Rheumatology

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Minimally important differences in the Mahler's Transition Dyspnoea Index in a large randomized controlled trial—results from the Scleroderma Lung Study
Rheumatology, 09/25/09

Khanna D et al. – A change (improvement/worsening) of 1.5 U in the TDI is the MID for SSc-related interstitial lung disease (SSc-ILD). This can aid in interpreting clinically important changes in breathlessness in SSc-ILD.

• 158 participants
• Data from two treatment groups were combined for this analysis
• 5 patient-reported anchors from the short form (SF)-36 instrument to assess MID for TDI—SF-36 transition question and four questions from SF-36 pertaining to walking on flat surface or climbing stairs
• On SF-36 transition question, patients who rated as a little better or a little worse were defined as the MID subgroup
• Those reporting improvement from ‘Limited a lot’ to ‘Limited a little’ and ‘Limited a little’ to ‘No limit’ and vice versa defined as MID subgroup

• MID estimates for TDI improvement and worsening ranged from 1.05 to 2.16 (mean score = 1.5) U and from –0.61 to –2.55 (mean score = –1.5) U, respectively
• Change in group was larger than that of the no-change group (mean score = 0.38 U)
• Patients who achieved the MID for improvement at 12 months had a greater improvement in FVC% predicted (3.6%) compared with those who did not

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