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退行性颈脊髓病患者日本矫形协会评分的最小临床重要差异和患者可接受的症状状态。

Minimum Clinically Important Difference and Patient Acceptable Symptom State of Japanese Orthopaedic Association Score in Degenerative Cervical Myelopathy Patients.

机构信息

Department of Orthopaedic Surgery, the University of Tokyo, Tokyo, Japan.

Department of Orthopaedics, Jichi Medical University, Shimotsuke, Japan.

出版信息

Spine (Phila Pa 1976). 2019 May 15;44(10):691-697. doi: 10.1097/BRS.0000000000002928.


DOI:10.1097/BRS.0000000000002928
PMID:30395093
Abstract

STUDY DESIGN: A retrospective analysis. OBJECTIVE: The aim of this study was to elucidate the psychometric properties of the original Japanese Orthopaedic Association (JOA) score, including the minimum detectable change (MDC), minimum clinically important difference (MCID), and patient-accepted symptom state (PASS). SUMMARY OF BACKGROUND DATA: Despite the worldwide popularity of modified JOA score (mJOA), the original JOA score is still commonly used in East Asian countries, including Japan. However, unlike mJOA score, the psychometric properties of JOA score remain poorly understood. METHODS: We retrospectively reviewed a consecutive series of laminoplasty for degenerative cervical myelopathy patients in a single academic institution. Pre- and postoperative JOA scores were collected, and the recovery rate was calculated. Anchor-based methods were used to determine the cut-off values by a receiver operating characteristic (ROC) curve analysis. The patients were also asked to answer an anchor question analyzing their postoperative health transition used for the MDC and another question assessing the patient satisfaction used for the MCID and PASS. RESULTS: A total of 101 patients were included in the analysis. The mean preoperative JOA score was 10.3 [standard deviation (SD): 2.4), and the mean postoperative JOA score was 13.4 (SD: 2.5). The mean recovery rate was 44%. A total of 68% of the patients admitted that their health condition was at least "somewhat better" than their preoperative condition, and 66% were at least "somewhat satisfied" with the treatment results. On the basis of ROC curve analyses, the MDC and MCID for JOA score in degenerative cervical myelopathy patients were calculated to be 2.5. The PASS was estimated to be 14.5, and the MCID for JOA recovery rate was 52.8%. CONCLUSION: The MDC, MCID, and PASS for JOA score for degenerative cervical myelopathy patients were reported by anchor-based ROC curve analyses. LEVEL OF EVIDENCE: 4.

摘要

研究设计:回顾性分析。

目的:本研究旨在阐明原始日本矫形协会(JOA)评分的心理测量特性,包括最小可检测变化(MDC)、最小临床重要差异(MCID)和患者可接受症状状态(PASS)。

背景数据概要:尽管改良 JOA 评分(mJOA)在全球范围内得到广泛应用,但原始 JOA 评分在包括日本在内的东亚国家仍被广泛使用。然而,与 mJOA 评分不同,JOA 评分的心理测量特性仍知之甚少。

方法:我们对一家学术机构的连续颈椎退行性脊髓病患者行椎板成形术的病例进行了回顾性研究。收集了术前和术后的 JOA 评分,并计算了恢复率。使用基于锚定的方法通过接收者操作特征(ROC)曲线分析来确定截断值。还要求患者回答一个锚定问题,分析他们术后健康状态的变化,用于确定 MDC,以及另一个评估患者对治疗结果满意度的问题,用于确定 MCID 和 PASS。

结果:共有 101 例患者纳入分析。平均术前 JOA 评分为 10.3(标准差:2.4),平均术后 JOA 评分为 13.4(标准差:2.5)。平均恢复率为 44%。68%的患者表示他们的健康状况至少“有所改善”,而 66%的患者对治疗结果至少“有些满意”。基于 ROC 曲线分析,退行性颈椎脊髓病患者 JOA 评分的 MDC 和 MCID 分别计算为 2.5。PASS 估计为 14.5,JOA 恢复率的 MCID 为 52.8%。

结论:基于锚定 ROC 曲线分析,报告了退行性颈椎脊髓病患者 JOA 评分的 MDC、MCID 和 PASS。

证据水平:4 级。

相似文献

[1]
Minimum Clinically Important Difference and Patient Acceptable Symptom State of Japanese Orthopaedic Association Score in Degenerative Cervical Myelopathy Patients.

