PMID- 37984881
OWN - NLM
STAT- Publisher
LR  - 20231221
IS  - 2192-5682 (Print)
IS  - 2192-5682 (Linking)
DP  - 2023 Nov 20
TI  - Preoperative Disability Influences Effectiveness of Minimal Clinically Important 
      Difference and Patient Acceptable Symptom State in Predicting Patient Improvement 
      Following Cervical Spine Surgery.
PG  - 21925682231215765
LID - 10.1177/21925682231215765 [doi]
AB  - STUDY DESIGN: Retrospective cohort. OBJECTIVE: To compare the characteristics of 
      the minimal clinically important difference (MCID) and patient acceptable symptom 
      state (PASS) metrics when interpreting Neck Disability Index (NDI) following 
      cervical spine surgery. METHODS: Patients who underwent primary cervical fusion, 
      discectomy, or laminectomy were included. NDI and global rating change (GRC) data 
      at 6 months/1 year/2 years were analyzed. Sensitivity, specificity, positive 
      predictive value (PPV) and negative predictive value (NPV) of MCID and PASS in 
      predicting improvement on GRC were calculated for the overall cohort and 
      separately for patients with minimal (NDI <30), moderate (NDI 30 - 49), and 
      severe (NDI >/= 50) preoperative disability. Two groups with patients who achieved 
      PASS but not MCID and patients who achieved MCID but not PASS were analyzed. 
      RESULTS: 141 patients (206 responses) were included. PASS had significantly 
      greater sensitivity for the overall cohort (85% vs 73% with MCID, P = .02) and 
      patients with minimal disability (96% vs 53% with MCID, P < .001). MCID had 
      greater sensitivity for patients with severe disability (78% vs 57% with PASS, P 
      = .05). Sensitivity was not significantly different for PASS and MCID in patients 
      with moderate preoperative disability (83% vs 92%, P = .1). 17% of patients 
      achieved PASS but not MCID and 9% of patients achieved MCID but not PASS. Most of 
      these patients still reported improvement with no significant difference between 
      the 2 groups (89% vs 72%, P = .13). CONCLUSION: PASS and MCID are better metrics 
      for patients with minimal and severe preoperative disability, respectively. Both 
      metrics are equally effective for patients with moderate preoperative disability.
FAU - Shahi, Pratyush
AU  - Shahi P
AUID- ORCID: 0000-0003-4903-9697
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Maayan, Omri
AU  - Maayan O
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
AD  - Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, 
      USA.
FAU - Subramanian, Tejas
AU  - Subramanian T
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
AD  - Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, 
      USA.
FAU - Singh, Nishtha
AU  - Singh N
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Singh, Sumedha
AU  - Singh S
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Araghi, Kasra
AU  - Araghi K
AUID- ORCID: 0000-0003-0061-2640
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Tuma, Olivia
AU  - Tuma O
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Asada, Tomoyuki
AU  - Asada T
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Korsun, Maximilian
AU  - Korsun M
AUID- ORCID: 0000-0001-7289-7564
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Sheha, Evan
AU  - Sheha E
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Dowdell, James
AU  - Dowdell J
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
FAU - Qureshi, Sheeraz A
AU  - Qureshi SA
AUID- ORCID: 0000-0002-7177-1756
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
AD  - Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, 
      USA.
FAU - Iyer, Sravisht
AU  - Iyer S
AUID- ORCID: 0000-0002-8338-9757
AD  - Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 
      USA. RINGGOLD: 25062
AD  - Department of Orthopaedic Surgery, Weill Cornell Medical College, New York, NY, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20231120
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
OTO - NOTNLM
OT  - cervical
OT  - minimal clinically important difference
OT  - neck disability index
OT  - outcomes
OT  - patient acceptable symptom state
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/11/21 01:07
MHDA- 2023/11/21 01:07
CRDT- 2023/11/20 20:23
PHST- 2023/11/21 01:07 [pubmed]
PHST- 2023/11/21 01:07 [medline]
PHST- 2023/11/20 20:23 [entrez]
AID - 10.1177/21925682231215765 [doi]
PST - aheadofprint
SO  - Global Spine J. 2023 Nov 20:21925682231215765. doi: 10.1177/21925682231215765.