What Are the MCIDs for PROMIS, NDI, and ODI Instruments Among Patients With Spinal Conditions?

Hung, Man; Saltzman, Charles L.; Kendall, Richard; Bounsanga, Jerry; Voss, Maren Wright; Lawrence, Brandon D.; Spiker, Ryan; Brodke, Darrel S.

doi:10.1097/corr.0000000000000419

Cited by 142 publications

(132 citation statements)

References 51 publications

Supporting

Mentioning

128

Contrasting

Order By: Relevance

“…To understand the clinical relevance of our findings, the differences in mean PROMIS scores by provider type can be compared to minimal clinically important differences (MCIDs) for PROMIS measures. Previously published PROMIS MCIDs for musculoskeletal patients with various diagnoses have ranged from 1.9 to 4.2 for Physical Function, 2.4 to 5.5 for Pain Interference, 2.3 to 3.4 for Anxiety, and 2.0 to 5.3 for Depression . Our results are within range of these values, which suggests the variation in PROMIS scores by provider type is likely clinically meaningful.…”

Section: Discussionsupporting

confidence: 72%

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

Cheng

Calfee

Colditz

et al. 2019

PM&R

View full text Add to dashboard Cite

Background: Physiatrists' unique training in person-centered biopsychosocial management of complex problems may influence musculoskeletal patients' expectations and self-and/or physician-referral patterns to physiatrists. Consequently, average patient complexity and need for multi-disciplinary services may be increased in physiatric patients. Objective: To compare musculoskeletal patients' self-reported physical and emotional health according to provider specialty. Researchers tested the null hypothesis that there is no significant difference in Patient-Reported Outcomes Measurement Information System (PROMIS) scores between patients who present to physiatrists in comparison to other musculoskeletal specialists. Design: Cross-sectional study. Setting: Orthopedic department of a tertiary academic medical center. Patients: Participants included 31 791 new adult patients (mean age 52.6 AE 16.2 years) who presented for initial elective evaluation of a musculoskeletal problem by an orthopedic surgeon or sports medicine trained emergency medicine, family medicine, pediatric, or physiatric physician. Methods: Patients completed the PROMIS computer adaptive test (CAT) Physical Function, Pain Interference, Anxiety, and Depression domains at department check-in prior to the physician encounter. Score differences by provider type were assessed using Wilcoxon rank-sum tests. Main Outcome Measurements: Mean PROMIS score in each domain subdivided by physiatric, surgical, and other nonsurgical provider type. Results: In total, 2081 patients presented to physiatrists, 28 267 presented to surgeons, and 1443 presented to other nonsurgical providers. For each respective provider type, average PROMIS scores were Physical Function 38.9 AE 8.2, 41.5 AE 9.5, and 43.5 AE 8.2; Pain Interference 62.6 AE 7.2, 60.9 AE 7.7, and 59.2 AE 6.8; Anxiety 54.5 AE 10. 4, 51.9 AE 10.6, and 49.8 AE 9.8; and Depression 49.3 AE 10.4, 47.0 AE 10.0, and 44.2 AE 8.7. Physiatric patients had significantly worse average scores for all domains compared to surgical (P < .001) and other nonsurgical patients (P < .001). Conclusions: Average PROMIS Physical Function, Pain Interference, Anxiety, and Depression scores were worse in musculoskeletal patients who presented to physiatrists in comparison to surgical or other nonsurgical providers. This suggests that some patients who choose to see or are referred to see physiatrists may have more or be more willing to endorse having biopsychosocial impairments.

show abstract

Section: Discussionsupporting

confidence: 72%

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

Cheng

Calfee

Colditz

et al. 2019

PM&R

View full text Add to dashboard Cite

show abstract

“…Reporting PROM data based on CSO thresholds helps to build a more practical and patient-centered interpretation of PRO scores. [28][29][30][31] Hung et al 32 calculated the MCID for the PROMIS PF CAT using both distribution-and anchor-based methods in patients with spine conditions and found a median MCID of 8. SCB, introduced by Glassman et al 16 as an outcome measurement in spine orthopaedics, has remained largely unexplored in the lower-extremity sports medicine literature.…”

Section: Discussionmentioning

confidence: 99%

How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?

Okoroha

Nwachukwu

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

“…Despite a lack of standardization surrounding MCID calculation, overall reporting and desirability have increased in recent years. 6,8,16 The authors recognize that the PSI anchor, dichotomized by response, was not a validated assessment of clinical improvement; however, the methodology was consistent with several existing studies using similar subjective anchors. 9,15 Copay et al 9 found that a satisfaction-with-results scale was better associated with PROM change scores compared to the health transition item found on the Short Form of the Medical Outcomes Study (SF-36).…”

Section: Discussionmentioning

confidence: 69%

“…9 When compared to previously defined MCID thresholds in patients with low back pain, this study's results suggest that a MCID may not necessarily be considered a static value when applied to PROMs. 16 The expanding compilation of proposed values lends itself to the use of MCID ranges for different purposes. For instance, providers may tailor the use of MCID with respect to treatment risk.…”

Section: Discussionmentioning

confidence: 99%

Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients

2020

View full text Add to dashboard Cite

Background: Patient-reported outcome measures (PROMs) are critical tools used in the assessment and reporting of surgical outcomes. However, significant differences in PROM scores have not been shown to consistently correlate with clinical improvement from the physician or patient perspective. Defining a minimum clinically important difference (MCID) for PROMs offers interpretation of surgical outcomes with an emphasis on patient-centered feedback. The goal of this study was to define a MCID for the following PROMs in lumbar tubular microdecompression (LTMD) patients: the EuroQol-Five Dimensions (EQ-5D) index, Oswestry Disability Index (ODI), leg pain visual analog scale (VAS), and low back pain VAS. Methods: This study examined 235 index LTMD patients with PROMs collected at preoperative evaluation and 1year follow-up. Using an anchor-based approach with patient satisfaction index, a receiver operating characteristic analysis was performed to define a MCID in the EQ-5D index, ODI, leg pain VAS, and low back pain VAS. Results: The patients had a mean age of 65.18 6 12.81 years, and 47.7% were male. The MCID values for the EQ-5D, ODI, leg pain VAS, and low back pain VAS are 0.219, 15.0-16.5, 0.5, and 2.5-3.5, respectively. Conclusions: This study helps define a MCID for the EQ-5D index in LTMD patients. Given its ease of administration and economic relevance, further characterization of the EQ-5D index may warrant its use as a potential alternative or adjunct to the routinely collected PROMs following spine surgery.

show abstract

What Are the MCIDs for PROMIS, NDI, and ODI Instruments Among Patients With Spinal Conditions?

Abstract: Level I, diagnostic study.

Cited by 142 publications

References 51 publications

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

How Should We Define Clinically Significant Improvement on Patient-Reported Outcomes Measurement Information System Test for Patients Undergoing Knee Meniscal Surgery?

Defining a Minimum Clinically Important Difference in Patient-Reported Outcome Measures in Lumbar Tubular Microdecompression Patients

Contact Info

Product

Resources

About