PMID- 23328688
OWN - NLM
STAT- MEDLINE
DCOM- 20131104
LR  - 20211021
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 72
IP  - 5
DP  - 2013 May
TI  - Microvascular decompression for classic trigeminal neuralgia: determination of 
      minimum clinically important difference in pain improvement for patient reported 
      outcomes.
PG  - 749-54; discussion 754
LID - 10.1227/NEU.0b013e318286fad2 [doi]
AB  - BACKGROUND: Outcomes studies use patient-reported outcome (PRO) measurements to 
      assess treatment effectiveness, but can lack direct clinical meaning. Minimum 
      clinically important difference (MCID) calculation provides a point estimate of 
      the critical threshold needed to achieve clinically relevant treatment 
      effectiveness. MCID remains uninvestigated for microvascular decompression (MVD), 
      a common surgical procedure for trigeminal neuralgia. OBJECTIVE: We aimed to 
      determine MCID for the most commonly used PRO measures of pain after MVD: Visual 
      Analog Scale (VAS) and Barrow Neurological Institute Pain Scale (BNI-PS). 
      METHODS: Sixty consecutive patients with classic trigeminal neuralgia who decided 
      to undergo MVD by a single surgeon were prospectively assessed with VAS and 
      BNI-PS preoperatively and 2 years postoperatively. Three anchors were used to 
      assign each patient's outcome. We then used 3 well-established, anchor-based 
      methods to calculate MCID. RESULTS: Patients experienced significant improvement 
      in both VAS (9.9 vs. 2.0, P < .001) and BNI-PS (5.0 vs. 1.9, P < .001) after MVD. 
      The area under the receiver-operating characteristic curve was greater for BNI-PS 
      than for VAS for all 3 anchors, indicating that BNI-PS is probably better suited 
      for calculating MCID. The 3 MCID calculation methods generated a range of MCID 
      values for each of the PROs (VAS: 1.40-8.87, BNI-PS: 0.95-3.26). CONCLUSION: 
      MVD-specific MCID is highly variable based on calculation technique. Some of 
      these calculations appear to either overestimate or underestimate the patients' 
      preoperative expectations. When the different MCID methods are averaged, the 
      results are clinically appropriate and consistent with preoperative expectations. 
      The average MCID for VAS is 6.25 and for BNI-PS is 2.44.
FAU - Reddy, Vishruth K
AU  - Reddy VK
AD  - Vanderbilt University Medical Center, Nashville, Tennessee, USA.
FAU - Parker, Scott L
AU  - Parker SL
FAU - Patrawala, Samit A
AU  - Patrawala SA
FAU - Lockney, Dennis T
AU  - Lockney DT
FAU - Su, Pei-Fang
AU  - Su PF
FAU - Mericle, Robert A
AU  - Mericle RA
LA  - eng
GR  - T35 HL090555/HL/NHLBI NIH HHS/United States
GR  - T-35 HL090555/HL/NHLBI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - *Diagnostic Self Evaluation
MH  - Female
MH  - Humans
MH  - Male
MH  - *Microvascular Decompression Surgery
MH  - Middle Aged
MH  - Pain/*diagnosis/etiology/*prevention & control
MH  - Pain Measurement/*methods
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
MH  - Trigeminal Neuralgia/complications/*diagnosis/*surgery
EDAT- 2013/01/19 06:00
MHDA- 2013/11/05 06:00
CRDT- 2013/01/19 06:00
PHST- 2013/01/19 06:00 [entrez]
PHST- 2013/01/19 06:00 [pubmed]
PHST- 2013/11/05 06:00 [medline]
AID - 10.1227/NEU.0b013e318286fad2 [doi]
PST - ppublish
SO  - Neurosurgery. 2013 May;72(5):749-54; discussion 754. doi: 
      10.1227/NEU.0b013e318286fad2.