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Alvaro Ibaseta, Rafa Rahman, Nicholas S. Andrade, Richard L. Skolasky, Khaled M. Kebaish, Daniel M. Sciubba, and Brian J. Neuman

PROMIS is an adequate measure of health status in patients with ASD, and minimal clinically important differences (MCIDs) (the smallest change in an outcome that would prompt a change in treatment) have not been reported. Therefore, we investigated the concurrent validity, discriminant ability, and responsiveness of PROMIS domains in ASD. We also estimated PROMIS MCIDs for this population. We hypothesized that legacy PROs would be correlated moderately or strongly with PROMIS, that PROMIS would be able to discriminate between levels of disease severity in ASD, and

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Shelby Sabourin, Justin Tram, Breanna L. Sheldon, and Julie G. Pilitsis

T he dynamic nature of therapeutic innovation has revealed the necessity of developing an efficacious, accurate, and precise method to translate data analysis to clinical implications. 1 Statistical significance, a well-established method of analysis used by investigators in a variety of research fields, may fall short in demonstrating the clinical efficacy of potential treatments. 1–3 The concept of minimal clinically important difference (MCID) arose out of efforts to bridge this problem and determine the minimum change value necessary to achieve

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Hideyuki Arima, Steven D. Glassman, Keith Bridwell, Yu Yamato, Mitsuru Yagi, Kota Watanabe, Morio Matsumoto, Satoshi Inami, Hiroshi Taneichi, Yukihiro Matsuyama, and Leah Y. Carreon

patients undergoing surgery, not only for adolescent idiopathic scoliosis but also for adult spinal deformity (ASD). 6–9 , 11 Generally, a statistically significant difference between PROs before and after surgery is interpreted as a measure of treatment effectiveness. However, the differences measured between these groups may not be clinically relevant to the individual patient. The minimal clinically important difference (MCID) is the smallest difference in a health-related quality of life (HRQOL) score that is considered to be worthwhile or clinically important to the

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Nathan Evaniew, David W. Cadotte, Nicolas Dea, Christopher S. Bailey, Sean D. Christie, Charles G. Fisher, Jerome Paquet, Alex Soroceanu, Kenneth C. Thomas, Y. Raja Rampersaud, Neil A. Manson, Michael Johnson, Andrew Nataraj, Hamilton Hall, Greg McIntosh, and W. Bradley Jacobs

characteristics that affect treatment decision making and predict clinical outcome in patients with cervical spondylotic myelopathy . Spine (Phila Pa 1976 ) . 2013 ; 38 ( 22 )( suppl 1 ): S89 – S110 . 7 Tetreault L , Wilson JR , Kotter MRN , Predicting the minimum clinically important difference in patients undergoing surgery for the treatment of degenerative cervical myelopathy . Neurosurg Focus . 2016 ; 40 ( 6 ): E14 . 8 Jaeschke R , Singer J , Guyatt GH . Measurement of health status. Ascertaining the minimal clinically important difference . Control

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Junseok Bae, Alexander A. Theologis, Russell Strom, Bobby Tay, Shane Burch, Sigurd Berven, Praveen V. Mummaneni, Dean Chou, Christopher P. Ames, and Vedat Deviren

), the 36-Item Short Form Health Survey (SF-36), and the Scoliosis Research Society 22-question Questionnaire (SRS-22). Two standard summary scores, the physical component summary (PCS) and the mental component summary (MCS), were based on the SF-36. 30 The SRS-22 provided a total score and scores on 5 subdomains, including pain, function, self-image, mental health, and satisfaction. To place HRQoL outcomes in a clinically relevant context, values for minimal clinically important differences (MCIDs) have been established. In this study, MCIDs were defined as the

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Mohamed Macki, Travis Hamilton, Seokchun Lim, Edvin Telemi, Michael Bazydlo, David R. Nerenz, Hesham Mostafa Zakaria, Lonni Schultz, Jad G. Khalil, Miguelangelo J. Perez-Cruet, Ilyas S. Aleem, Paul Park, Jason M. Schwalb, Muwaffak M. Abdulhak, and Victor Chang

