PMID- 29290132
OWN - NLM
STAT- MEDLINE
DCOM- 20191017
LR  - 20191017
IS  - 1092-0684 (Electronic)
IS  - 1092-0684 (Linking)
VI  - 44
IP  - 1
DP  - 2018 Jan
TI  - Defining the minimum clinically important difference for grade I degenerative 
      lumbar spondylolisthesis: insights from the Quality Outcomes Database.
PG  - E2
LID - 2017.10.FOCUS17554 [pii]
LID - 10.3171/2017.10.FOCUS17554 [doi]
AB  - OBJECTIVE Patient-reported outcomes (PROs) play a pivotal role in defining the 
      value of surgical interventions for spinal disease. The concept of minimum 
      clinically important difference (MCID) is considered the new standard for 
      determining the effectiveness of a given treatment and describing patient 
      satisfaction in response to that treatment. The purpose of this study was to 
      determine the MCID associated with surgical treatment for degenerative lumbar 
      spondylolisthesis. METHODS The authors queried the Quality Outcomes Database 
      registry from July 2014 through December 2015 for patients who underwent 
      posterior lumbar surgery for grade I degenerative spondylolisthesis. Recorded 
      PROs included scores on the Oswestry Disability Index (ODI), EQ-5D, and numeric 
      rating scale (NRS) for leg pain (NRS-LP) and back pain (NRS-BP). Anchor-based 
      (using the North American Spine Society satisfaction scale) and 
      distribution-based (half a standard deviation, small Cohen's effect size, 
      standard error of measurement, and minimum detectable change [MDC]) methods were 
      used to calculate the MCID for each PRO. RESULTS A total of 441 patients (80 who 
      underwent laminectomies alone and 361 who underwent fusion procedures) from 11 
      participating sites were included in the analysis. The changes in functional 
      outcome scores between baseline and the 1-year postoperative evaluation were as 
      follows: 23.5 +/- 17.4 points for ODI, 0.24 +/- 0.23 for EQ-5D, 4.1 +/- 3.5 for NRS-LP, 
      and 3.7 +/- 3.2 for NRS-BP. The different calculation methods generated a range of 
      MCID values for each PRO: 3.3-26.5 points for ODI, 0.04-0.3 points for EQ-5D, 
      0.6-4.5 points for NRS-LP, and 0.5-4.2 points for NRS-BP. The MDC approach 
      appeared to be the most appropriate for calculating MCID because it provided a 
      threshold greater than the measurement error and was closest to the average 
      change difference between the satisfied and not-satisfied patients. On subgroup 
      analysis, the MCID thresholds for laminectomy-alone patients were comparable to 
      those for the patients who underwent arthrodesis as well as for the entire 
      cohort. CONCLUSIONS The MCID for PROs was highly variable depending on the 
      calculation technique. The MDC seems to be a statistically and clinically sound 
      method for defining the appropriate MCID value for patients with grade I 
      degenerative lumbar spondylolisthesis. Based on this method, the MCID values are 
      14.3 points for ODI, 0.2 points for EQ-5D, 1.7 points for NRS-LP, and 1.6 points 
      for NRS-BP.
FAU - Asher, Anthony L
AU  - Asher AL
AD  - 1Department of Neurosurgery, Carolina Neurosurgery and Spine Associates and 
      Neuroscience Institute, Carolinas HealthCare System, Charlotte, North Carolina.
FAU - Kerezoudis, Panagiotis
AU  - Kerezoudis P
AD  - 2Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
FAU - Mummaneni, Praveen V
AU  - Mummaneni PV
AD  - 3Department of Neurologic Surgery, University of California, San Francisco, 
      California.
FAU - Bisson, Erica F
AU  - Bisson EF
AD  - 4Department of Neurologic Surgery, University of Utah, Salt Lake City, Utah.
FAU - Glassman, Steven D
AU  - Glassman SD
AD  - 5Norton Leatherman Spine Center, Louisville, Kentucky.
FAU - Foley, Kevin T
AU  - Foley KT
AD  - 6Department of Neurologic Surgery, University of Tennessee, Memphis, Tennessee.
FAU - Slotkin, Jonathan R
AU  - Slotkin JR
AD  - 7Geisinger Health, Danville, Pennsylvania.
