Contemporary Analysis of Minimal Clinically Important Difference in the Neurosurgical Literature. Issue 4 (28th December 2020)

• Record Type: Journal Article
• Authors: Zervos, Thomas M; Asmaro, Karam; Air, Ellen L
• Is Part Of: Neurosurgery. Volume 88:Issue 4(2021)
• Page Start: 713
• Page End: 719
• Publication Date: 2020-12-28
• Subjects: Clinimetrics -- Outcome measures -- Health-related quality of life -- Minimal clinically important difference -- Patient-reported outcomes -- Quality of life -- Statistical significance; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa490
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND: Minimal clinically important difference (MCID) is determined when a patient or physician defines the minimal change that outweighs the costs and untoward effects of a treatment. These measurements are "anchored" to validated quality-of-life instruments or physician-rated, disease-activity indices. To capture the subjective clinical experience in a measurable way, there is an increasing use of MCID. OBJECTIVE: To review the overall concept, method of calculation, strengths, and weaknesses of MCID and its application in the neurosurgical literature. METHODS: Recent articles were reviewed based on PubMed query. To illustrate the strengths and limitations of MCID, studies regarding the measurement of pain are emphasized and their impact on subsequent publications queried. RESULTS: MCID varies by population baseline characteristics and calculation method. In the context of pain, MCID varied based on the quality of pain, chronicity, and treatment options. CONCLUSION: MCID evaluates outcomes relative to whether they provide a meaningful change to patients, incorporating the risks and benefits of a treatment. Using MCID in the process of evaluating outcomes helps to avoid the error of interpreting a small but statistically significant outcome difference as being clinically important.