Goudman Lisa, Smedt Ann De, Forget Patrice, Moens Maarten
Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Belgium.
Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium.
J Clin Med. 2020 Nov 21;9(11):3747. doi: 10.3390/jcm9113747.
The Medication Quantification Scale III (MQS) is a tool to represent the negative impact of medication. A reduction in medication can serve as an indicator to evaluate treatment success. However, no cut-off value has yet been determined to evaluate whether a decrease in medication is clinically relevant. Therefore, the objective is to estimate the thresholds for the MQS and morphine milligram equivalents (MMEs) that best identify a clinically relevant important improvement for patients. Data from the Discover registry, in which patients with failed back surgery syndrome were treated with high-dose spinal cord stimulation, were used. Patient satisfaction was utilized to evaluate a clinically important outcome 12 months after stimulation. Anchor-based and distribution-based methods were applied to determine the minimal clinical important difference (MCID). Distribution-based methods revealed a value of 4.28 for the MQS and 33.61 for the MME as MCID. Anchor-based methods indicated a percentage change score of 41.2% for the MQS and 28.2% for the MME or an absolute change score of 4.72 for the MQS and 22.65 for the MME. For assessing a treatment outcome, we recommend using the percentage change score, which better reflects a clinically important outcome and is not severely influenced by high medication intake at baseline.
药物量化量表III（MQS）是一种反映药物负面影响的工具。药物减少可作为评估治疗成功与否的指标。然而，尚未确定用于评估药物减少是否具有临床相关性的临界值。因此，目的是估计MQS和吗啡毫克当量（MME）的阈值，以最佳地识别患者临床上相关的重要改善情况。使用了来自发现登记处的数据，其中接受高剂量脊髓刺激治疗的腰椎手术失败综合征患者参与了该研究。利用患者满意度来评估刺激后12个月的临床重要结果。采用基于锚定和基于分布的方法来确定最小临床重要差异（MCID）。基于分布的方法显示，MQS的MCID值为4.28，MME的MCID值为33.61。基于锚定的方法表明，MQS的百分比变化评分为41.2%，MME的百分比变化评分为28.2%；或MQS的绝对变化评分为4.72，MME的绝对变化评分为22.65。为了评估治疗结果，我们建议使用百分比变化评分，它能更好地反映临床重要结果，且不受基线时高药物摄入量的严重影响。
