We appreciate the authors’ response to our letter,
1
but we believe their response is insufficient to address our point. In their response
they stated, “We believe that the MCID of the BI in both studies was not directly
applicable to our study because of differences in the population or length of follow-up.
We focused on patients with mild to severe dementia who underwent hip fracture surgery
and examined the BI at discharge from acute-care hospitals (median [25th-75th percentile]
postoperative length of stay, 21d [15-30d]).3 We believe that the clinical importance of changes in the BI differ with different
patient populations or clinical settings.” We somewhat agree that the findings of
the earlier studies that we mentioned in our letter
2
might not be generalized to patients with mild-severe dementia after hip fracture
surgery in Uda’s study. Still, we understand Uda et al have not addressed our raised
point whether their finding is beyond clinical significance. We believe we researchers
should be humble about use of clinical or statistical significance, especially when
we deal with big data.To read this article in full you will need to make a payment
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References
- Author’s response to letter to the editor.Arch Phys Med Rehabil. 2019; 101: 172
- Intensive in-hospital rehabilitation after hip fracture surgery and activities of daily living in patients with dementia: retrospective analysis of a nationwide inpatient database.Arch Phys Med Rehabil. 2020; 101: 171-172
Article info
Publication history
Published online: March 07, 2020
Footnotes
Disclosures: none.
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Copyright
© 2020 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
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- Author’s Response to Letter to the EditorArchives of Physical Medicine and RehabilitationVol. 101Issue 6
- PreviewWe thank the authors for their reply to our most recent response. However, we believe that our findings were clinically significant. Specifically, we believe that a 5-point improvement in the Barthel Index (BI) is clinically meaningful. Such an increase can be interpreted by patients and clinicians as an improvement in at least 1 level of dependence in 1 task of activities of daily living.
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