What does/should the minimum clinically important difference measure?: a reconsideration of its clinical value in evaluating efficacy of lumbar fusion surgery
The Clinical Journal of Pain, 05/14/2012
Gatchel RJ et al. – A call is made for a more comprehensive approach to synthesize a nearly decade's worth of clinical research that has still not yielded consensus concerning the best MCID approach to objectively document lumbar spine fusion patients' outcomes.
Methods- This study provides a review of the literature suggesting that the MCID metric is not being applied and interpreted in practice in a manner that realizes its potential.
- The MCID has often been used as a means of delineating whether patients are “feeling better.”
- This does not, though, necessarily indicate that they are “doing better” in terms of physical or socioeconomic functioning.
- The imperfect correlation between “feeling” and “doing” better makes it difficult to interpret the clinical implications of articles using MCID measures, particularly in the lumbar spine fusion literature.
- Alternative and more scientifically rigorous approaches to the MCID are presented.
