Chung Andrew S, Copay Anne G, Olmscheid Neil, Campbell David, Walker J Brock, Chutkan Norman
University of Arizona College of Medicine-Phoenix, Orthopedic Surgery Residency, Phoenix, AZ.
SPIRITT Research, St. Louis, MO.
Spine (Phila Pa 1976). 2017 Jul 15;42(14):1096-1105. doi: 10.1097/BRS.0000000000001990.
Review of the 2011 to 2015 minimum clinically important difference (MCID)-related publications in Spine, Spine Journal, Journal of Neurosurgery-Spine, and European Spine Journal.
To summarize the various determinations of MCID and to analyze its usage in the spine literature of the past 5 years in order to develop a basic reference to help practitioners interpret or utilize MCID.
MCID represents the smallest change in a domain of interest that is considered beneficial to a patient or clinician. The many sources of variation in calculated MCID values and inconsistency in its utilization have resulted in confusion in the interpretation and use of MCID.
All articles from 2011 to 2015 were reviewed. Only clinical science articles utilizing patient reported outcome scores (PROs) were included in the analysis. A keyword search was then performed to identify articles that used MCID. MCID utilization in the selected papers was characterized and recorded.
MCID was referenced in 264/1591 (16.6%) clinical science articles that utilized PROs: 22/264 (8.3%) independently calculated MCID values and 156/264 (59.1%) used previously published MCID values as a gauge of their own results. Despite similar calculation methods, there was a two- or three-fold range in the recommended MCID values for the same instrument. Half the studies recommended MCID values within the measurement error. Most studies (97.2%) using MCID to evaluate their own results relied on generic MCID. The few studies using specific MCID (MCID calculated for narrowly defined indications or treatments) did not consistently match the characteristics of their sample to the specificity of the MCID. About 48% of the studies compared group averages instead of individual scores to the MCID threshold.
Despite a clear interest in MCID as a measure of patient improvement, its current developments and uses have been inconsistent.
N/A.
回顾2011年至2015年发表在《脊柱》《脊柱杂志》《神经外科杂志 - 脊柱》和《欧洲脊柱杂志》上的与最小临床重要差异（MCID）相关的出版物。
总结MCID的各种测定方法，并分析其在过去5年脊柱文献中的应用情况，以便建立一个基础参考，帮助从业者解释或使用MCID。
MCID代表在感兴趣的领域中被认为对患者或临床医生有益的最小变化。计算MCID值时存在多种变异来源，且其应用不一致，导致在MCID的解释和使用上出现混乱。
回顾了2011年至2015年的所有文章。分析仅纳入使用患者报告结局评分（PROs）的临床科学文章。然后进行关键词搜索，以识别使用MCID的文章。对所选论文中MCID的应用进行特征描述和记录。
在1591篇使用PROs的临床科学文章中，有264篇（16.6%）引用了MCID：22篇（8.3%）独立计算了MCID值，156篇（59.1%）使用先前发表的MCID值来衡量自己的结果。尽管计算方法相似，但同一工具的推荐MCID值存在两到三倍的范围。一半的研究推荐的MCID值在测量误差范围内。大多数使用MCID评估自身结果的研究（97.2%）依赖通用MCID。少数使用特定MCID（为狭义定义的适应症或治疗计算的MCID）的研究并未始终将其样本特征与MCID的特异性相匹配。约48%的研究将组平均值而非个体分数与MCID阈值进行比较。
尽管人们对将MCID作为衡量患者改善情况的指标有明显兴趣，但其目前的发展和应用并不一致。
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