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Publication - Miss Daisy Gaunt

    The minimum clinically important difference (MCID) for a falls intervention in Parkinson's

    A delphi study

    Citation

    Henderson, E, Morgan, G, Amin, J, Gaunt, D & Ben-Shlomo, Y, 2019, ‘The minimum clinically important difference (MCID) for a falls intervention in Parkinson's: A delphi study’. Parkinsonism and Related Disorders, vol 61., pp. 106-110

    Abstract

    Background: Falls are common in Parkinson's disease so any intervention that reduced falls risk would be of value. One potential intervention is the use of cholinesterase inhibitor (ChEi) drugs. Objective: To establish the minimum clinically important difference (MCID) for fall rates to inform the effect estimate for sample size calculations of future clinical trials. Methods: We performed a Delphi study assembling a panel of experts in Parkinson's disease from academic and clinical medicine in order to reach a consensus of opinion. Responses from a panel were summarised and resent to the group, until consensus was reached. Results: 780 clinicians, who had been caring for people with Parkinson's for an average of 14 years, were contacted via three routes. The median (Interquartile range (IQR)) MCID after round 1 was 25% (IQR 20–30%) which equates to the prevention of 5 (IQR 4–6) falls per year. Increasing consensus after round two confirmed the MCID of 25%, narrowing the (IQ) range to 20%–25%. This was unchanged when the panel were shown the number of participants that would need to be recruited to a clinical trial in order to achieve this difference. Conclusions: We have established that an expert panel of PD specialists consider that an intervention that demonstrated a 25% (IQR 20–25%) relative reduction in falls rate would be clinically meaningful. This estimate can be used to help determine the sample size for any future clinical trial.

    Full details in the University publications repository