PMID- 17448732
OWN - NLM
STAT- MEDLINE
DCOM- 20080104
LR  - 20220410
IS  - 1529-9430 (Print)
IS  - 1529-9430 (Linking)
VI  - 7
IP  - 5
DP  - 2007 Sep-Oct
TI  - Understanding the minimum clinically important difference: a review of concepts 
      and methods.
PG  - 541-6
AB  - BACKGROUND CONTEXT: The effectiveness of spinal surgery as a treatment option is 
      currently evaluated through the assessment of patient-reported outcomes (PROs). 
      The minimum clinically important difference (MCID) represents the smallest 
      improvement considered worthwhile by a patient. The concept of an MCID is offered 
      as the new standard for determining effectiveness of a given treatment and 
      describing patient satisfaction in reference to that treatment. PURPOSE: Our goal 
      is to review the various definitions of MCID and the methods available to 
      determine MCID. STUDY DESIGN: The primary means of determining the MCID for a 
      specific treatment are divided into anchor-based and distribution-based methods. 
      Each method is further subdivided and examined in detail. METHODS: The overall 
      limitations of the MCID concept are first identified. The basic assumptions, 
      statistical biases, and shortcomings of each method are examined in detail. 
      RESULTS: Each method of determining the MCID has specific shortcomings. Three 
      general limitations in the accurate determination of an MCID have been 
      identified: the multiplicity of MCID determinations, the loss of the patient's 
      perspective, and the relationship between pretreatment baseline and posttreatment 
      change scores. CONCLUSIONS: An ideal means of determining the MCID for a given 
      intervention is yet to be determined. It is possible to develop a useful method 
      provided that the assumptions and methodology are initially declared. Our efforts 
      toward the establishment of a MCID will rely on the establishment of specific 
      external criteria based on the symptoms of the patient and treatment intervention 
      being evaluated.
FAU - Copay, Anne G
AU  - Copay AG
AD  - The Spinal Research Foundation, 1831 Wiehle Avenue, Suite 200, Reston, VA 20190, 
      USA. acopay@spinemd.com
FAU - Subach, Brian R
AU  - Subach BR
FAU - Glassman, Steven D
AU  - Glassman SD
FAU - Polly, David W Jr
AU  - Polly DW Jr
FAU - Schuler, Thomas C
AU  - Schuler TC
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20070402
PL  - United States
TA  - Spine J
JT  - The spine journal : official journal of the North American Spine Society
JID - 101130732
SB  - IM
MH  - *Bias
MH  - Clinical Trials as Topic/*methods
MH  - *Data Interpretation, Statistical
MH  - Humans
MH  - Sensitivity and Specificity
MH  - Spinal Diseases/*therapy
MH  - Treatment Outcome
RF  - 35
EDAT- 2007/04/24 09:00
MHDA- 2008/01/05 09:00
CRDT- 2007/04/24 09:00
PHST- 2006/09/07 00:00 [received]
PHST- 2006/12/12 00:00 [revised]
PHST- 2007/01/24 00:00 [accepted]
PHST- 2007/04/24 09:00 [pubmed]
PHST- 2008/01/05 09:00 [medline]
PHST- 2007/04/24 09:00 [entrez]
AID - S1529-9430(07)00052-6 [pii]
AID - 10.1016/j.spinee.2007.01.008 [doi]
PST - ppublish
SO  - Spine J. 2007 Sep-Oct;7(5):541-6. doi: 10.1016/j.spinee.2007.01.008. Epub 2007 
      Apr 2.