{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T15:53:23Z","timestamp":1789487603418,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Minimum clinically important difference (MCID) helps distinguish clinically meaningful benefit from statistically significant, but clinically trivial, change. Modified versions of the Essential Tremor Rating Assessment Scale (TETRAS), including the modified activities of daily living (mADL) scale and the mADL11 scale, are frequently used as primary outcome measures in essential tremor (ET) clinical trials, but MCIDs for these measures have not been established. Here, we estimated MCIDs for the mADL and mADL11 scales in ET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the TRANQUIL multicenter, randomized controlled trial of an artificial intelligence\u2013driven transcutaneous peripheral nerve stimulation device for ET were analyzed. Anchor\u2010based approaches using the Clinical Global Impression of Improvement (CGI\u2010I) and the Patient Global Impression of Improvement (PGI\u2010I) were used as primary methods for MCID estimation. Mean changes in mADL and mADL11 were calculated for participants rated as \u201cminimally improved\u201d and \u201cno change.\u201d Associations between anchor measures and score changes were assessed with Spearman's correlation coefficients. Receiver operating characteristic (ROC) analyses were performed to identify cutoff values that best distinguished minimal improvement from no change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The anchor measures demonstrated acceptable correlations with changes in mADL and mADL11 scores. Estimated MCID values for mADL ranged from \u22123.5 to \u22126.2, and values for mADL11 ranged from \u22121.0 to \u22124.1 ROC\u2010derived estimates produced the lowest thresholds, whereas PGI\u2010I\u2013based estimates yielded the highest. Our recommended MCID values, based on patient report, are \u22126.2 for mADL and\u2009\u22124.1 for mADL11.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study establishes clinically meaningful change thresholds for two commonly used TETRAS\u2010based outcome measures in ET. These MCIDs may aid interpretation of future clinical ET trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70807","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T14:50:45Z","timestamp":1789483845000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimal Clinically Important Difference in\n                    <scp>TETRAS<\/scp>\n                    Score for Essential Tremor"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6090-4261","authenticated-orcid":false,"given":"William G.","family":"Ondo","sequence":"first","affiliation":[{"name":"Houston Methodist Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9914-5706","authenticated-orcid":false,"given":"Stuart H.","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Parkinson's Disease and Movement Disorder Center of Boca Raton  Boca Raton Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Lv","sequence":"additional","affiliation":[{"name":"Sir Run Run Shaw Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6535-4606","authenticated-orcid":false,"given":"Xiaodong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Tianjin Medical University General Hospital  Heping China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9782-584X","authenticated-orcid":false,"given":"Yongsheng","family":"Hu","sequence":"additional","affiliation":[{"name":"Xuanwu Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Yuan","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital, Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-136X","authenticated-orcid":false,"given":"Alberto J.","family":"Espay","sequence":"additional","affiliation":[{"name":"University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9412-931X","authenticated-orcid":false,"given":"Sheng\u2010Han","family":"Kuo","sequence":"additional","affiliation":[{"name":"Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly A.","family":"Shill","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly E.","family":"Lyons","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Yang","sequence":"additional","affiliation":[{"name":"Fasikl Inc  Bloomington Minnesota USA"},{"name":"University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Fasikl Inc  Bloomington Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0804-8741","authenticated-orcid":false,"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fasikl Inc  Bloomington Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-6466","authenticated-orcid":false,"given":"Rajesh","family":"Pahwa","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City Kansas 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