PMID- 37651575
OWN - NLM
STAT- MEDLINE
DCOM- 20231201
LR  - 20240416
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 36
IP  - 10
DP  - 2023 Dec 1
TI  - Preoperative Disability Influences Effectiveness of MCID and PASS in Predicting 
      Patient Improvement Following Lumbar Spine Surgery.
PG  - E506-E511
LID - 10.1097/BSD.0000000000001517 [doi]
AB  - STUDY DESIGN: Retrospective cohort. SUMMARY OF BACKGROUND DATA: Although minimal 
      clinically important difference (MCID) and patient acceptable symptom state 
      (PASS) are utilized to interpret Oswestry Disability Index (ODI), it is unclear 
      whether there is a clearly better metric between the two and if not, which metric 
      should be utilized when. OBJECTIVE: To compare the characteristics of MCID and 
      PASS when interpreting ODI after lumbar spine surgery. METHODS: Patients who 
      underwent primary minimally invasive transforaminal lumbar interbody fusion or 
      decompression were included. The ODI and global rating change data at 1 year were 
      analyzed. The global rating change was collapsed to a dichotomous outcome 
      variable-(a) improved, (b) not improved The sensitivity, specificity, positive 
      predictive value and negative predictive value of MCID and PASS were calculated 
      for the overall cohort and separately for patients with minimal, moderate, and 
      severe preoperative disability. Two groups with patients who achieved PASS but 
      not MCID and patients who achieved MCID but not PASS were analyzed. RESULTS: Two 
      hundred twenty patients (mean age 62 y, 57% males) were included. PASS (86% vs. 
      69%) and MCID (88% vs. 63%) had significantly greater sensitivity in patients 
      with moderate and severe preoperative disability, respectively. Nineteen percent 
      of patients achieved PASS but not MCID and 10% of patients achieved MCID but not 
      PASS, with the preoperative ODI being significantly greater in the latter. Most 
      of these patients still reported improvement with no significant difference 
      between the 2 groups (93% vs. 86%). CONCLUSION: Significant postoperative 
      clinical improvement is most effectively assessed by PASS in patients with 
      minimal or moderate preoperative disability and by MCID in patients with severe 
      preoperative disability. Adequate interpretation of ODI using the PASS and MCID 
      metrics warrants individualized application as their utility is highly dependent 
      on the degree of preoperative disability.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Shahi, Pratyush
AU  - Shahi P
AD  - Hospital for Special Surgery.
FAU - Subramanian, Tejas
AU  - Subramanian T
AD  - Hospital for Special Surgery.
AD  - Weill Cornell Medical College, New York, NY.
FAU - Maayan, Omri
AU  - Maayan O
AD  - Hospital for Special Surgery.
AD  - Weill Cornell Medical College, New York, NY.
FAU - Araghi, Kasra
AU  - Araghi K
AD  - Hospital for Special Surgery.
FAU - Singh, Nishtha
AU  - Singh N
AD  - Hospital for Special Surgery.
FAU - Singh, Sumedha
AU  - Singh S
AD  - Hospital for Special Surgery.
FAU - Asada, Tomoyuki
AU  - Asada T
AD  - Hospital for Special Surgery.
FAU - Tuma, Olivia
AU  - Tuma O
AD  - Hospital for Special Surgery.
FAU - Korsun, Maximilian
AU  - Korsun M
AD  - Hospital for Special Surgery.
FAU - Sheha, Evan
AU  - Sheha E
AD  - Hospital for Special Surgery.
FAU - Dowdell, James
AU  - Dowdell J
AD  - Hospital for Special Surgery.
FAU - Qureshi, Sheeraz A
AU  - Qureshi SA
AD  - Hospital for Special Surgery.
AD  - Weill Cornell Medical College, New York, NY.
FAU - Iyer, Sravisht
AU  - Iyer S
AD  - Hospital for Special Surgery.
AD  - Weill Cornell Medical College, New York, NY.
LA  - eng
PT  - Journal Article
DEP - 20230829
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - Female
MH  - Treatment Outcome
MH  - *Minimal Clinically Important Difference
MH  - Retrospective Studies
MH  - Lumbar Vertebrae/surgery
MH  - Predictive Value of Tests
MH  - *Spinal Fusion
COIS- S.A.Q.: Royalties: Stryker K2M, Globus Medical, Inc.; Globus Medical, Inc.: HS2, 
      LLC; Private Investments: Tissue Differentiation Intelligence; Consulting: 
      Stryker K2M, Globus Medical, Inc.; Speaking and/or Teaching Arrangements: 
      AMOpportunities, Globus Medical, Inc.; Board of Directors: Society of Minimally 
      Invasive Spine Surgery; Scientific Advisory Board/Other Office: International 
      Society for the Advancement of Spine Surgery, Cervical Spine Research Society, 
      Lumbar Spine Research Society, North American Spine Society, Association of Bone 
      and Joint Surgeons, Simplify Medical, Inc., LifeLink.com Inc., Society of 
      Minimally Invasive Spine Surgery, Minimally Invasive Spine Study Group, Spinal 
      Simplicity, LLC, Contemporary Spine Surgery, Annals of Translational Medicine. 
      The remaining authors declare no conflict of interest.
EDAT- 2023/08/31 18:41
MHDA- 2023/12/01 06:45
CRDT- 2023/08/31 14:23
PHST- 2023/03/13 00:00 [received]
PHST- 2023/06/19 00:00 [accepted]
PHST- 2023/12/01 06:45 [medline]
PHST- 2023/08/31 18:41 [pubmed]
PHST- 2023/08/31 14:23 [entrez]
AID - 01933606-990000000-00201 [pii]
AID - 10.1097/BSD.0000000000001517 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2023 Dec 1;36(10):E506-E511. doi: 10.1097/BSD.0000000000001517. 
      Epub 2023 Aug 29.