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Multicenter Study
. 2020 Sep 15;45(18):1309-1316.
doi: 10.1097/BRS.0000000000003501.

Evaluating the Minimal Clinically Important Difference of EQ-5D-3L in Patients With Degenerative Lumbar Spinal Stenosis: A Swiss Prospective Multicenter Cohort Study

Jakob M Burgstaller  1 , Maria M Wertli  1   2 , Nils H Ulrich  1 , Giuseppe Pichierri  1 , Florian Brunner  3 , Mazda Farshad  4 , François Porchet  5 , Johann Steurer  1 , Isaac Gravestock  1 ; LSOS Study Group
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Free article
Multicenter Study

Evaluating the Minimal Clinically Important Difference of EQ-5D-3L in Patients With Degenerative Lumbar Spinal Stenosis: A Swiss Prospective Multicenter Cohort Study

Jakob M Burgstaller et al. Spine (Phila Pa 1976). .
Free article

Abstract

Study design: Analysis of a prospective, multicenter cohort study.

Objective: The aim of our study was to compare thresholds of published minimal clinically important differences (MCID) for the three-level EuroQol-5D health survey (EQ-5D-3L) summary index (range -0.53 to 1.00) with our anchor-based estimate and evaluate how useful these thresholds are in determining treatment success in patients undergoing surgery for degenerative lumbar spinal stenosis (DLSS).

Summary of background data: MCID values for EQ-5D-3L are specific to the underlying disease and only three studies have been published for DLSS patients reporting different values.

Methods: Patients of the multicenter Lumbar Stenosis Outcome Study with confirmed DLSS undergoing first-time decompression or fusion surgery with 12-month follow-up were enrolled in this study. To calculate MCID we used the Spinal Stenosis Measure satisfaction subscale as anchor.

Results: For this study, 364 patients met the inclusion criteria; of these, 196 were very satisfied, 72 moderately satisfied, 43 somewhat satisfied, and 53 unsatisfied 12 months after surgery. The MCID calculation estimated for EQ-5D-3L a value of 0.19. Compared with published MCID values (ranging from 0.30 to 0.52), our estimation is less restrictive.

Conclusions: In patients with LSS undergoing surgery, we estimated an MCID value for EQ-5D-3L summary index of 0.19 with the help of the average change anchor-based method, which we find to be the most suitable method for assessing patient change scores.

Level of evidence: 3.

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