Minimal Important Change in Canadian Occupational Performance Measure: A Systematic Review

Abstract

The Canadian Occupational Performance Measure (COPM) recognizes a significant clinical shift with a minimum two-point alteration post-intervention. However, there is sparse evidence supporting this criterion’s clinical significance. To investigate and report minimal important change (MIC) and minimal detectable change (MDC) within the COPM in various populations. In May 2023, a search was conducted to locate studies that calculated MIC and MDC in the COPM using multiple databases. Studies were screened and extracted to assess bias risk in the final article selections. After screening 229 included studies, five studies were selected; four studies calculated MIC (performance: 0.20–3.20 points, satisfaction: 1.45–3.20 points) and one study calculated MDC (performance: 1.47–3.14 points, satisfaction: 1.80–3.98 points) within the COPM. The study populations, reassessment periods, and risk of bias varied. To effectively use COPM’s MIC and MDC as references, clients and intervention conditions must be considered.

Plain Language Summary

A Systematic Review of Minimal Important Change and Minimal Detectable Change in the Canadian Occupational Performance Measure Using a Literature Database

The Canadian Occupational Performance Measure (COPM) is an interview used to assess clients’ progress in occupational therapy in self-care, productivity, and leisure. COPM is considered to be clinically significant after a change of at least two points after intervention. However, studies that can explain these points with scientific evidence are scarce and must be tested in different client populations and intervention settings. This study aimed to investigate and report the numerical values of clinically significant changes in COPM in various populations. In May 2023, a search was conducted to locate studies that calculated a clinically significant change in COPM using databases such as CINAHL, Cochrane Library, EMBASE, MEDLINE, OT Seeker, the Physiotherapy Evidence Database (PEDro), PsycINFO, and Web of Science. Studies were screened and extracted to assess the risk of bias in the final article selection. After screening 229 included studies, five studies were selected for analysis. In four studies, the minimal important change (MIC) of the COPM was calculated as 0.20 to 3.20 points for performance and 1.45 to 3.20 points for satisfaction. One study calculated a minimal detectable change (MDC) as 1.47 to 3.14 points for performance and 1.80 to 3.98 points for satisfaction. Study populations, reassessment periods, and risk of bias varied. Effective reference to the number of clinically significant changes in COPM requires consideration of the clients receiving occupational therapy and the intervention conditions.