Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and Pain Scales

Criteria for failure and worsening after surgery for lumbar disc herniation: a multicenter observational study based on data from the Norwegian Registry for Spine Surgery

“…Back pain, both the mean % change, and the final raw score at 12 months, also showed high accuracy for identifying failure. We found no significant difference in outcome scores among patient groups who considered themselves as ''unchanged'' or ''slightly worse'', which is in accordance with a previous study [12]. A final ODI raw score of more than 48 at 12-month follow-up had the highest accuracy for identifying patients reporting worsening, followed by a final raw score of 7.5 for NRS back pain.…”

“…In addition, cutoffs for substantial clinical improvements, such as ''success'' after lumbar disc surgery, have been reported both for the ODI (20), NRS back pain (2.5), NRS leg pain (3.5), and EQ-5D (0.3) [9][10][11]. A large proportion of the patients are difficult to classify as either improved, unchanged, or worse after surgery [12]. Consequently, cutoffs on the PROMs for deterioration and ''failure'' may be different from those of ''non-success''.…”

“…Consequently, cutoffs on the PROMs for deterioration and ''failure'' may be different from those of ''non-success''. Previously, authors have used various methods and different concepts for defining cutoffs for clinical meaningful improvements [10,12], resulting in a diversity of recommended threshold values [8,21,22]. This makes it even more difficult to disentangle ''failure'' from constructs developed to identify improvements.…”

Clinical evaluation of the preliminary safety and effectiveness of a minimally invasive interspinous process device APERIUS® in degenerative lumbar spinal stenosis with symptomatic neurogenic intermittent claudication

“…The patient's outcome at 12 months post-procedure was based on the use of the MCID thresholds for score improvement [7,9,10], considered to be the most objective parameter in the assessment of clinical outcome, providing an immediate evaluation of the effectiveness of the treatment. The data show that the IPD can be beneficial for up to 12 months after implantation in a high proportion of patients, with the majority of patients showing clinically important improvements in ZCQ symptom severity and physical function scores, VAS scores for pain, and EQ5D scores at 12 months versus baseline.…”

“…Improvements in ZCQ, VAS and EQ5D scores were considered clinically significant when they reached a threshold defined in earlier publications [7,9,10], as reported in Table 1. This is described as the Minimum Clinically Important Difference (MCID).…”