PMID- 24335815
OWN - NLM
STAT- MEDLINE
DCOM- 20141014
LR  - 20211021
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 74
IP  - 3
DP  - 2014 Mar
TI  - Percutaneous stereotactic radiofrequency lesioning for trigeminal neuralgia: 
      determination of minimum clinically important difference in pain improvement for 
      patient-reported outcomes.
PG  - 262-6; discussion 266
LID - 10.1227/NEU.0000000000000262 [doi]
AB  - BACKGROUND: The Visual Analog Scale (VAS) and the Barrow Neurological Institute 
      Pain Scale (BNI-PS) are 2 patient-reported outcome (PRO) tools frequently used to 
      rate pain from trigeminal neuralgia (TN). Outcomes studies often use these 
      patient-reported outcomes to assess treatment effectiveness, but it is unknown 
      exactly what degree of change in the numerical scores constitutes the minimum 
      clinically important difference (MCID). MCID remains uninvestigated for 
      percutaneous stereotactic radiofrequency lesioning (RFL), a common surgical 
      procedure for TN. OBJECTIVE: To determine MCID values for the VAS and BNI-PS in 
      patients undergoing RFL. METHODS: Forty-three consecutive patients with TN who 
      underwent RFL by a single surgeon were prospectively assessed with the VAS and 
      BNI-PS preoperatively and 3 years postoperatively. Three anchors were used to 
      assign each patient's outcome: satisfaction, willingness to have the surgery 
      again, and Health Transition Index. We then used 3 well-established, anchor-based 
      methods to calculate MCID: average change, minimum detectable change, and change 
      difference. RESULTS: Patients experienced substantial improvement in both VAS 
      (9.81 vs 3.35; P < .001) and BNI-PS (4.95 vs 2.44; P < .001) after RFL. The 3 
      MCID calculation methods generated a range of MCID values for each of the PROs 
      (VAS, 4.13-8.20; BNI-PS, 1.03-3.30). The area under the receiver-operating 
      characteristic curve was greater for BNI-PS compared with VAS for all 3 anchors, 
      indicating that BNI-PS is probably better suited for calculating MCID. 
      CONCLUSION: RFL-specific MCID is variable on the basis of the calculation 
      technique. With the use of the minimum detectable change calculation method with 
      the Health Transition Index anchor, the minimum clinically important difference 
      is 4.49 for VAS and 1.16 for BNI-PS after RFL for TN. ABBREVIATIONS: AUC, area 
      under the receiver-operating characteristic curveBNI-PS, Barrow Neurological 
      Institute Pain ScaleHTI, Health Transition IndexMCID, minimum clinically 
      important differenceMDC, minimum detectable changePRO, patient-reported 
      outcomeRFL, percutaneous stereotactic radiofrequency lesioningTN, trigeminal 
      neuralgiaVAS, Visual Analog Scale.
FAU - Reddy, Vishruth K
AU  - Reddy VK
AD  - *Vanderbilt University Medical Center, Nashville, Tennessee; double daggerVanderbilt 
      University Center for Quantitative Sciences, Nashville, Tennessee;  section signDepartment of 
      Statistics, National Cheng Kung University, Tainan, Taiwan;  paragraph signHW Neurological 
      Institute, Nashville, Tennessee.
FAU - Parker, Scott L
AU  - Parker SL
FAU - Lockney, Dennis T
AU  - Lockney DT
FAU - Patrawala, Samit A
AU  - Patrawala SA
FAU - Su, Pei-Fang
AU  - Su PF
FAU - Mericle, Robert A
AU  - Mericle RA
LA  - eng
GR  - T32 GM007347/GM/NIGMS NIH HHS/United States
GR  - T32 GM07347/GM/NIGMS NIH HHS/United States
GR  - T35HL090555/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - *Patient Outcome Assessment
MH  - ROC Curve
MH  - Radiosurgery/*methods
MH  - Trigeminal Neuralgia/psychology/*surgery
EDAT- 2013/12/18 06:00
MHDA- 2014/10/15 06:00
CRDT- 2013/12/17 06:00
PHST- 2013/12/17 06:00 [entrez]
PHST- 2013/12/18 06:00 [pubmed]
PHST- 2014/10/15 06:00 [medline]
AID - 10.1227/NEU.0000000000000262 [doi]
PST - ppublish
SO  - Neurosurgery. 2014 Mar;74(3):262-6; discussion 266. doi: 
      10.1227/NEU.0000000000000262.