Review Articles

Interval estimation for minimal clinically important difference and its classification error via a bootstrap scheme

Zehua Zhou ,

a Department of Biostatistics, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA

Jiwei Zhao ,

a Department of Biostatistics, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA

zhaoj@buffalo.edu

Melissa Kluczynski

b Department of Orthopaedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA

Pages | Received 23 Jul. 2021, Accepted 23 Jul. 2021, Published online: 23 Jul. 2021,
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Abstract

With the improved knowledge on clinical relevance and more convenient access to the patient-reported outcome data, clinical researchers prefer to adopt minimal clinically important difference (MCID) rather than statistical significance as a testing standard to examine the effectiveness of certain intervention or treatment in clinical trials. A practical method to determining the MCID is based on the diagnostic measurement. By using this approach, the MCID can be formulated as the solution of a large margin classification problem. However, this method only produces the point estimation, hence lacks ways to evaluate its performance. In this paper, we introduce an m-out-of-n bootstrap approach which provides the interval estimations for MCID and its classification error, an associated accuracy measure for performance assessment. A variety of extensive simulation studies are implemented to show the advantages of our proposed method. Analysis of the chondral lesions and meniscus procedures (ChAMP) trial is our motivating example and is used to illustrate our method.