{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T09:19:20Z","timestamp":1774257560236,"version":"3.50.1"},"reference-count":29,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The minimal clinically important difference (MCID) is most commonly defined using patient-reported assessments of meaningful change. However, MCID values may also be derived from clinician judgments. Patient and physical therapist (PT) ratings of meaningful change may differ due to differences in clinical priorities and observational focus. It remains unclear whether MCID values defined by PTs align with those defined by patients themselves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study aim to determine the agreement in perceived improvement between patients and PTs and compare MCID values for the Simplified Chinese Lower Extremity Functional Scale (SC-LEFS) based on these improvement ratings. Patients aged 18\u201350 years with non-osteoarthritic lower extremity injuries completed the SC-LEFS at initial assessment and 4-weeks follow-up. After 4-weeks of physical therapy, patients were classified into \u201cimproved\u201d and \u201cnot improved\u201d groups by using a 7-point global rating of change (GROC) scale. Based on both the patient\u2019s and physical therapist\u2019s independent ratings, patients were separately categorized as \u201cimproved\u201d (those reporting being improved or much improved) or \u201cnot improved\u201d (those reporting slightly improved, no change, slightly worse, worse, or greatly worse). Separate SC-LEFS MCID values were determined that best distinguished between the two groups for the patient and PT rating. Receiver operator characteristic (ROC) curve analyses were done to define the sensitivity and specificity for these MCID values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 763 patients with lower extremity injuries were included. Agreement between patients\u2019 and PTs\u2019 rating was substantial (quadratic weighted kappa = 0.8: 95% CI [0.77\u20130.84]). MCID values of 9.5 were found for both patient report and PT rating, with sensitivity and specificity ranging between of 0.66 and 0.72. The area under the cures (AUC) were 0.74 (95% CI [0.71\u20130.78]) for both patient report and PT rating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After 4 weeks of physical therapy, patients and PTs demonstrated agreement in their improvement ratings, and the SC-LEFS MCID thresholds for defining improvement were same for both groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.21001","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T08:47:31Z","timestamp":1774255651000},"page":"e21001","source":"Crossref","is-referenced-by-count":0,"title":["Comparing improvement ratings and minimal clinically important difference values between patients and physical therapists"],"prefix":"10.7717","volume":"14","author":[{"given":"Yongni","family":"Zhang","sequence":"first","affiliation":[{"name":"Duquesne University, Pittsburgh, PA, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhu","sequence":"additional","affiliation":[{"name":"The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weimin","family":"Li","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Zibo Traditional Chinese Medicine Hospital, Zibo, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongmei","family":"Ai","sequence":"additional","affiliation":[{"name":"Nanjing Drum Tower Hospital, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China"},{"name":"School of Medicine, Tongji University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaowen","family":"Lian","sequence":"additional","affiliation":[{"name":"Rehabilitation Hospital Affilated to Fujian University of Traditional Chinese, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"RobRoy L.","family":"Martin","sequence":"additional","affiliation":[{"name":"Duquesne University, Pittsburgh, PA, United States of America"},{"name":"UPMC Center for Sports Medicine, Pittsburgh, PA, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiongwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Kunshan Rehabilitation Hospital, Kunshan, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"10.7717\/peerj.21001\/ref-1","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1177\/0363546513489284","article-title":"Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery","volume":"41","author":"Ardern","year":"2013","journal-title":"American Journal of Sports Medicine"},{"key":"10.7717\/peerj.21001\/ref-2","doi-asserted-by":"publisher","first-page":"3192","DOI":"10.1097\/00007632-200012150-00015","article-title":"Understanding the relevance of measured change through studies of responsiveness","volume":"25","author":"Beaton","year":"2000","journal-title":"Spine"},{"key":"10.7717\/peerj.21001\/ref-3","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s11136-006-9109-9","article-title":"Minimally important change determined by a visual method integrating an anchor-based and a distribution-based approach","volume":"16","author":"De\u00a0Vet","year":"2007","journal-title":"Quality of Life Research"},{"key":"10.7717\/peerj.21001\/ref-4","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.2106\/jbjs.G.01095","article-title":"Defining substantial clinical benefit following lumbar spine arthrodesis","volume":"90","author":"Glassman","year":"2008","journal-title":"Journal of Bone and Joint Surgery. 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