Back pain monitoring response to therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
Methods of determining the minimal clinically important difference (MCID)
The Oswestry low back pain disability questionnaire (ODQ) contains 10 questions that have 5-point Likert scale answers and can measure the response to therapy.[1]
- The ODQ questions are worded to reduce recall bias[2].
- The minimal clinically important differences (MCID) has been proposed as >0.5 standard deviation improvement.[3]
- MCID of 12.8 has been proposed[4]
- Copay et al used various methods to determine the optimal MCID[4].
- Receiver-operating characteristic curve derived MCID: " The optimal cut-off value for a ROC curve corresponds to the point of optimal trade-off between sensitivity and specificity "
- Half a standard deviation: Template:Sfrac \times {SD}
- Standard error of measurement SD \times \sqrt{1 - r}, "where SD is the standard deviation of the baseline scores and r is the test-retest reliability coefficient"
- Minimum detectable change: 1.96 \times \sqrt{2} \times{SEM}
- Effect size derived MCID: "multiplying the SD of the baseline scores by 0.2 (the small effect size)"
- Copay et al used various methods to determine the optimal MCID[4].
Recommendations for the minimal clinically important difference (MCID)
Copay calculated the MCID to be 12.8[4]. Davidson recommends an MCID of 10.5 or 15[5].
Fritz calculated a value for the MCID of 6.[6]
Vianin's literature review finds the range of MCIDs proposed is 4 to 10.5.[7]
See also
References
- ↑ Fairbank JC, Couper J, Davies JB, O'Brien JP (1980). "The Oswestry low back pain disability questionnaire". Physiotherapy. 66 (8): 271–3. PMID 6450426.
- ↑ Tiao, Justin; Rosenberg, Ashley M.; Bienstock, Dennis M.; Sacks, Brittany; Laurore, Charles; Herrera, Michael; Shankar, Dhruv S.; Bronson, Wesley H.; Chaudhary, Saad B.; Poeran, Jashvant; Iatridis, James C.; Hecht, Andrew C. (2025-04-01). "The Oswestry Disability Index and 12-Item Short Form Health Survey Physical Component Scores Are Not Affected by Recall Bias in Posterior Lumbar Spine Surgery Patients: A Prospective Study Using Data From Fitness Trackers". Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews. 9 (4): e24.00185. doi:10.5435/JAAOSGlobal-D-24-00185. ISSN 2474-7661. PMC 11981322 Check
|pmc=value (help). PMID 40215470 Check|pmid=value (help). - ↑ Delitto A, Piva SR, Moore CG, Fritz JM, Wisniewski SR, Josbeno DA; et al. (2015). "Surgery versus nonsurgical treatment of lumbar spinal stenosis: a randomized trial". Ann Intern Med. 162 (7): 465–73. doi:10.7326/M14-1420. PMC 6252248. PMID 25844995. Review in: Evid Based Med. 2016 Feb;21(1):31
- ↑ 4.0 4.1 4.2 Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY (2008). "Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales". Spine J. 8 (6): 968–74. doi:10.1016/j.spinee.2007.11.006. PMID 18201937.
- ↑ Davidson M, Keating JL (2002). "A comparison of five low back disability questionnaires: reliability and responsiveness". Phys Ther. 82 (1): 8–24. doi:10.1093/ptj/82.1.8. PMID 11784274.
- ↑ Fritz, J. M.; Irrgang, J. J. (2001). "A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale" (PDF). Physical Therapy. 81 (2): 776–788. doi:10.1093/ptj/81.2.776. ISSN 0031-9023. PMID 11175676. Retrieved 2025-08-19.
- ↑ Vianin M (2008). "Psychometric properties and clinical usefulness of the Oswestry Disability Index". J Chiropr Med. 7 (4): 161–3. doi:10.1016/j.jcm.2008.07.001. PMC 2697602. PMID 19646379.