Establishing minimal clinically important difference of Canadian Occupational Performance Measure

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K19925
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Tokyo University of Technology
• Principal Investigator: Ohno Kanta 東京工科大学, 医療保健学部, 助教 (70827823)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: カナダ作業遂行測定 / 臨床上意味のある最小重要差 / 患者報告式アウトカム / 回復期リハビリテーション病院 / COPM / MIC / レスポンスシフト

Outline of Final Research Achievements

Our study aimed to examine the minimal important change (MIC) of the Canadian Occupational Performance Measure (COPM) in inpatients undergoing subacute rehabilitation. The MIC values were calculated using anchor-based analyses with the transition index (TI) as an external criterion; the predictive modeling method adjusted for the proportion of improved patients (MICadjust). We recruited 100 inpatients with various health conditions. Data were collected twice: an initial assessment and a reassessment one month later. Three patients who indicated deterioration on the TI were excluded from all analyses, and 97 patients were analyzed in this study. The MICadjust values were 2.20 points (95% confidence interval, 1.80 to 2.59) for the COPM performance score and 2.06 points (95% confidence interval, 1.73 to 2.39) for the COPM satisfaction score.The MICadjust value estimates from this study can help detect whether the patients’ perceived occupational performance improved or did not change.

Free Research Field

作業療法

Academic Significance and Societal Importance of the Research Achievements

カナダ作業遂行測定（COPM）は，国内外の作業療法実践において領域や病期を問わずに幅広く活用されている効果指標である．これまでCOPMのMICはマニュアルに記載されていた「2.0点」が慣例的に使用されていたが，今回，統計学的に厳密な手法である人数比調整を実施した予測モデリング法（MICadjust）を適応したことで，COPMを採用した介入研究の結果の解釈を補助する資料を提供することができた．
殊に，個人の個別性を重視する作業療法においては，事例報告などの標本数が小さい介入研究が多く，MICを参照することで，対照群を設定しない介入研究の結果の解釈にも有用となる．