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Minimal Clinically Important Difference (MCID) of the EOSQ-24 Questionnaire.

Alexander M Park1, Mehdi M Elfilali1, Michael W Brown1

  • 1Columbia University Irving Medical Center, New York, NY.

Journal of Pediatric Orthopedics
|June 15, 2026
PubMed
Summary

A minimal clinically important difference (MCID) of 5 points was established for the Early Onset Scoliosis Questionnaire (EOSQ-24) in patients with early onset scoliosis (EOS). This 5-point threshold signifies a meaningful change in health-related quality of life (HRQoL) for EOS patients.

Keywords:
EOSQ-24early onset scoliosis (EOS)minimal clinically important difference (MCID)outcomes

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Area of Science:

  • Orthopaedic surgery
  • Paediatric spine deformity
  • Health-related quality of life (HRQoL) assessment

Background:

  • Orthopaedic management of early onset scoliosis (EOS) often focuses on radiographic correction, but patient-reported outcomes like HRQoL are crucial.
  • The Early Onset Scoliosis Questionnaire (EOSQ-24) measures HRQoL in EOS patients, but a definitive minimal clinically important difference (MCID) was lacking.
  • Previous assumptions suggested a 10% score difference indicated clinical significance, necessitating evidence-based MCID determination for the EOSQ-24.

Purpose of the Study:

  • To determine the MCID for the EOSQ-24 questionnaire in patients diagnosed with early onset scoliosis (EOS).
  • To establish a clinically relevant threshold for assessing meaningful changes in patient HRQoL using the EOSQ-24.

Main Methods:

  • A prospective, multicenter study involving 85 EOS patients who completed the EOSQ-24 pre- and post-treatment.
  • Anchor-based MCID determination using receiver operating characteristic curves on global assessment survey data.
  • Secondary calculation of a distribution-based MCID using 1 standard error of measurement (1 SEM) and prior reliability data.

Main Results:

  • The mean change in EOSQ-24 scores across all patients was 8.5 points (SD = 8.1).
  • The anchor-based MCID was calculated as 5.2 points, with an area under the curve (AUC) of 0.600.
  • The distribution-based MCID, representing change beyond measurement error, was 4.6 points.

Conclusions:

  • A 5-point change in EOSQ-24 scores is established as the minimal clinically important difference (MCID) for early onset scoliosis (EOS) patients.
  • The consistency between anchor-based and distribution-based methods supports the robustness of this 5-point threshold for meaningful HRQoL changes.
  • Accurate clinician recognition of important HRQoL shifts, guided by this MCID, is vital for enhancing clinical care in EOS management.