@article{TEXTUAL,
      recid = {8810},
      author = {Auffinger, Brenda M. and Lall, Rishi R. and Dahdaleh,  Nader S. and Wong, Albert P. and Lam, Sandi K. and Koski,  Tyler and Fessler, Richard G. and Smith, Zachary A.},
      title = {Measuring Surgical Outcomes in Cervical Spondylotic  Myelopathy Patients Undergoing Anterior Cervical Discectomy  and Fusion: Assessment of Minimum Clinically Important  Difference},
      journal = {PLOS ONE},
      address = {2013-06-24},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Object: The concept of minimum clinically important  difference (MCID) has been used to measure the threshold by  which the effect of a specific treatment can be considered  clinically meaningful. MCID has previously been studied in  surgical patients, however few studies have assessed its  role in spinal surgery. The goal of this study was to  assess the role of MCID in patients undergoing anterior  cervical discectomy and fusion (ACDF) for cervical  spondylotic myelopathy (CSM).&lt;/p&gt;&lt;p&gt;Methods: Data was  collected on 30 patients who underwent ACDF for CSM between  2007 and 2012. Preoperative and 1-year postoperative Neck  Disability Index (NDI), Visual-Analog Scale (VAS), and  Short Form-36 (SF-36) Physical (PCS) and Mental (MCS)  Component Summary PRO scores were collected. Five  distribution- and anchor-based approaches were used to  calculate MCID threshold values average change, change  difference, receiver operating characteristic curve (ROC),  minimum detectable change (MDC) and standard error of  measurement (SEM). The Health Transition Item of the SF-36  (HTI) was used as an external anchor.&lt;/p&gt;&lt;p&gt;Results:  Patients had a significant improvement in all mean physical  PRO scores postoperatively (p&lt;0.01) NDI (29.24 to 14.82),  VAS (5.06 to 1.72), and PCS (36.98 to 44.22). The five MCID  approaches yielded a range of values for each PRO:  2.00–8.78 for PCS, 2.06–5.73 for MCS, 4.83–13.39 for NDI,  and 0.36–3.11 for VAS. PCS was the most representative PRO  measure, presenting the greatest area under the ROC curve  (0.94). MDC values were not affected by the choice of  anchor and their threshold of improvement was statistically  greater than the chance of error from unimproved  patients.&lt;/p&gt;&lt;p&gt;Conclusion: SF-36 PCS was the most  representative PRO measure. MDC appears to be the most  appropriate MCID method. When MDC was applied together with  HTI anchor, the MCID thresholds were: 13.39 for NDI, 3.11  for VAS, 5.56 for PCS and 5.73 for MCS.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/8810},
}