PMID- 22395333
OWN - NLM
STAT- MEDLINE
DCOM- 20120830
LR  - 20120509
IS  - 1536-5409 (Electronic)
IS  - 0749-8047 (Linking)
VI  - 28
IP  - 5
DP  - 2012 Jun
TI  - What does/should the minimum clinically important difference measure? A 
      reconsideration of its clinical value in evaluating efficacy of lumbar fusion 
      surgery.
PG  - 387-97
LID - 10.1097/AJP.0b013e3182327f20 [doi]
AB  - OBJECTIVES: The Minimum Clinical Important Difference (MCID) was initially 
      intended to provide outcome measures that would be more clinically meaningful 
      than measurements based simply on mean improvement in some outcomes. Indeed, a 
      basic concept behind the MCID was that statistically significant differences in 
      measures did not necessarily reflect clinically meaningful benefits. METHODS: 
      This study provides a review of the literature suggesting that the MCID metric is 
      not being applied and interpreted in practice in a manner that realizes its 
      potential. The MCID has often been used as a means of delineating whether 
      patients are "feeling better." This does not, though, necessarily indicate that 
      they are "doing better" in terms of physical or socioeconomic functioning. 
      RESULTS: The imperfect correlation between "feeling" and "doing" better makes it 
      difficult to interpret the clinical implications of articles using MCID measures, 
      particularly in the lumbar spine fusion literature. Alternative and more 
      scientifically rigorous approaches to the MCID are presented. DISCUSSION: A call 
      is made for a more comprehensive approach to synthesize a nearly decade's worth 
      of clinical research that has still not yielded consensus concerning the best 
      MCID approach to objectively document lumbar spine fusion patients' outcomes.
FAU - Gatchel, Robert J
AU  - Gatchel RJ
AD  - University of Texas at Arlington, TX, USA. gatchel@uta.edu
FAU - Mayer, Tom G
AU  - Mayer TG
FAU - Chou, Roger
AU  - Chou R
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Clin J Pain
JT  - The Clinical journal of pain
JID - 8507389
SB  - IM
MH  - Adaptation, Psychological
MH  - Disability Evaluation
MH  - Employment
MH  - Humans
MH  - Low Back Pain/economics/surgery
MH  - *Lumbosacral Region
MH  - Pain/etiology
MH  - Recovery of Function
MH  - Reproducibility of Results
MH  - Socioeconomic Factors
MH  - *Spinal Fusion/economics
MH  - Treatment Outcome
EDAT- 2012/03/08 06:00
MHDA- 2012/08/31 06:00
CRDT- 2012/03/08 06:00
PHST- 2012/03/08 06:00 [entrez]
PHST- 2012/03/08 06:00 [pubmed]
PHST- 2012/08/31 06:00 [medline]
AID - 10.1097/AJP.0b013e3182327f20 [doi]
PST - ppublish
SO  - Clin J Pain. 2012 Jun;28(5):387-97. doi: 10.1097/AJP.0b013e3182327f20.