A prospective study to establish the minimal clinically important difference of the Mini-BESTest in individuals with stroke.
Marla K Beauchamp, Rudy Niebuhr, Patricia Roche and 2 others
PMID 34128411WHAT IT FOUND
A 4-point change on the Mini-BESTest indicates small improvement, and 5 points indicate substantial improvement in stroke patients.
A 1-point change is not enough to be considered clinically important, despite some statistical discrimination.
Key findings
01The minimal clinically important difference for small change is 4 points and for substantial change is 5 points on the Mini-BESTest total score.
02A change of 1 point on the Mini-BESTest was identified by ROC analysis but is lower than the minimal detectable change and thus not recommended as the MCID.
03There was no agreement between patients and physiotherapists on their perception of change, with a weighted kappa of 0.06.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study only provides MCID values for improvement, not for decline, because most patients improved. The findings may not generalize to inpatients or stroke populations with different mobility levels. There was poor agreement between patient and therapist perceptions of change, suggesting these groups value different aspects of balance. Distribution-based estimates relied on test-retest reliability coefficients from a previous study rather than new data from this sample.
Declared interests
The authors declared no potential conflicts of interest. Funding was provided by the Health Sciences Centre Foundation, Winnipeg, and the Canada Research Chairs Program.
The easy way to misread this
Do not use the 1-point change identified by ROC analysis as the minimal clinically important difference. This value is lower than the minimal detectable change and the anchor-based estimates, meaning it likely represents measurement error rather than true clinical improvement.