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Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular
Trent A Vanhorn1,1, Ziyad O Knio1,1, Tadhg J O'Gara1,2,1
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Background:
Patient-reported outcome measures (PROMs) are critical tools used in the assessment and reporting of surgical outcomes. However, significant differences in PROM scores have not been shown to consistently correlate with clinical improvement from the physician or patient perspective. Defining a minimum clinically important difference (MCID) for PROMs offers interpretation of surgical outcomes with an emphasis on patient-centered feedback. The goal of this study was to define a MCID for the following PROMs in lumbar tubular microdecompression (LTMD) patients: the EuroQol-Five Dimensions (EQ-5D) index, Oswestry Disability Index (ODI), leg pain visual analog scale (VAS), and low back pain VAS.
Methods:
This study examined 235 index LTMD patients with PROMs collected at preoperative evaluation and 1-year follow-up. Using an anchor-based approach with patient satisfaction index, a receiver operating characteristic analysis was performed to define a MCID in the EQ-5D index, ODI, leg pain VAS, and low back pain VAS.
Results:
The patients had a mean age of 65.18 ± 12.81 years, and 47.7% were male. The MCID values for the EQ-5D, ODI, leg pain VAS, and low back pain VAS are 0.219, 15.0-16.5, 0.5, and 2.5-3.5, respectively.
Conclusions:
This study helps define a MCID for the EQ-5D index in LTMD patients. Given its ease of administration and economic relevance, further characterization of the EQ-5D index may warrant its use as a potential alternative or adjunct to the routinely collected PROMs following spine surgery.
Level Of Evidence:
3.
Insights
This study defines minimum clinically important difference (MCID) values for patient-reported outcome measures (PROMs) in lumbar tubular microdecompression (LTMD) surgery. These MCID values help interpret surgical outcomes and patient satisfaction after LTMD procedures.
Area of Science:
- Neurosurgery
- Orthopedics
- Health Outcomes Research
Background:
- Patient-reported outcome measures (PROMs) are crucial for assessing surgical success.
- Interpreting PROM score changes requires defining a minimum clinically important difference (MCID).
- This study focuses on PROMs for lumbar tubular microdecompression (LTMD).
Purpose of the Study:
- To define the MCID for key PROMs in LTMD patients.
- To establish patient-centered benchmarks for surgical outcomes.
- To evaluate the EuroQol-Five Dimensions (EQ-5D) index, Oswestry Disability Index (ODI), and visual analog scales (VAS) for leg and low back pain.
Main Methods:
- An anchor-based approach using patient satisfaction was employed.
- Receiver operating characteristic (ROC) analysis was performed on 235 LTMD patients.
- PROMs were collected preoperatively and at 1-year follow-up.
Main Results:
- MCID for EQ-5D index: 0.219.
- MCID for ODI: 15.0–16.5.
- MCID for leg pain VAS: 0.5; low back pain VAS: 2.5–3.5.
Conclusions:
- Established MCID values provide meaningful interpretation of PROM changes after LTMD.
- The EQ-5D index shows potential as a valuable tool in spine surgery outcome assessment.
- Further research into the EQ-5D index may support its use alongside routine PROMs.
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