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Anthony L. Asher, Panagiotis Kerezoudis, Praveen V. Mummaneni, Erica F. Bisson, Steven D. Glassman, Kevin T. Foley, Jonathan R. Slotkin, Eric A. Potts, Mark E. Shaffrey, Christopher I. Shaffrey, Domagoj Coric, John J. Knightly, Paul Park, Kai-Ming Fu, Clinton J. Devin, Kristin R. Archer, Silky Chotai, Andrew K. Chan, Michael S. Virk and Mohamad Bydon

surgical interventions and changes in disease trajectory. More importantly, PROs are more frequently incorporated in clinical trials as the primary outcome comparing health interventions for chronic diseases. 26 , 27 However, a challenge to interpreting the meaning of improvement in PROs is that the extent of change in a numerical score lacks a direct meaning or clinical significance. 14 The concept of minimum clinically important difference (MCID) has been put forth as the smallest improvement in the PRO needed to achieve a level of clinical improvement. In other

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Lindsay Tetreault, Jefferson R. Wilson, Mark R. N. Kotter, Aria Nouri, Pierre Côté, Branko Kopjar, Paul M. Arnold and Michael G. Fehlings

, and gait dysfunction. 29 Patients with DCM may have substantial functional impairment, significantly reduced quality of life, and be unable to perform certain activities of daily living. Surgery is typically recommended as the preferred management strategy for patients with clinical and imaging evidence of DCM. 5 , 8 In general, surgical decompression of the cervical spine is effective at halting neurological deterioration, relieving certain symptoms, and improving functional status and quality of life. The minimum clinically important difference (MCID) is

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Justin K. Scheer, Virginie Lafage, Justin S. Smith, Vedat Deviren, Richard Hostin, Ian M. McCarthy, Gregory M. Mundis, Douglas C. Burton, Eric Klineberg, Munish C. Gupta, Khaled M. Kebaish, Christopher I. Shaffrey, Shay Bess, Frank Schwab, Christopher P. Ames and the International Spine Study Group (ISSG)

the VAS and ODI were calculated as the preoperative value − the postoperative value. Changes in the MCS, PCS, and SRS values were calculated as the postoperative value − the preoperative value. Positive values for either of these equations indicate an improvement in outcomes, and negative values indicate a decrease in outcomes. To place HRQOL outcomes in a clinically relevant context, minimum clinically important difference (MCID) values have been established for the HRQOL instruments. 6 , 15 Therefore, differences in the proportion of patients across age groups

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Joseph Laratta, Leah Y. Carreon, Avery L. Buchholz, Andrew Y. Yew, Erica F. Bisson, Praveen V. Mummaneni and Steven D. Glassman

Index (ODI) 19 , 20 and the EQ-5D, 21 to assess treatment effects. Unfortunately, statistically significant changes in numerical scores for these assessment tools may not represent clinically meaningful differences. Thus, the determination of minimum clinically important differences (MCIDs), defined as the smallest change important to patients, is integral in the evaluations of and justifications for particular interventions. 22 Thresholds for MCID likely vary based on treatment, pathology, and patient characteristics. Although MCID thresholds have been broadly

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Taemin Oh, Justin K. Scheer, Justin S. Smith, Richard Hostin, Chessie Robinson, Jeffrey L. Gum, Frank Schwab, Robert A. Hart, Virginie Lafage, Douglas C. Burton, Shay Bess, Themistocles Protopsaltis, Eric O. Klineberg, Christopher I. Shaffrey, Christopher P. Ames and the International Spine Study Group

, surgical intervention remains one of the cornerstones of therapy. Recent research led by our group and others has shown that, compared with nonoperative treatment, surgery is associated with significantly greater improvement in pain, functionality, and quality of life (QOL), as well as increasing the likelihood of reaching a minimum clinically important difference (MCID) for these improvements. 2 , 3 , 12 , 19 , 27 , 29 , 33 , 35 However, this observation is not universal, because in select patients the associated postoperative complications may impact the benefits. For

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Owoicho Adogwa, Aladine A. Elsamadicy, Jing L. Han, Joseph Cheng, Isaac Karikari and Carlos A. Bagley

important difference (MCID) were calculated for each patient cohort (ALIF, TLIF, and LLIF). MCID is the smallest change in an outcome measure that represents a change that would be considered meaningful by the patient. MCID values were calculated for all health status measures. Different approaches can be used to determine MCID. One approach is to use receiver operating characteristic curves to define the cutoff point that best discriminates between patients reporting or denying any improvement. Another is to estimate the mean change score in patients who actually report

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Scott L. Parker, Stephen K. Mendenhall, David Shau, Owoicho Adogwa, Joseph S. Cheng, William N. Anderson, Clinton J. Devin and Matthew J. McGirt

P atient -reported outcome questionnaires have become the standard measure for treatment effectiveness following spinal surgery. The most commonly used PRO questionnaires include pain scales for back and leg pain (VAS), 8 , 10 ODI, 6 , 7 , 20 SF-36, 25 and EQ-5D. 1 , 14 A well-defined shortcoming of such questionnaires is that their numerical scores lack a direct, clinically significant meaning. 17 As a result, the concept of MCID has been put forth as a measure for the critical threshold needed to achieve clinically meaningful treatment effectiveness

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Scott L. Parker, Owoicho Adogwa, Alexandra R. Paul, William N. Anderson, Oran Aaronson, Joseph S. Cheng and Matthew J. McGirt

P atient -reported outcome questionnaires have become the standard measure for treatment effectiveness following spine surgery. The most commonly used PRO questionnaires include scales for back and leg pain (the BP-VAS and LP-VAS), 8 , 9 the ODI, 6 , 7 , 17 the SF-36, 22 and the EQ-5D. 1 , 14 A shortcoming of these questionnaires is that their numerical scores lack a direct, clinically significant meaning. 15 Because of this, the concept of MCID has recently been put forth as a measure for the critical threshold needed to achieve treatment

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Alex Soroceanu, Justin S. Smith, Darryl Lau, Michael P. Kelly, Peter G. Passias, Themistocles S. Protopsaltis, Jeffrey L. Gum, Virginie Lafage, Han-Jo Kim, Justin K. Scheer, Munish Gupta, Gregory M. Mundis Jr., Eric O. Klineberg, Douglas Burton, Shay Bess, Christopher P. Ames and the International Spine Study Group

minimum clinically important difference (MCID) represents the smallest change in PRO that corresponds to meaningful improvement. MCID is dependent on specific pathology and the appropriateness of PRO questionnaires. Patients with ACD have many inherently distinct features and characteristics compared to the degenerative cervical conditions used in the development of the cervical-specific PRO questionnaires. Whereas MCID thresholds have been established for adult thoracolumbar deformity and for degenerative cervical spine pathologies, to our knowledge there are no

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Scott L. Parker, Saniya S. Godil, David N. Shau, Stephen K. Mendenhall and Matthew J. McGirt

, clinically significant meaning. Thus, the concept of MCID has been introduced as a measure for the critical threshold needed to achieve treatment effectiveness. Treatment effects reaching the MCID threshold value imply clinical significance and justification for incorporating a treatment into clinical practice. In other words, MCID can be thought of as the smallest change in an outcome measure that reflects meaningful improvement to patients. 25 In determining the MCID, anchor-based approaches are the most accepted and often used calculation method. These approaches