: patient satisfaction, achieving a minimal clinically important difference (MCID) on the Oswestry Disability Index (ODI) for low-back pain, and return to work. Satisfaction was measured using the North American Spine Society patient satisfaction index, where “satisfied patients” were defined as a score of 1 ("the treatment met my expectations") or 2 ("I did not improve as much as I had hoped, but I would undergo the same treatment for the same outcome"), and “dissatisfied patients” were defined as a score of 3 ("I did not improve as much as I had hoped, and I would not

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Erica F Bisson, Jian Guan, Mohamad Bydon, Mohammed A Alvi, Anshit Goyal, Steven D Glassman, Kevin T Foley, Eric A Potts, Christopher I Shaffrey, Mark E Shaffrey, Domagoj Coric, John J Knightly, Paul Park, Michael Y Wang, Kai-Ming Fu, Jonathan R Slotkin, Anthony L Asher, Michael S Virk, Andrew Y Yew, Regis W Haid, Andrew K Chan, and Praveen V Mummaneni

the North American Spine Society (NASS) satisfaction questionnaire, which grades satisfaction from 1 (surgery met my expectations) to 4 (I am the same or worse as compared with before surgery). In addition, the number of patients who reached a minimal clinically important difference (MCID) of improvement in ODI score was analyzed, with MCID defined as an improvement of 12.8. 10 Finally, we also analyzed factors associated with 30% change in ODI score at 24 months to account for baseline differences in ODI scores. 11 , 12 PRO data included in the QOD were obtained

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Hesham Mostafa Zakaria, Tarek R. Mansour, Edvin Telemi, Karam Asmaro, Mohamed Macki, Michael Bazydlo, Lonni Schultz, David R. Nerenz, Muwaffak Abdulhak, Jason M. Schwalb, Paul Park, and Victor Chang

quality is being given to lumbar fusion surgery, as this procedure is associated with high costs 3 , 23 and inconsistent efficacy. 15 , 17 While “quality” care is abstract, “good quality” is generally associated with decreased morbidity and costs, together with an increased likelihood of postoperative improvement in pain, as measured by minimal clinically important difference (MCID) scores and a return to work. As such, there is an increased focus on identifying patient preoperative factors that can predict these outcomes, especially after lumbar fusion. 4 , 18 , 27

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Joshua Bakhsheshian, Justin K. Scheer, Jeffrey L. Gum, Richard Hostin, Virginie Lafage, Shay Bess, Themistocles S. Protopsaltis, Douglas C. Burton, Malla Kate Keefe, Robert A. Hart, Gregory M. Mundis Jr., Christopher I. Shaffrey, Frank Schwab, Justin S. Smith, Christopher P. Ames, and The International Spine Study Group

events during hospitalization after spine surgery. 15 However, other investigations have failed to demonstrate an association between self-reported psychological conditions and outcome scores following lumbar spine surgery. 1 , 13 Of note, these studies did not have predefined comparative study groups, meaning that they did not classify patients with significant functional impairment as scoring at or below the 25th percentile for age- and sex-matched US population norms. 20 Further, the minimal clinically important differences (MCIDs) were not evaluated. To date

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Alexander A. Theologis, Tamir Ailon, Justin K. Scheer, Justin S. Smith, Christopher I. Shaffrey, Shay Bess, Munish Gupta, Eric O. Klineberg, Khaled Kebaish, Frank Schwab, Virginie Lafage, Douglas Burton, Robert Hart, Christopher P. Ames, and The International Spine Study Group

achieving ≥ 1 minimal clinically important difference (MCID) on the ODI (12.8) 13 versus not. Model building followed the same principles outlined above. From this model, probit regression was used to determine the predicted likelihood of reaching ≥ 1 MCID on the ODI based on the patients’ baseline MSPQ score, adjusted for potential confounders. Results Demographics Of the 1254 consecutive patients with ASD who were offered enrollment at all participating institutions, 608 were enrolled. Of the 608 patients who were enrolled, 365 were eligible for 2-year follow