PMID- 29652783
OWN - NLM
STAT- MEDLINE
DCOM- 20190531
LR  - 20210115
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 43
IP  - 21
DP  - 2018 Nov 1
TI  - Minimum Clinically Important Difference in SF-36 Scores for Use in Degenerative 
      Cervical Myelopathy.
PG  - E1260-E1266
LID - 10.1097/BRS.0000000000002684 [doi]
AB  - STUDY DESIGN: Post-hoc analysis of 606 patients enrolled in the AOSpine CSM-NA or 
      CSM-I prospective, multicenter cohort studies. OBJECTIVE: The aim of this study 
      was to determine the minimum clinically important difference (MCID) in SF-36v2 
      Physical Component Summary (PCS) and Mental Component Summary (MCS) scores in 
      patients undergoing surgery for degenerative cervical myelopathy (DCM). SUMMARY 
      OF BACKGROUND DATA: There has been a shift toward focus on patient-reported 
      outcomes (PROs) in spine surgery. However, the numerical scores of PROs lack 
      immediate clinical meaning. The MCID adds a dimension of interpretability to PRO 
      scales; by defining the smallest change, a patient would consider meaningful. 
      METHODS: The MCID of the SF-36v2 PCS and MCS were determined by distribution- and 
      anchor-based methods comparing preoperative to 12-month scores. 
      Distribution-based approaches included calculation of the half standard deviation 
      and standard error of measurement (SEM). Change in Neck Disability Index (NDI) 
      served as the anchor: "worse" (DeltaNDI>7.5); "unchanged" (7.5>/=DeltaNDI>-7.5); "slightly 
      improved" (-7.5>/=DeltaNDI>-15); and "markedly improved" (DeltaNDI </=-15). Receiver 
      operating characteristic (ROC) analysis was performed to determine the change 
      score for the MCID with even sensitivity and specificity to distinguish patients 
      who were "slightly improved" versus "unchanged" on the NDI. RESULTS: The MCID for 
      the SF-36v2 PCS and MCS were 4.6 and 6.8 by half standard deviation and 2.9 and 
      4.3 by SEM, respectively. By ROC analysis, the MCID was 3.9 for the SF-36v2 PCS 
      score and 3.2 for the SF-36v2 MCS score. Using a cutoff of 4 points, the SF-36v2 
      PCS had a sensitivity of 72.2% and specificity of 68.1%, and MCS 61.9% and 64.6%, 
      respectively, in separating patients who were "markedly improved" or "slightly 
      improved" from those who were "unchanged" or "worse." CONCLUSION: We found the 
      MCID of the SF-36v2 PCS and MCS to be 4 points. This will facilitate use of the 
      SF-36v2 as an outcome in future studies of DCM. LEVEL OF EVIDENCE: 3.
FAU - Badhiwala, Jetan H
AU  - Badhiwala JH
AD  - Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, 
      Ontario, Canada.
FAU - Witiw, Christopher D
AU  - Witiw CD
FAU - Nassiri, Farshad
AU  - Nassiri F
FAU - Akbar, Muhammad A
AU  - Akbar MA
FAU - Jaja, Blessing
AU  - Jaja B
FAU - Wilson, Jefferson R
AU  - Wilson JR
FAU - Fehlings, Michael G
AU  - Fehlings MG
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cervical Vertebrae
MH  - Decompression, Surgical
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - *Patient Reported Outcome Measures
MH  - Prospective Studies
MH  - ROC Curve
MH  - Spinal Cord Compression/*surgery
MH  - Spinal Diseases/complications/*surgery
EDAT- 2018/04/14 06:00
MHDA- 2019/06/01 06:00
CRDT- 2018/04/14 06:00
PHST- 2018/04/14 06:00 [pubmed]
PHST- 2019/06/01 06:00 [medline]
PHST- 2018/04/14 06:00 [entrez]
AID - 00007632-201811010-00005 [pii]
AID - 10.1097/BRS.0000000000002684 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2018 Nov 1;43(21):E1260-E1266. doi: 
      10.1097/BRS.0000000000002684.