What Is the Most Appropriate Method for Determining Minimally Clinical Important Difference in Grade 2 Spondylolisthesis? A QOD Spine CORe® Study

BACKGROUND AND OBJECTIVES: Minimally clinically important difference (MCID) defines the smallest difference in patient-reported outcomes (PROs) required for a level of clinical improvement. The hypothesis of this study is that at least one of the MCID thresholds in this study will provide appropriate MCID thresholds for the PROs in grade 2 spondylolisthesis. METHODS: This study used the Grade 2 Spondylolisthesis module of the Quality Outcomes Database Spine CORe® Study Group, which included 328 patients from 14 institutions. PROs collected include Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) for back pain and leg pain, and European Quality of Life-5 Dimensions (EQ-5D). Seven MCID thresholds were calculated with North American Spine Society satisfaction scale as the anchor. Each method was evaluated using area under the curve, reflecting the ability to predict satisfaction. RESULTS: There were 328 patients with ≥80% 5-year follow-up. The optimal percentage cutoff method generally demonstrated the highest predictive accuracy for defining MCID in ODI, NRS back pain, and NRS leg pain, whereas the optimal numeric cutoff method generally demonstrated the highest predictive accuracy for EQ-5D. For ODI, 2-year optimal percentage cutoff was 30.4% and 5-year optimal percentage cutoff was 38.1%. For NRS back pain, 2-year optimal percentage cutoff was 75.0% and 5-year optimal percentage cutoff was 42.9%. For NRS leg pain, 2-year optimal percentage cutoff was 62.5% and 5-year optimal percentage cutoff was 66.6%. For EQ-5D, the optimal numeric cutoffs were 0.293 at 2 years and 0.128 at 5 years. CONCLUSION: Using satisfaction as an anchor, this study identified the optimal percentage cutoff as the most appropriate method for determining MCID in ODI and NRS pain scores, while the optimal numeric cutoff was most appropriate for EQ-5D in grade 2 spondylolisthesis. These findings provide reference definitions for evaluating postoperative improvement in this patient population.

Authors

Institutions

Publication Details

Journal
Neurosurgery
Published
2026-10-30
DOI
https://doi.org/10.1227/neu.0000000000004279
Primary Topic
Musculoskeletal pain and rehabilitation
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

What Is the Most Appropriate Method for Determining Minimally Clinical Important Difference in Grade 2 Spondylolisthesis? A QOD Spine CORe® Study

Erica Fay Bisson, Izza Tahir, Paul K. Kim, Paul Park et al.
2 links
Neurosurgery
Musculoskeletal pain and rehabilitation
article

What Is the Most Appropriate Method for Determining Minimally Clinical Important Difference in Grade 2 Spondylolisthesis? A QOD Spine CORe® Study

Erica Fay Bisson, Izza Tahir, Paul K. Kim, Paul Park, Maliya Delawan, Steven D. Glassman, Praveen V. Mummaneni, Matthew J. McGirt, Mohamad Bydon, Christopher I. Shaffrey, Cheerag D. Upadhyaya, Oren N. Gottfried, Chun-Po Yen, Juan S. Uribe, Kevin T. Foley, Domagoj Coric, Vincent J. Alentado, Michael S. Virk, Daniel Zeitouni, Andrew Kai-Hong Chan, Dean Chou, Eric A. Potts, Vivian P. Le, Jay D. Turner, Kai-Ming G. Fu, Anthony L. Asher, Timothy J. Yee, Regis William Haid, Michael Y. Wang
article en

Abstract

BACKGROUND AND OBJECTIVES: Minimally clinically important difference (MCID) defines the smallest difference in patient-reported outcomes (PROs) required for a level of clinical improvement. The hypothesis of this study is that at least one of the MCID thresholds in this study will provide appropriate MCID thresholds for the PROs in grade 2 spondylolisthesis. METHODS: This study used the Grade 2 Spondylolisthesis module of the Quality Outcomes Database Spine CORe® Study Group, which included 328 patients from 14 institutions. PROs collected include Oswestry Disability Index (ODI), Numeric Rating Scale (NRS) for back pain and leg pain, and European Quality of Life-5 Dimensions (EQ-5D). Seven MCID thresholds were calculated with North American Spine Society satisfaction scale as the anchor. Each method was evaluated using area under the curve, reflecting the ability to predict satisfaction. RESULTS: There were 328 patients with ≥80% 5-year follow-up. The optimal percentage cutoff method generally demonstrated the highest predictive accuracy for defining MCID in ODI, NRS back pain, and NRS leg pain, whereas the optimal numeric cutoff method generally demonstrated the highest predictive accuracy for EQ-5D. For ODI, 2-year optimal percentage cutoff was 30.4% and 5-year optimal percentage cutoff was 38.1%. For NRS back pain, 2-year optimal percentage cutoff was 75.0% and 5-year optimal percentage cutoff was 42.9%. For NRS leg pain, 2-year optimal percentage cutoff was 62.5% and 5-year optimal percentage cutoff was 66.6%. For EQ-5D, the optimal numeric cutoffs were 0.293 at 2 years and 0.128 at 5 years. CONCLUSION: Using satisfaction as an anchor, this study identified the optimal percentage cutoff as the most appropriate method for determining MCID in ODI and NRS pain scores, while the optimal numeric cutoff was most appropriate for EQ-5D in grade 2 spondylolisthesis. These findings provide reference definitions for evaluating postoperative improvement in this patient population.

Neurosurgery
University of North Carolina at Chapel Hill (US), Barrow Neurological Institute (US), St. Joseph's Hospital and Medical Center (US), Carolinas Healthcare System (US), University of Miami (US), University of California, San Francisco (US), University of Utah (US), University of Michigan (US), Columbia University Irving Medical Center (US), University of Chicago (US), Carolina Neurosurgery and Spine Associates (US), Semmes Murphey Foundation (US), Duke Medical Center (US), Weill Cornell Medicine (US), Goodman Campbell Brain and Spine (US), Norton Leatherman Spine (US), University of Virginia (US), Columbia University (US)
Good health and well-being
Openalex Percentile: Top 13%
Musculoskeletal pain and rehabilitation
DOISourceOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.

Laika access coming soon