PMID- 29215503
OWN - NLM
STAT- MEDLINE
DCOM- 20181116
LR  - 20210115
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 43
IP  - 13
DP  - 2018 Jul 1
TI  - Minimum Detectable Measurement Difference for Health-Related Quality of Life 
      Measures Varies With Age and Disability in Adult Spinal Deformity: Implications 
      for Calculating Minimal Clinically Important Difference.
PG  - E790-E795
LID - 10.1097/BRS.0000000000002519 [doi]
AB  - STUDY DESIGN: Retrospective cohort. OBJECTIVE: To investigate the minimum 
      detectable measurement difference (MDMD) in the Scoliosis Research Society-22r 
      (SRS-22r) outcomes instrument in adult spinal deformity (ASD) and to evaluate the 
      effect of baseline data on measurable difference. SUMMARY OF BACKGROUND DATA: The 
      minimum clinically important difference (MCID) is the smallest, clinically 
      relevant change observed and has been proposed for the SRS-22r instrument in ASD 
      as 0.4. The MCID must be greater than the MDMD to be useful. The MDMD for the 
      SRS-22r has not been calculated, nor have the effect of patient baseline values 
      on MDMD. METHODS: A prospective observation cohort was queried for patients 
      treated both operatively and nonoperatively for ASD. Patients with baseline and 
      1-year, 2-year follow-up SRS-22r data were included in the analysis. The MDMD was 
      calculated using classical test theory and item-response theory methods. Effect 
      size and standardized response means were calculated. The effect of baseline data 
      values was evaluated for MDMD. RESULTS: A total 839 Patients were eligible for 
      cohort inclusion with 428 (51%) eligible for analysis with complete data. MDMD 
      for Pain (0.6) and Self-Image (0.5) were greater than 0.4. MDMD varied with age 
      (highest for the youngest patients) and with disability (highest for SF-36 
      Physical Component Summary <28.6). MDMD was less than 0.4 for Activity (0.3), 
      Mental Health (0.3), and Total Score (0.2). Gender and mental health did not 
      affect MDMD for the SRS-22r instrument. CONCLUSION: An MCID of 0.4 for the 
      SRS-22r total score and domain scores may not be an appropriate value as the 
      calculated MDMD is greater than 0.4 for both the Pain and Self-Image subscores. 
      The MDMD for the SRS-22r instrument varied with age and baseline disability, 
      making the assessment of clinically significant change more difficult using this 
      tool. The MCID must be considered in the setting of the MDMD for instruments used 
      to assess outcomes in ASD. LEVEL OF EVIDENCE: 3.
FAU - Kelly, Michael P
AU  - Kelly MP
AD  - Department of Orthopedic Surgery, Washington University School of Medicine, Saint 
      Louis, MO.
FAU - Kim, Han Jo
AU  - Kim HJ
AD  - Hospital for Special Surgery, New York, NY.
FAU - Ames, Christopher P
AU  - Ames CP
AD  - Department of Neurological Surgery, University of California, San Francisco, San 
      Francisco, CA.
FAU - Burton, Douglas C
AU  - Burton DC
AD  - Department of Orthopedic Surgery, University of Kansas, Kansas City, KS.
FAU - Carreon, Leah Yacat
AU  - Carreon LY
AD  - Norton Leatherman Spine Center, Louisville, KY.
FAU - Polly, David W Jr
AU  - Polly DW Jr
AD  - Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.
FAU - Hostin, Richard
AU  - Hostin R
AD  - Department of Orthopedic Surgery, Baylor Scoliosis Center, Plano, TX.
FAU - Jain, Amit
AU  - Jain A
AD  - Department of Orthopedic Surgery, Johns Hopkins Medical School, Baltimore, MD.
FAU - Gum, Jeffrey L
AU  - Gum JL
AD  - Norton Leatherman Spine Center, Louisville, KY.
FAU - Lafage, Virginie
AU  - Lafage V
AD  - Hospital for Special Surgery, New York, NY.
FAU - Schwab, Frank J
AU  - Schwab FJ
AD  - Hospital for Special Surgery, New York, NY.
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - Department of Neurological Surgery, University of Virginia Medical Center, 
      Charlottesville, VA.
FAU - Smith, Justin S
AU  - Smith JS
AD  - Department of Neurological Surgery, University of Virginia Medical Center, 
      Charlottesville, VA.
FAU - Bess, Shay
AU  - Bess S
AD  - Rocky Mountain Scoliosis and Spine, Denver, CO.
CN  - International Spine Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Cohort Studies
MH  - Disabled Persons/*psychology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kyphosis/*psychology/*therapy
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Prospective Studies
MH  - Quality of Life/*psychology
MH  - Retrospective Studies
MH  - Self Concept
EDAT- 2017/12/08 06:00
MHDA- 2018/11/18 06:00
CRDT- 2017/12/08 06:00
PHST- 2017/12/08 06:00 [pubmed]
PHST- 2018/11/18 06:00 [medline]
PHST- 2017/12/08 06:00 [entrez]
AID - 00007632-201807010-00021 [pii]
AID - 10.1097/BRS.0000000000002519 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2018 Jul 1;43(13):E790-E795. doi: 
      10.1097/BRS.0000000000002519.