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Patients with subacute and chronic LBP showed
improvements of > 3.29 in PCS and > 3.77 in MCS.
Quality of life is one of the essential aspects to be assessed in patients with low back pain (LBP). For its measurement, SF-12 (a survey) is the most extensively used method, but its Minimal Clinically Important Difference (MCID) was not known.
A multicenter, prospective, cohort study was performed with an objective to assess the MCID for the physical (PCS) and mental (MCS) component summaries of Short Form SF-12 (SF-12), in patients with low back pain (LBP).
In this study, patient (n-458) with subacute and chronic LBP were consecutively recruited across 21 practices. Upon recruitment and 12 months later, specific criteria like LBP, referred pain, disability, PCS and MCS were evaluated. The external standard used were self-reported health status change between baseline and 12 month-assessment. Estimation of MCID for SF-12 was done following four anchor-based methods for which the Area Under the Curve (AUC) was calculated. These methods include minimal detectable change (MDC); average change (AC); change difference (CD); and receiver operating characteristic curve (ROC). The effect on MCID values of pain duration and baseline scores were also assessed.
The findings of the study revealed the values for PCS: 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. Values of MCID were found to be
smaller among chronic patients and those with better baseline quality of life.
Therefore, it can be concluded that calculating MCID through
different methods leads to different results. In subacute and chronic LBP
patients, improvements > 3.77 in MCS and > 3.29 in PCS, can be considered
clinically relevant. MCID was noted to be smaller in patients having longer
pain duration and better baseline quality of life.
Spine (Phila Pa 1976). 2017 Dec 15;42(24):1908-1916.
Minimal Clinically Important Difference in Quality of Life for Patients with Low Back Pain
Díaz-Arribas MJ, Fernández-Serrano M et al.
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