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Research ArticleLumbar Spine

Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients

Trent A. VanHorn, Ziyad O. Knio and Tadhg J. O'Gara
International Journal of Spine Surgery July 2020, 7071; DOI: https://doi.org/10.14444/7071
Trent A. VanHorn
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
BS
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Ziyad O. Knio
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
MD
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Tadhg J. O'Gara
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
2Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
MD
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ABSTRACT

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.

  • Oswestry Disability Index
  • EQ-5D
  • health state
  • patient-reported outcome measures

Footnotes

  • Disclosures and COI: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors report no conflicts of interest.

  • ©International Society for the Advancement of Spine Surgery
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International Journal of Spine Surgery: 19 (S2)
International Journal of Spine Surgery
Vol. 19, Issue S2
1 Apr 2025
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Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients
Trent A. VanHorn, Ziyad O. Knio, Tadhg J. O'Gara
International Journal of Spine Surgery Jul 2020, 7071; DOI: 10.14444/7071

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Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients
Trent A. VanHorn, Ziyad O. Knio, Tadhg J. O'Gara
International Journal of Spine Surgery Jul 2020, 7071; DOI: 10.14444/7071
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Keywords

  • oswestry disability index
  • EQ-5D
  • health state
  • patient-reported outcome measures

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