Spine (Phila Pa 1976). 2019-5-15

[2]
Minimum clinically important difference in outcome scores among patients undergoing cervical laminoplasty.

Eur Spine J. 2019-3-14

[3]
Determination of the patient acceptable symptom state for the Japanese Orthopaedic Association Score in patients undergoing anterior cervical discectomy and fusion for cervical spondylotic myelopathy.

Spine J. 2020-11

[4]
Psychometric analysis and critical appraisal of the original, revised, and modified versions of the Japanese Orthopaedic Association score in the assessment of patients with cervical spondylotic myelopathy.

Neurosurg Focus. 2016-6

[5]
Prediction of outcome following laminoplasty of cervical spondylotic myelopathy: Focus on the minimum clinically important difference.

J Clin Neurosci. 2020-11

[6]
The Minimum Clinically Important Difference of the Modified Japanese Orthopaedic Association Scale in Patients with Degenerative Cervical Myelopathy.

Spine (Phila Pa 1976). 2015-11

[7]
Severity of Preoperative Myelopathy Symptoms Affects Patient-reported Outcomes, Satisfaction, and Return to Work After Anterior Cervical Discectomy and Fusion for Degenerative Cervical Myelopathy.

Spine (Phila Pa 1976). 2020-5-15

[8]
Comparison of the Japanese Orthopaedic Association (JOA) score and modified JOA (mJOA) score for the assessment of cervical myelopathy: a multicenter observational study.

PLoS One. 2015-4-2

[9]
The impact of dynamic factors on surgical outcomes after double-door laminoplasty for ossification of the posterior longitudinal ligament of the cervical spine.

J Neurosurg Spine. 2014-12

[10]
Comparison Between the Japanese Orthopaedic Association (JOA) Score and Patient-Reported JOA (PRO-JOA) Score to Evaluate Surgical Outcomes of Degenerative Cervical Myelopathy.

Global Spine J. 2022-6

引用本文的文献

[1]
Response to Letter to the Editor for "Achieving the Minimum Clinically Important Difference in Japanese Orthopaedic Association Score after Surgery for Degenerative Cervical Myelopathy: Predictive Factors and Impact on Patient-Reported Outcome Measures".

Global Spine J. 2025-9-4

[2]
Predictors of poor outcomes after posterior decompression surgery in patients with degenerative cervical myelopathy.

Spinal Cord. 2025-9-4

[3]
The impact of early vs. delayed surgery on outcomes in cervical spinal cord injury without fracture or dislocation.

Front Surg. 2025-8-13

[4]
Clinical Setting Does Not Impact Baseline Patient Reported Outcomes Measures in Patients Undergoing Anterior Cervical Diskectomy and Fusion: A Prospective Study.

J Clin Med. 2025-8-19

[5]
Achieving the Minimum Clinically Important Difference in Japanese Orthopaedic Association Score After Surgery for Degenerative Cervical Myelopathy: Predictive Factors and Impact on Patient-Reported Outcome Measures.

Global Spine J. 2025-8-14

[6]
Radiographical changes and clinical prognosis after cervical laminectomy with posterior instrumented fusion for degenerative cervical myelopathy.

Eur Spine J. 2025-5-29

[7]
Prevalence of idiopathic normal pressure hydrocephalus in patients with degenerative cervical myelopathy.

Eur Spine J. 2025-5-28

[8]
Despite a Multifactorial Etiology, Rates of Distal Junctional Kyphosis After Adult Cervical Deformity Corrective Surgery Can be Dramatically Diminished by Optimizing Age Specific Radiographic Improvement.

Global Spine J. 2025-5

[9]
K-Line Tilt May Influence the Short-Term Surgical Outcomes After Laminoplasty in Patients With Degenerative Cervical Myelopathy.

Global Spine J. 2025-5

[10]
White matter spinal tracts impairment in patients with degenerative cervical myelopathy evaluated with the magnetization transfer saturation MRI technique.

Spinal Cord. 2024-10

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