Minimal Clinically Important Difference in Quality of Life for Patients with Low Back Pain

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Minimal Clinically Important Difference in Quality of Life for Patients with Low Back Pain
Key Take-Away: 

It is important to evaluate the quality of life of patients with low back pain and SF-12 (the SF-12 is a multipurpose short form survey with 12 questions, all selected from the SF-36 Health Survey) is usually adopted for this purpose. However, the Minimal Clinically Important Difference (MCID) is not known.  The present study successfully estimated that the MCID for the physical (PCS) and mental (MCS) component summaries of Quality of life measure (Short Form, SF-12), in patients with low back pain (LBP).

The 2010 Global Burden of Disease Study estimated that low back pain is among the top 10 diseases and injuries that account for the highest number of daily-adjusted life years (DALYs) worldwide.

ABSTRACT: 
Background: 

The 2010 Global Burden of Disease Study estimated that low back pain is among the top 10 diseases and injuries that account for the highest number of daily-adjusted life years (DALYs) worldwide.

It significantly impairs the quality of life of people suffering from this disease. The study aimed to estimate the Minimal Clinically Important Difference (MCID) for the physical (PCS) and mental (MCS) component summaries of Short Form SF-12 (SF-12) survey, in patients with low back pain (LBP).

Methods: 

A total of 458 patients with sub-acute and chronic LBP were consecutively recruited across 21 practices. LBP referred pain, disability, PCS and MCS were assessed upon recruitment and 12 months later. Self-reported health status change between baseline and 12 month-assessment, was used as the external criterion.

The MCID for SF-12 was estimated following four anchor-based methods; minimal detectable change (MDC); average change (AC); change difference (CD); and receiver operating characteristic curve (ROC), for which the Area Under the Curve (AUC) was calculated. The effect on MCID values of pain duration and baseline scores was assessed.

Results: 

Values for PCS were, MDC: 0.56, AC: 2.71, CD: 3.29, ROC: 1.14.

Values for MCS, were, MDC: 3.77, AC: 3.54, CD: 1.13, ROC: 4.23. AUC values were < 0.7. MCID, values were smaller among chronic patients and those with better baseline quality of life.

Conclusion: 

Different methods for MCID calculation lead to different results. In patients with sub-acute and chronic LBP, improvements > 3.77 in MCS and > 3.29 in PCS, can be considered clinically relevant. MCID is smaller in patients with longer pain duration and better baseline quality of life.

 

Source:

Spine (Phila Pa 1976). 2017 Jun 27

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28658040

The original title of the article:

Minimal Clinically Important Difference in Quality of Life for Patients with Low Back Pain

Authors:

Díaz-Arribas MJ et al

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