PMID- 30986576
OWN - NLM
STAT- MEDLINE
DCOM- 20200413
LR  - 20200413
IS  - 1878-1632 (Electronic)
IS  - 1529-9430 (Linking)
VI  - 19
IP  - 8
DP  - 2019 Aug
TI  - The minimum detectable measurement difference for the Scoliosis Research 
      Society-22r in adolescent idiopathic scoliosis: a comparison with the minimum 
      clinically important difference.
PG  - 1319-1323
LID - S1529-9430(19)30127-5 [pii]
LID - 10.1016/j.spinee.2019.04.008 [doi]
AB  - BACKGROUND CONTEXT: The minimal clinically important difference (MCID) is the 
      smallest change in an outcomes instrument deemed relevant to a patient. MCID 
      values proposed in spine research are limited by poor discriminative abilities to 
      accurately classify patients as "improved" or "not improved." Furthermore, the 
      MCID should not compare relative effectiveness between two groups of patients, 
      though it is frequently used for this. The minimum detectable measurement 
      difference (MDMD) is an alternative to the MCID in outcomes research. The MDMD 
      must be greater than the MCID for the latter to be of value and the MDMD can 
      compare change between groups. PURPOSE: The purpose of this study was to 
      determine the MDMD for the Scoliosis Research Society-22r (SRS-22r) in adolescent 
      idiopathic scoliosis (AIS) patients treated with surgery. STUDY DESIGN: 
      Retrospective cohort study from multi-center registry. PATIENT SAMPLE: Patients 
      treated surgically for AIS. OUTCOME MEASURES: Self-reported SRS-22r. METHODS: An 
      observational cohort of surgically treated AIS patients was queried for patients 
      with complete baseline, 1-year, and 2-year SRS-22r data. The MDMD was calculated 
      for SRS-22r domain and subscores. Effect size (ES) and standardized response mean 
      were calculated to measure responsiveness of the SRS-22r to change. MDMD values 
      were compared with MCID values. Research grants were received from DePuy Synthes 
      Spine, EOS imaging, K2M, Medtronic, NuVasive, and Zimmer Biomet to Setting 
      Scoliosis Straight Foundation. RESULTS: One thousand two hundred and eighty-one 
      AIS patients (1,034 female, 247 male, mean age 14.6 years) were analyzed. MDMD 
      values were between 0.23 and 0.31. SRS-Pain MDMD was 0.3, greater than the MCID 
      of 0.2. SRS-Activity MDMD was 0.24, greater than the MCID of 0.08. SRS-self-image 
      MDMD was 0.3, less than the MCID of 0.98. Sixty-four percent of those with 
      baseline SRS-self-image>4.0 improved MDMD or more, whereas only 14% improved 
      beyond the MCID. ES and standardized response mean were highest for subscore and 
      self-image. CONCLUSIONS: The MDMD can compare the relevance of change in SRS-22r 
      scores between groups of AIS patients. SRS-pain and SRS-activity MDMD values are 
      greater than the MCID and should serve as the threshold for clinically relevant 
      improvement. MDMD may help evaluate change in patients with baseline 
      self-image>4.0.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Kelly, Michael P
AU  - Kelly MP
AD  - Washington University School of Medicine, Saint Louis, MO, USA. Electronic 
      address: kellymi@wudosis.wustl.edu.
FAU - Lenke, Lawrence G
AU  - Lenke LG
AD  - The Spine Hospital, Columbia College of Physicians and Surgeons, 5141 Broadway, 
      New York, NY 10034, USA.
FAU - Sponseller, Paul D
AU  - Sponseller PD
AD  - Division of Pediatric Orthopaedics, All Children's Hospital at Johns Hopkins, 
      1800 Orleans St., Baltimore, MD 21287, USA.
FAU - Pahys, Joshua M
AU  - Pahys JM
AD  - Shriners' Hospital for Children, 3551 N Broad St, Philadelphia, PA 19140, USA.
FAU - Bastrom, Tracey P
AU  - Bastrom TP
AD  - Department of Orthopedic Surgery, Rady Children's Hospital, 3020 Children's Way, 
      San Diego, CA 92123, USA.
FAU - Lonner, Baron S
AU  - Lonner BS
AD  - Department of Orthopaedic Surgery, Mount Sinai Hospital, 1 Gustave L. Levy Pl, 
      New York, NY 10029, USA.
FAU - Abel, Mark F
AU  - Abel MF
AD  - University of Virginia School of Medicine, 1215 Lee St, Charlottesville, VA 
      22908, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190412
PL  - United States
TA  - Spine J
JT  - The spine journal : official journal of the North American Spine Society
JID - 101130732
SB  - IM
MH  - Adolescent
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - *Minimal Clinically Important Difference
MH  - Neurosurgical Procedures/standards/statistics & numerical data
MH  - Quality of Life
MH  - Scoliosis/*surgery
MH  - Self Report
OTO - NOTNLM
OT  - Adolescent idiopathic scoliosis
OT  - Comparative effectiveness
OT  - Minimum clinically important difference
OT  - Minimum detectable change
OT  - Patient reported outcomes
OT  - SRS-22r
EDAT- 2019/04/16 06:00
MHDA- 2020/04/14 06:00
CRDT- 2019/04/16 06:00
PHST- 2018/10/23 00:00 [received]
PHST- 2019/04/03 00:00 [revised]
PHST- 2019/04/09 00:00 [accepted]
PHST- 2019/04/16 06:00 [pubmed]
PHST- 2020/04/14 06:00 [medline]
PHST- 2019/04/16 06:00 [entrez]
AID - S1529-9430(19)30127-5 [pii]
AID - 10.1016/j.spinee.2019.04.008 [doi]
PST - ppublish
SO  - Spine J. 2019 Aug;19(8):1319-1323. doi: 10.1016/j.spinee.2019.04.008. Epub 2019 
      Apr 12.