FAU - Potts, Eric A
AU  - Potts EA
AD  - 8Department of Neurologic Surgery, Indiana University; Goodman Campbell Brain and 
      Spine, Indianapolis, Indiana.
FAU - Shaffrey, Mark E
AU  - Shaffrey ME
AD  - 9Department of Neurologic Surgery, University of Virginia Health System, 
      Charlottesville, Virginia.
FAU - Shaffrey, Christopher I
AU  - Shaffrey CI
AD  - 9Department of Neurologic Surgery, University of Virginia Health System, 
      Charlottesville, Virginia.
FAU - Coric, Domagoj
AU  - Coric D
AD  - 1Department of Neurosurgery, Carolina Neurosurgery and Spine Associates and 
      Neuroscience Institute, Carolinas HealthCare System, Charlotte, North Carolina.
FAU - Knightly, John J
AU  - Knightly JJ
AD  - 10Atlantic Neurosurgical Specialists, Morristown, New Jersey.
FAU - Park, Paul
AU  - Park P
AD  - 11Department of Neurologic Surgery, University of Michigan, Ann Arbor, Michigan; 
      and.
FAU - Fu, Kai-Ming
AU  - Fu KM
AD  - 12Department of Neurologic Surgery, Weill Cornell Medical College, New York, New 
      York.
FAU - Devin, Clinton J
AU  - Devin CJ
AD  - 13Department of Orthopedic Surgery, Vanderbilt University.
FAU - Archer, Kristin R
AU  - Archer KR
AD  - 13Department of Orthopedic Surgery, Vanderbilt University.
AD  - 14Department of Physical Medicine and Rehabilitation, Vanderbilt University 
      Medical Center, Nashville, Tennessee.
FAU - Chotai, Silky
AU  - Chotai S
AD  - 13Department of Orthopedic Surgery, Vanderbilt University.
FAU - Chan, Andrew K
AU  - Chan AK
AD  - 3Department of Neurologic Surgery, University of California, San Francisco, 
      California.
FAU - Virk, Michael S
AU  - Virk MS
AD  - 12Department of Neurologic Surgery, Weill Cornell Medical College, New York, New 
      York.
FAU - Bydon, Mohamad
AU  - Bydon M
AD  - 2Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Neurosurg Focus
JT  - Neurosurgical focus
JID - 100896471
SB  - IM
EIN - Neurosurg Focus. 2018 Apr;44(4):E15. PMID: 29606043
MH  - Adult
MH  - Aged
MH  - Back Pain/etiology/*surgery
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/*surgery
MH  - Lumbosacral Region/*surgery
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement/methods
MH  - Patient Satisfaction
MH  - Spondylolisthesis/diagnosis/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - AUC = area under the curve
OT  - HTI = health transition item
OT  - MCID
OT  - MCID = minimum clinically important difference
OT  - MDC = minimum detectable change
OT  - NASS = North American Spine Society
OT  - NRS-BP = numeric rating scale for back pain
OT  - NRS-LP = NRS for leg pain
OT  - ODI = Oswestry Disability Index
OT  - PRO = patient-reported outcome
OT  - QOD = Quality Outcomes Database
OT  - Quality Outcomes Database
OT  - ROC = receiver operating characteristic
OT  - SD = standard deviation
OT  - SEM = standard error of measurement
OT  - TLIF = transforaminal interbody fusion
OT  - VAS = visual analog scale
OT  - lumbar
OT  - minimum clinically important difference
OT  - patient-reported outcomes
OT  - quality of life
OT  - spondylolisthesis
EDAT- 2018/01/02 06:00
MHDA- 2019/10/18 06:00
CRDT- 2018/01/02 06:00
PHST- 2018/01/02 06:00 [entrez]
PHST- 2018/01/02 06:00 [pubmed]
PHST- 2019/10/18 06:00 [medline]
AID - 2017.10.FOCUS17554 [pii]
AID - 10.3171/2017.10.FOCUS17554 [doi]
PST - ppublish
SO  - Neurosurg Focus. 2018 Jan;44(1):E2. doi: 10.3171/2017.10.FOCUS17554.