Objective: We aimed to estimate the MCIDs of HFS-30 and HFS-7, and factors associated with the MCID along with baseline and change score of HFS-30 at 1 month of follow-up (F/U).

Background: Hemifacial spasm (HFS) affects health-related quality of life (HRQoL). The HFS-30 and HFS-7 questionnaires assess the HFS HRQoL. Their minimally clinical important difference (MCIDs) have never been estimated.

Method: We collected data prospectively at one referral center Botulinum toxin (BoNT) clinic between 2022 and 2023 in all HFS patients aged ≥ 18 years. We collected HFS scores, Samsung Medical Center (SMC) grade, PHQ-9 and a patient-reported HRQoL global rating scale of change (GRS) at pre-treatment baseline, followed by GRS and/or HFS scores at 2-day intervals until 2 weeks and 1-month F/U. The first F/U visit with patient-reported minimal improvement determined the MCID.

Results: 112 patients were recruited. The median age and HFS duration were 62.8 years (IQR 56.6, 69.3) and 10 years (IQR 4, 17), respectively. The MCID of HFS-30 and HFS-7 by the was -4.46 points (95%CI -5.41, -3.65) and -2.63 points (95%CI -3.33, -1.92), respectively. Moderate-to-severe depression patients reported significantly higher MCID than those with none-mild depression (p<0.001). Age and PHQ-9 were significantly associated with baseline HFS-30, and these along with HFS clinical severity were significantly associated with change score at 1-month F/U (all p<0.05).

Conclusion: The MCIDs of HFS-30 and HFS-7 were -4.46 and -2.63 points, respectively. MCID and HFS-30 scores were associated with age, depression, and clinical severity.

[Table1] Baseline patient characteristics

[Figure1] Subgroup analyses of changes of HFS-30

References: [1] Weiss D, Sturm J, Hieber L, et al. Health-related quality of life outcomes from botulinum toxin treatment in hemifacial spasm. Ther Adv Neurol Disord 2017;10(4):211-16.doi: 10.1177/1756285616682676
[2] Tan EK, Fook-Chong S, Lum SY, Lim E. Botulinum toxin improves quality of life in hemifacial spasm: validation of a questionnaire (HFS-30). J Neurol Sci 2004;219(1-2):151-5.doi: 10.1016/j.jns.2004.01.010
[3] Mouelhi Y, Jouve E, Castelli C, Gentile S. How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods. Health Qual Life Outcomes 2020;18(1):136.doi: 10.1186/s12955-020-01344-w
[4] Setthawatcharawanich S, Aui-aree N, Limapichart K, et al. The validation of the disease-specific questionnaire for health-related quality of life in Thai patients with hemifacial spasm. J Med Assoc Thai 2008;91(11):1691-7.
[5] Neely JG, Karni RJ, Engel SH, et al. Practical guides to understanding sample size and minimal clinically important difference (MCID). Otolaryngol Head Neck Surg 2007;136(1):14-8.doi: 10.1016/j.otohns.2006.11.001
[6] Rudzińska M, Wójcik M, Malec M, et al. Factors affecting the quality of life in hemifacial spasm patients. Neurol Neurochir Pol 2012;46(2):121-9.doi: 10.5114/ninp.2012.28254

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MDS Abstracts - https://www.mdsabstracts.org/abstract/minimally-clinical-important-differences-of-hemifacial-spasm-score-30-hfs-30-and-hemifacial-spasm-score-7-hfs-7-for-patients-with-hemifacial-spasm/