biostudies-literatureSayers AMRC FellowshipMedical Research CouncilNational Institute for Health Research (NIHR)e014041https://www.ebi.ac.uk/biostudies/studies/S-EPMC5577889biostudies-literatureUnknown7(7)<h4>Objective</h4>This article reviews and compares four commonly used approaches to assess patient responsiveness with a treatment or therapy (return to normal (RTN), minimal important difference (MID), minimal clinically important improvement (MCII), OMERACT-OARSI [Outcome Measures in Rheumatology-Osteoarthris Reseach Society International] (OO)) and demonstrates how each of the methods can be formulated in a multilevel modelling (MLM) framework.<h4>Design</h4>Cohort study.<h4>Setting</h4>A cohort of patients undergoing total hip and knee replacement were recruited from a single UK National Health Service hospital.<h4>Population</h4>400 patients from the Arthroplasty Pain Experience cohort study undergoing total hip (n=210) and knee (n=190) replacement who completed the Intermittent and BMJ openA unified multi-level model approach to assessing patient responsiveness including; return to normal, minimally important differences and minimal clinically important improvement for patient reported outcome measures.PMC5577889RP-PG-0407-10070MR/L01226X/1NF-SI-0515-10048Sayers AGooberman-Hill RBeard DDawson JWylde VBlom AWPrice ALenguerrand EfalseA unified multi-level model approach to assessing patient responsiveness including; return to normal, minimally important differences and minimal clinically important improvement for patient reported outcome measures.<h4>Objective</h4>This article reviews and compares four commonly used approaches to assess patient responsiveness with a treatment or therapy (return to normal (RTN), minimal important difference (MID), minimal clinically important improvement (MCII), OMERACT-OARSI [Outcome Measures in Rheumatology-Osteoarthris Reseach Society International] (OO)) and demonstrates how each of the methods can be formulated in a multilevel modelling (MLM) framework.<h4>Design</h4>Cohort study.<h4>Setting</h4>A cohort of patients undergoing total hip and knee replacement were recruited from a single UK National Health Service hospital.<h4>Population</h4>400 patients from the Arthroplasty Pain Experience cohort study undergoing total hip (n=210) and knee (n=190) replacement who completed the Intermittent and 2017-01-01T00:00:00Z2017 Jul2026-05-05T23:38:41.154Z2019-03-26T22:45:42ZS-EPMC55778892873329610.1136/bmjopen-2016-014041