A Clinically Significant Difference on the COPM: A Review.
Mary Ann McColl, Celine Boyer Denis, Kate-Lin Douglas and 5 others
PMID 36650928WHAT IT FOUND
The common rule that a 2-point COPM change is clinically important lacks research evidence.
Client self-report of meaningful functional gain should be used instead of assuming a 2-point change matters.
Key findings
01Sources cited for the 2-point rule repeated earlier claims rather than providing new empirical evidence.
02Client-rated studies found meaningful change thresholds below and above 2 points.
03Using the conventional 2-point rule, 69 of 100 articles detected a change above 2 on Performance and 73 on Satisfaction.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a scoping review, not a systematic review, because the authors judged the evidence base insufficient for systematic review. The search was limited to CINAHL, Medline, and the COPM archive and to articles published between 1991 and 2020. Studies with fewer than 25 participants per group or without published COPM scores were excluded, so smaller studies were not considered. The authors did not use extended scoping review methods or consult stakeholders.
The easy way to misread this
Do not treat a 2-point COPM change as proof that a client has improved meaningfully. The review found no empirical evidence for that threshold, and client-rated studies suggested thresholds below and above 2 points.