret because the proportions of the improved patients subgroup were more than 50% (82.5%).

Conclusions: The MIC_adjust value estimates from this study can help detect whether the patients' perceived occupational performance improved or did not change. The results support the multidisciplinary use of COPM in clinical practice and research on subacute rehabilitation inpatients.

Keywords: Canadian Occupational Performance Measure; Minimal clinically important difference; Patient-reported Outcome; Response shift; Subacute rehabilitation hospital.

Grants and funding

19K19925/japan society for the promotion of science