Minimal Clinically Important Differences in EQ-5D-5L Index and VAS after a Respiratory Muscle Training Program in Individuals Experiencing Long-Term Post-COVID-19 Symptoms

Abstract

The primary aim of this study was to determine the minimal clinically important difference (MCID) for the EuroQol-5D questionnaire (EQ-5D-5L) index and visual analogic scale (VAS) in individuals experiencing long-term post-COVID-19 symptoms. In addition, it was pretended to determine which variable discriminates better and to compare changes between individuals classified by the MCID. Design: Secondary analysis of a randomized controlled trial involving 42 individuals who underwent an 8-week intervention in a respiratory muscle training program. Results: A change of at least 0.262 and 7.5 for the EQ-5D-5L index and VAS represented the MCID, respectively. Only the EQ-5D-5L VAS showed acceptable discrimination between individuals who were classified as “improved” and those classified as “stable/not improved” (area under the curve = 0.78), although with a low Youden index (Youden index, 0.39; sensitivity, 46.2%; specificity, 93.1%). Those individuals who exceeded the established MCID for EQ-5D-5L VAS had significantly greater improvements in inspiratory muscle function, exercise tolerance, and peripheral muscle strength compared to participants classified as “stable/not improved”. Conclusions: Only the EQ-5D-5L VAS, especially when MCID was exceeded, showed an acceptable discriminative ability to evaluate the efficacy of an intervention in individuals with long-term post-COVID-19 symptoms.