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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several recently published investigations have examined the relationship between the magnitude of the standard error of measurement (SEM) and established thresholds for a minimal clinically important difference (MCID) or a minimal important difference (MID) for change scores on health-related quality of life (HRQOL) or health status measures. These investigations, however, have resulted in differing SEM criteria for the MCID or MID. This study reviews and compares two sets of studies: (1) three investigations using a disease-specific HRQOL measure among patient samples with the chronic disease (heart disease, chronic obstructive pulmonary disease, or asthma) that have consistently demonstrated a 1 SEM correspondence with the established MCIDs or MIDs and (2) three investigations among patients referred to physical therapists with back, lower extremity, and neck pain showing that approximately 2.3 SEMs estimated the established MCID standards for three different measures of health status. Chronic disease patients were classified to have a MCID or MID if their global change ratings for the better or the worse were 1, 2, or 3 on a Likert scale ranging from 1 (almost the same, hardly any better, or worse at all) to 7 (a very great deal better or worse). Back pain patients, however, needed average global transition scores of 5, 6, or 7 (a good, a great, or a very great deal better) on the same 7-point Likert scale in order to experience an MCID in their condition. Charting these change levels against their respective SEM-MID criteria provides insight and promise for linking SEM-based criteria to MCID standards for other HRQOL and health status measures.
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PMID:Minimal important difference thresholds and the standard error of measurement: is there a connection? 1502 2

This paper investigates comorbidity between chronic back and neck pain and other physical and mental disorders in the US population, and assesses the contributions of chronic spinal pain and comorbid conditions to role disability. A probability sample of US adults (n=5692) was interviewed. Chronic spinal pain, other chronic pain conditions and selected chronic physical conditions were ascertained by self-report. Mood, anxiety and substance use disorders were ascertained with the Composite International Diagnostic Interview (CIDI). Role disability was assessed with questions about days out of role and with impaired role functioning. The 1 year prevalence of chronic spinal pain was 19.0%. The vast majority (87.1%) of people with chronic spinal pain reported at least one other comorbid condition, including other chronic pain conditions (68.6%), chronic physical conditions (55.3%), and mental disorders (35.0%). Anxiety disorders showed as strong an association with chronic spinal pain as did mood disorders. Common conditions not significantly comorbid with chronic spinal pain were diabetes, heart disease, cancer, and drug abuse. Chronic spinal pain was significantly associated with role disability after controlling for demographic variables and for comorbidities. However, comorbid conditions explained about one-third of the gross association of chronic spinal pain with role disability. We conclude that chronic spinal pain is highly comorbid with other pain conditions, chronic diseases, and mental disorders, and that comorbidity plays a significant role in role disability associated with chronic spinal pain. The societal burdens of chronic spinal pain need to be understood and managed within the context of comorbid conditions.
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PMID:Chronic spinal pain and physical-mental comorbidity in the United States: results from the national comorbidity survey replication. 1566 41