Quantifying the minimal clinically important difference of the self-administered foot evaluation…

Cohort studyThe Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons· Jul 2026

Quantifying the minimal clinically important difference of the self-administered foot evaluation questionnaire (SAFE-Q) in patients undergoing surgery for ankle osteoarthritis.

Rintaro Harada, Hiroyuki Seki, Tetsuro Kokubo

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OrthopedicsCohort studyClinical practiceQ2IF 1.6

Pain and physical function subscales show clinically meaningful improvement thresholds of 9-14 points.

Quantifying the minimal clinically important difference of the self-administered foot evaluation questionnaire (SAFE-Q) in patients undergoing surgery for ankle osteoarthritis.

Rintaro Harada … Tetsuro Kokubo

The Journal of foot and ankle surgery · Jul 2026 · Q2 in Orthopedics

Background

The Self-Administered Foot Evaluation Questionnaire (Self-Administered Foot Evaluation Questionnaire) is a validated foot- and ankle-specific patient-reported outcome measure.

Purpose

To determine anchor-based and distribution-based MCIDs for Self-Administered Foot Evaluation Questionnaire subscales in patients undergoing surgery for ankle osteoarthritis.

Methods

We analyzed 88 patients with ankle osteoarthritis undergoing surgery who completed Self-Administered Foot Evaluation Questionnaire preoperatively and ≥12 months postoperatively.

n = 88 patients

Results

these subscales need 9 to 14 point gains to feel meaningfully better to patients

PP

13.9points

PF

9.1points

More results

Self-Administered Foot Evaluation Questionnaire scores improved significantly across all domains.

Eighty patients (91%) reported satisfaction.

Anchor-based MCIDs were +13.9 for PP and +9.1 for PF, with acceptable discriminative accuracy (area under the ROC curve 0.759 and 0.743, respectively).

More results

In contrast, GH was affected by ceiling effects, and social function and SH showed limited discriminative ability.

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Conclusion · 1 of 3

This study provides the first minimal clinically important difference estimates for Self-Administered Foot Evaluation Questionnaire in ankle osteoarthritis surgery.

Conclusion · 2 of 3

PP and PF demonstrated clinically meaningful MCIDs of approximately 9-14 points, indicating that these subscales are most appropriate for assessing meaningful postoperative improvement.

Conclusion · 3 of 3

These thresholds offer practical guidance for clinical interpretation and future trial design.

Quantifying the minimal clinically important difference of the self-administered foot evaluation questionnaire (SAFE-Q) in patients undergoing surgery for ankle osteoarthritis.

Quantifying the minimal clinically important difference of the self-administered foot evaluation questionnaire (SAFE-Q) in patients undergoing surgery for ankle osteoarthritis.

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