PMID- 33290370
OWN - NLM
STAT- MEDLINE
DCOM- 20210608
LR  - 20230830
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 46
IP  - 9
DP  - 2021 May 1
TI  - The Minimum Clinically Important Difference for Patient Health Questionnaire-9 in 
      Minimally Invasive Transforaminal Interbody Fusion.
PG  - 603-609
LID - 10.1097/BRS.0000000000003853 [doi]
AB  - STUDY DESIGN: Retrospective cohort. OBJECTIVE: To investigate and establish 
      minimum clinically important differences (MCID) for Patient Health 
      Questionnaire-9 (PHQ-9) among patients undergoing minimally invasive 
      transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND: Spine 
      surgery is linked to postoperative improvements in anxiety, depression, and 
      mental health. These improvements have been documented using patient-reported 
      outcome measures such as PHQ-9. Few studies evaluated the clinical significance 
      of PHQ-9 for lumbar spine surgery. METHODS: Patients who underwent single-level, 
      primary MIS TLIF from 2015 to 2017 were retrospectively reviewed in a prospective 
      database. Patients with incomplete preoperative and 2-year postoperative PHQ-9 
      surveys were excluded. Demographic and perioperative characteristics were 
      recorded. PHQ-9, 12-Item Short Form (SF-12), and Veterans RAND 12-Item Health 
      Survey (VR-12) Mental Component Summary (MCS) were collected at preoperative, 
      6-week, 12-week, 6-month, 1-year, and 2-year intervals. MCID was calculated using 
      anchor and distribution-based methods. SF-12 served as an anchor. MCID was 
      assessed using mean change methodology, four receiver operating characteristic 
      curve assessments, and standard error measurement. Cutoff values were selected 
      from receiver operating characteristic curve analysis. MCID achievement rates for 
      all patient-reported outcome measures were calculated. RESULTS: A total of 139 
      patients met inclusion criteria, with a mean age of 55 years and 39% females. The 
      most common spinal pathology was radiculopathy (92%). MCID analysis revealed the 
      following ranges of values: 2.0 to 4.8 (PHQ-9), 6.7 to 12.1 (SF-12 MCS), and 7.5 
      to 15.9 (VR-12 MCS). Final MCID thresholds were 3.0 (PHQ-9), 9.1 (SF-12 MCS), and 
      8.1 (VR-12 MCS). MCID achievement at 2-years for PHQ-9, SF-12 MCS, and VR-12 MCS 
      was 89.2%, 85.6%, and 84.9% respectively. CONCLUSION: Our 2-year postoperative 
      MCID analysis is the first mental health calculation from an MIS TLIF cohort. We 
      report a 2-year MCID value for PHQ-9 of 3.0 (2.0-4.8). MCID values for mental 
      health instruments are important for determining overall success of lumbar spine 
      surgery.Level of Evidence: 3.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Lynch, Conor P
AU  - Lynch CP
AD  - Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL.
FAU - Cha, Elliot D K
AU  - Cha EDK
FAU - Jenkins, Nathaniel W
AU  - Jenkins NW
FAU - Parrish, James M
AU  - Parrish JM
FAU - Mohan, Shruthi
AU  - Mohan S
FAU - Jadczak, Caroline N
AU  - Jadczak CN
FAU - Geoghegan, Cara E
AU  - Geoghegan CE
FAU - Singh, Kern
AU  - Singh K
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Patient Health Questionnaire/*standards
MH  - *Patient Reported Outcome Measures
MH  - Prospective Studies
MH  - Radiculopathy/diagnosis/surgery
MH  - Retrospective Studies
MH  - Spinal Diseases/diagnosis/*surgery
MH  - Spinal Fusion/methods/*trends
MH  - Treatment Outcome
EDAT- 2020/12/09 06:00
MHDA- 2021/06/09 06:00
CRDT- 2020/12/08 17:17
PHST- 2020/12/09 06:00 [pubmed]
PHST- 2021/06/09 06:00 [medline]
PHST- 2020/12/08 17:17 [entrez]
AID - 00007632-202105010-00009 [pii]
AID - 10.1097/BRS.0000000000003853 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2021 May 1;46(9):603-609. doi: 
      10.1097/BRS.0000000000003853.