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Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity.

Abstract

STUDY DESIGN

Longitudinal cohort.

OBJECTIVE

To calculate the minimum clinically important difference (MCID) threshold values for the Scoliosis Research Society-22R (SRS-22R) in Japanese patients with adult spinal deformity (ASD) and to compare the results with previously reported values in a North American population.

SUMMARY OF BACKGROUND DATA

The SRS-22R has been shown to be reliable, valid, and responsive to change in patients with ASD undergoing surgery. The MCID quantifies a threshold value of improvement that is clinically relevant to the patient. We hypothesize that MCID threshold values of SRS-22R differ between different cultural groups.

METHODS

We identified ASD patients who completed the SRS-22R preoperatively and the SRS-30 at minimum two years after surgery. Answers to the last seven questions of the SRS-30 were used as anchors to determine the MCID for the SRS-22R Activity, Pain, Appearance, Mental domains, and Total score using receiver operating characteristic (ROC) curve analysis.

RESULTS

A total of 122 (16 male, 106 female) patients were included in the analysis. There was a statistically significant improvement in all domain scores from preoperation to two years postoperation. There was a statistically significant difference in change in domain score among the responses to the anchors (p < .05). The ROC curve analysis yielded MCID values of 0.90 for Activity (area under the curve [AUC] = 0.766), 0.85 for Pain (AUC = 0.637), 1.05 for Appearance (AUC = 0.764), and 0.70 for Mental (AUC = 0.641) domain, 1.05 for Total score (AUC = 0.670). Except for Appearance, these MCID thresholds were higher compared with values reported in patients from North America (Activity = 0.60, Pain = 0.40, Appearance = 1.23, Total = 0.71).

CONCLUSIONS

Results of this study showed that cultural variations exist for MCID threshold values for SRS-22 Activity, Pain, Mental domains, and Total score after surgical treatment of ASD.

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  • Authors+Show Affiliations

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan; Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202 USA; Department of Orthopaedic Surgery, University of Louisville School of Medicine, 550 S. Jackson Street, 1st Floor ACB, Louisville, KY 40202 USA. Electronic address: arihidee@gmail.com.

    ,

    Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202 USA.

    ,

    Norton Leatherman Spine Center, 210 East Gray Street, Suite 900, Louisville, KY 40202 USA; Department of Orthopaedic Surgery, University of Louisville School of Medicine, 550 S. Jackson Street, 1st Floor ACB, Louisville, KY 40202 USA.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Division of Geriatric Musculoskeletal Health, Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu-city, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu Medical Center, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Division of Geriatric Musculoskeletal Health, Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu-city, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    ,

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192 Japan.

    Source

    Spine deformity 7:4 2019 Jul pg 627-632

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31202381

    Citation

    Arima, Hideyuki, et al. "Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity." Spine Deformity, vol. 7, no. 4, 2019, pp. 627-632.
    Arima H, Carreon LY, Glassman SD, et al. Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity. Spine Deform. 2019;7(4):627-632.
    Arima, H., Carreon, L. Y., Glassman, S. D., Yamato, Y., Hasegawa, T., Togawa, D., ... Matsuyama, Y. (2019). Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity. Spine Deformity, 7(4), pp. 627-632. doi:10.1016/j.jspd.2018.10.003.
    Arima H, et al. Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity. Spine Deform. 2019;7(4):627-632. PubMed PMID: 31202381.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cultural Variations in the Minimum Clinically Important Difference Thresholds for SRS-22R After Surgery for Adult Spinal Deformity. AU - Arima,Hideyuki, AU - Carreon,Leah Y, AU - Glassman,Steven D, AU - Yamato,Yu, AU - Hasegawa,Tomohiko, AU - Togawa,Daisuke, AU - Kobayashi,Sho, AU - Yoshida,Go, AU - Yasuda,Tatsuya, AU - Banno,Tomohiro, AU - Oe,Shin, AU - Mihara,Yuki, AU - Ushirozako,Hiroki, AU - Matsuyama,Yukihiro, PY - 2018/02/21/received PY - 2018/10/10/revised PY - 2018/10/14/accepted PY - 2019/6/17/entrez PY - 2019/6/17/pubmed PY - 2019/6/17/medline KW - Adult scoliosis KW - Adult spine deformity KW - Cultural difference KW - Minimum clinically important difference KW - Scoliosis Research Society–22R SP - 627 EP - 632 JF - Spine deformity JO - Spine Deform VL - 7 IS - 4 N2 - STUDY DESIGN: Longitudinal cohort. OBJECTIVE: To calculate the minimum clinically important difference (MCID) threshold values for the Scoliosis Research Society-22R (SRS-22R) in Japanese patients with adult spinal deformity (ASD) and to compare the results with previously reported values in a North American population. SUMMARY OF BACKGROUND DATA: The SRS-22R has been shown to be reliable, valid, and responsive to change in patients with ASD undergoing surgery. The MCID quantifies a threshold value of improvement that is clinically relevant to the patient. We hypothesize that MCID threshold values of SRS-22R differ between different cultural groups. METHODS: We identified ASD patients who completed the SRS-22R preoperatively and the SRS-30 at minimum two years after surgery. Answers to the last seven questions of the SRS-30 were used as anchors to determine the MCID for the SRS-22R Activity, Pain, Appearance, Mental domains, and Total score using receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 122 (16 male, 106 female) patients were included in the analysis. There was a statistically significant improvement in all domain scores from preoperation to two years postoperation. There was a statistically significant difference in change in domain score among the responses to the anchors (p < .05). The ROC curve analysis yielded MCID values of 0.90 for Activity (area under the curve [AUC] = 0.766), 0.85 for Pain (AUC = 0.637), 1.05 for Appearance (AUC = 0.764), and 0.70 for Mental (AUC = 0.641) domain, 1.05 for Total score (AUC = 0.670). Except for Appearance, these MCID thresholds were higher compared with values reported in patients from North America (Activity = 0.60, Pain = 0.40, Appearance = 1.23, Total = 0.71). CONCLUSIONS: Results of this study showed that cultural variations exist for MCID threshold values for SRS-22 Activity, Pain, Mental domains, and Total score after surgical treatment of ASD. SN - 2212-1358 UR - https://www.unboundmedicine.com/medline/citation/31202381/Cultural_Variations_in_the_Minimum_Clinically_Important_Difference_Thresholds_for_SRS-22R_After_Surgery_for_Adult_Spinal_Deformity L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-134X(18)30274-0 DB - PRIME DP - Unbound Medicine ER -