Brief communication: use of the minimal important difference for a meta-analysis on exercise and anxiety in adults with arthritis

Clinical Rheumatology
George A KelleyLeigh F Callahan

Abstract

A recent meta-analysis reported statistically significant improvements in anxiety as a result of exercise in adults with arthritis and other rheumatic diseases (AORD) using the traditional standardized mean difference (SMD) effect size (ES). The objective of this study was to use the more recently developed and clinically relevant minimal important difference (MID) approach to examine this association. Data from a previous meta-analysis of 14 randomized controlled trials representing 926 initially enrolled adults ≥ 18 years of age (539 exercise, 387 control) was used to calculate the ES using the MID approach. Minimal important difference data were derived from previously reported anchor-based values that represented the different instruments used to assess anxiety. Effect sizes were pooled using the inverse heterogeneity (IVhet) model. Overall, exercise resulted in a mean ES reduction in anxiety of - 0.80 (95% CI, - 1.60 to 0.001, p = 0.05; Q = 92.1, p < 0.001, I 2  = 83.7%, 95% CI, 74.9%, 89.5%), suggesting that overall, exercise may benefit an appreciable number of patients. Nonetheless, this effect spanned the range from many patients gaining important benefits to no patients improving. The clinically relevant effects of ex...Continue Reading

References

Apr 17, 2009·The Journal of Rheumatology·Robert M BennettAlesia B Sadosky
Jun 10, 2010·Health and Quality of Life Outcomes·Valerie S L WilliamsDouglas Feltner
Jan 28, 2015·Arthritis Care & Research·S A A Rongen-van DartelJ Fransen
May 25, 2015·Contemporary Clinical Trials·Suhail A R DoiGail M Williams
Mar 10, 2017·MMWR. Morbidity and Mortality Weekly Report·Kamil E BarbourTeresa J Brady
Jun 4, 2017·The Spine Journal : Official Journal of the North American Spine Society·Ronald H M A BartelsAndré L M Verbeek

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