PMID- 27927495
OWN - NLM
STAT- MEDLINE
DCOM- 20180927
LR  - 20200109
IS  - 2212-1358 (Electronic)
IS  - 2212-134X (Linking)
VI  - 4
IP  - 5
DP  - 2016 Sep
TI  - The Substantial Clinical Benefit Threshold for SRS-22R Domains After Surgical 
      Treatment of Adult Spinal Deformity.
PG  - 373-377
LID - S2212-134X(16)30066-1 [pii]
LID - 10.1016/j.jspd.2016.05.001 [doi]
AB  - STUDY DESIGN: Longitudinal cohort. OBJECTIVES: To determine Substantial Clinical 
      Benefit (SCB) thresholds for the SRS22R domains in patients undergoing adult 
      spinal deformity surgery. SUMMARY OF BACKGROUND DATA: The Scoliosis Research 
      Society 22R (SRS22R) has been shown to be reliable, valid, and responsive to 
      change in adult spinal deformity patients. Although the minimal clinically 
      important difference (MCID) is commonly used to quantify a threshold of 
      improvement, it could be considered a floor value rather than a goal. METHODS: 
      Patients enrolled in a prospective database of adult spinal deformity undergoing 
      surgery with complete SRS22R preoperation and the SRS30 one-year after surgery 
      were identified. One-year postoperative answers to the last 8 questions of the 
      SRS30 were used as anchors to determine the SCB for the Appearance and Activity 
      domains, Subtotal and Total Score using ROC Curve analysis. RESULTS: The sample 
      population consisted of 1,422 patients; 83% were females. Mean age was 53 +/- 16 
      years. Mean preoperative SRS22R Appearance score was 2.50 +/- 0.73 improving to 
      3.62 +/- 0.84 at one year postoperative. Mean preoperative SRS22R Activity score 
      was 2.96 +/- 0.59 improving to 3.33 +/- 0.80 at one year postoperative. Mean 
      preoperative SRS22R Pain score was 2.73 +/- 0.92 improving to 3.60 +/- 0.93 at one 
      year postoperative. Mean preoperative SRS22R Subtotal was 2.56 +/- 0.66 improving 
      to 3.11 +/- 0.80 at one year postoperative. There was a statistically significant 
      difference in domain scores among the responses to the anchors (p < .001). Based 
      on ROC analysis, SCB was 1.60 for Appearance, 0.87 for Activity, 0.69 for 
      Subtotal, and 0.94 for Total score. CONCLUSION: The results of the current study 
      in an adult spinal deformity population undergoing surgical treatment show SRS22R 
      SCB values of 1.60 for Appearance, 0.87 for Activity, 0.69 for Subtotal, and 0.94 
      for Total score. These SCB thresholds can be used to quantify the clinical 
      significance of health status change in the surgical management of adult spinal 
      deformity. LEVEL OF EVIDENCE: Level II.
CI  - Copyright (c) 2016 Scoliosis Research Society. Published by Elsevier Inc. All 
      rights reserved.
FAU - Crawford, Charles H 3rd
AU  - Crawford CH 3rd
AD  - Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 
      40202, USA; University of Louisville School of Medicine Department of Orthopaedic 
      Surgery, 550 S. Jackson St., 1st Floor ACB, Louisville, KY 40202, USA.
FAU - Glassman, Steven D
AU  - Glassman SD
AD  - Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 
      40202, USA; University of Louisville School of Medicine Department of Orthopaedic 
      Surgery, 550 S. Jackson St., 1st Floor ACB, Louisville, KY 40202, USA.
FAU - Bridwell, Keith H
AU  - Bridwell KH
AD  - Department of Orthopaedic Surgery, Washington University School of Medicine, 660 
      S Euclid Ave, Campus Box 8233, St. Louis, MO 63110, USA.
FAU - Carreon, Leah Y
AU  - Carreon LY
AD  - Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 
      40202, USA. Electronic address: leah.carreon@nortonhealthcare.org.
LA  - eng
PT  - Journal Article
DEP - 20160821
PL  - England
TA  - Spine Deform
JT  - Spine deformity
JID - 101603979
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - *Health Status
MH  - Humans
MH  - Middle Aged
MH  - Postoperative Period
MH  - Prospective Studies
MH  - *Quality of Life
MH  - Scoliosis/*surgery
MH  - Spine/*abnormalities/surgery
OTO - NOTNLM
OT  - Adult spinal deformity
OT  - Clinical outcomes
OT  - SRS-22R
OT  - Substantial clinical benefit
EDAT- 2016/12/09 06:00
MHDA- 2018/09/28 06:00
CRDT- 2016/12/09 06:00
PHST- 2016/03/03 00:00 [received]
PHST- 2016/05/08 00:00 [accepted]
PHST- 2016/12/09 06:00 [entrez]
PHST- 2016/12/09 06:00 [pubmed]
PHST- 2018/09/28 06:00 [medline]
AID - S2212-134X(16)30066-1 [pii]
AID - 10.1016/j.jspd.2016.05.001 [doi]
PST - ppublish
SO  - Spine Deform. 2016 Sep;4(5):373-377. doi: 10.1016/j.jspd.2016.05.001. Epub 2016 
      Aug 21.