PMID- 19544075
OWN - NLM
STAT- MEDLINE
DCOM- 20100708
LR  - 20211020
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Print)
IS  - 0940-6719 (Linking)
VI  - 18
IP  - 12
DP  - 2009 Dec
TI  - What is an acceptable outcome of treatment before it begins? Methodological 
      considerations and implications for patients with chronic low back pain.
PG  - 1858-66
LID - 10.1007/s00586-009-1070-1 [doi]
AB  - Understanding changes in patient-reported outcomes is indispensable for 
      interpretation of results from clinical studies. As a consequence the term 
      "minimal clinically important difference" (MCID) was coined in the late 1980s to 
      ease classification of patients into improved, not changed or deteriorated. 
      Several methodological categories have been developed determining the MCID, 
      however, all are subject to weaknesses or biases reducing the validity of the 
      reported MCID. The objective of this study was to determine the reproducibility 
      and validity of a novel method for estimating low back pain (LBP) patients' view 
      of an acceptable change (MCID(pre)) before treatment begins. One-hundred and 
      forty-seven patients with chronic LBP were recruited from an out-patient hospital 
      back pain unit and followed over an 8-week period. Original and modified versions 
      of the Oswestry disability index (ODI), Bournemouth questionnaire (BQ) and 
      numeric pain rating scale (NRS(pain)) were filled in at baseline. The modified 
      questionnaires determined what the patient considered an acceptable 
      post-treatment outcome which allowed us to calculate the MCID(pre). Concurrent 
      comparisons between the MCID(pre), instrument measurement error and a 
      retrospective approach of establishing the minimal clinically important 
      difference (MCID(post)) were made. The results showed the prospective acceptable 
      outcome method scores to have acceptable reproducibility outside measurement 
      error. MCID(pre) was 4.5 larger for the ODI and 1.5 times larger for BQ and 
      NRS(pain) compared to the MCID(post). Furthermore, MCID(pre) and patients 
      post-treatment acceptable change was almost equal for the NRS(pain) but not for 
      the ODI and BQ. In conclusion, chronic LBP patients have a reasonably realistic 
      idea of an acceptable change in pain, but probably an overly optimistic view of 
      changes in functional and psychological/affective domains before treatment 
      begins.
FAU - Lauridsen, Henrik Hein
AU  - Lauridsen HH
AD  - Clinical Locomotion Science, Institute for Sports Science and Clinical 
      Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, 
      Denmark. hlauridsen@health.sdu.dk
FAU - Manniche, Claus
AU  - Manniche C
FAU - Korsholm, Lars
AU  - Korsholm L
FAU - Grunnet-Nilsson, Niels
AU  - Grunnet-Nilsson N
FAU - Hartvigsen, Jan
AU  - Hartvigsen J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090623
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Attitude to Health
MH  - Chronic Disease/prevention & control/therapy
MH  - Female
MH  - Humans
MH  - Illness Behavior
MH  - Low Back Pain/diagnosis/*psychology/*therapy
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care/*methods
MH  - Pain Clinics/statistics & numerical data
MH  - Pain Measurement/*methods
MH  - Pilot Projects
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Psychology
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - *Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC2899444
EDAT- 2009/06/23 09:00
MHDA- 2010/07/09 06:00
PMCR- 2010/12/01
CRDT- 2009/06/23 09:00
PHST- 2008/08/20 00:00 [received]
PHST- 2009/06/01 00:00 [accepted]
PHST- 2009/04/27 00:00 [revised]
PHST- 2009/06/23 09:00 [entrez]
PHST- 2009/06/23 09:00 [pubmed]
PHST- 2010/07/09 06:00 [medline]
PHST- 2010/12/01 00:00 [pmc-release]
AID - 1070 [pii]
AID - 10.1007/s00586-009-1070-1 [doi]
PST - ppublish
SO  - Eur Spine J. 2009 Dec;18(12):1858-66. doi: 10.1007/s00586-009-1070-1. Epub 2009 
      Jun 23.