# Selecting the optimal MIC for five patient-reported outcome measures in patients with upper extremity injuries, using a systematic search and step-by-step decision tree

## TL;DR

This paper shows how to choose the best minimum important change (MIC) values for patient-reported outcome measures in upper extremity injury patients using a systematic method.

## Contribution

A systematic step-by-step approach is used to select optimal MIC values for five PROMs in upper extremity injury patients.

## Key findings

- Eleven studies were identified, but most scored low on additional credibility criteria.
- Optimal MIC values were selected for DASH, Q-DASH, PRWE, and PROMIS-UE.
- No studies were found for the MIC of the MHQ in upper extremity injury patients.

## Abstract

To illustrate how optimal MIC values can be selected for PROMs using a systematic step-by-step approach.

A systematic search was performed in PubMed, Embase and Cochrane, until June 2024 to identify all studies that estimated the MIC for the following PROMs in patients with upper extremity injuries: DASH, Q-DASH, MHQ, PRWE and PROMIS-UE. Credibility of the MIC values was examined using the MIC credibility instrument. The optimal MIC value was selected using a published systematic step-by-step approach, taking the credibility of the MIC studies, the correlation of the PROM change score with the anchor, the consistency of MIC values, and contextual factors (e.g. type of intervention) into account.

Eleven studies were included. Eight studies scored high on the core credibility items, but all studies scored low on the additional criteria, regarding the appropriateness of the time interval and the correlation between the anchor and (change in) PROM scores. The most credible estimates per PROM were not consistent and there were not enough estimates per PROM to study contextual factors. The following optimal MIC values (among ranges of MIC values found) were selected: DASH 9.4 (6.7–13.0), Q-DASH 7.4 (3.5–11.7), PRWE 11.5 (9.2–56.0), and PROMIS-UE v1.2 4.7 (4.6–4.8). No studies were found on the MIC of the MHQ in Upper Extremity Injury (UEI) patients.

This study serves as an example of how optimal MIC values can be carefully selected for a given PROM if multiple MIC values are reported in the literature.

The online version contains supplementary material available at 10.1007/s11136-025-04152-1.