Minimal Clinically Important Difference in Quality of Life for Patients With Low Back Pain
Abstract
Study Design.: Multicenter, prospective, cohort study. Objective.: To estimate the Minimal Clinically Important Difference (MCID) for the physical (PCS) and mental (MCS) component summaries of Short Form SF-12 (SF-12), in patients with low back pain (LBP). Summary of Background Data.: Quality of life is one of the core domains recommended to be assessed in patients with LBP. SF-12 is the most widely used instrument for this purpose, but its MCID was unknown. Methods.: A total of 458 patients with subacute and chronic LBP were consecutively recruited across 21 practices. LBP, referred pain, disability, PCS, and MCS were assessed upon recruitment and 12 months later. Self-reported health status change between baseline and 12 month-assessment, was used as the external criterion. The MCID for SF-12 was estimated following four anchor-based methods; minimal detectable change (MDC); average change (AC); change difference (CD); and receiver operating characteristic curve (ROC), for which the area under the curve (AUC) was calculated. The effect on MCID values of pain duration and baseline scores was assessed. Results.: Values for PCS were: MDC: 0.56, AC: 2.71, CD: 3.29, and ROC: 1.14. Values for MCS were: MDC: 3.77, AC: 3.54, CD: 1.13, and ROC: 4.23. AUC values were <0.7; MCID values were smaller among chronic patients and those with better baseline quality of life. Conclusion.: Different methods for MCID calculation lead to different results. In patients with subacute and chronic LBP, improvements >3.77 in MCS and >3.29 in PCS, can be considered clinically relevant. MCID is smaller in patients with longer pain duration and better baseline quality of life. Level of Evidence: 2
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It has been reported that improvements of more than 3.77 in mental health component scores and of more than 3.29 in physical component scores should be considered clinically relevant in people (average age 46 years) with low back pain.
“It has been reported that improvements of more than 3.77 in mental health component scores and of more than 3.29 in physical component scores should be considered clinically relevant in people (average age 46 years) with low back pain.46”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [46]
Diaz-Arribas et al. was the only study assessing SF-12 measurement error.
“Diaz-Arribas et al. [53] (doubtful quality) was the only study assessing measurement error.”
From Evidence on the measurement properties of health-related quality of life instruments is largely missing in patients with low back pain: A systematic review (2018) · cites this paper as [53]
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- Authors
- Díaz-Arribas, M. J., Fernández-Serrano, M., Royuela, A., Kovacs, F. M., Gallego-Izquierdo, T., Ramos-Sánchez, M., Llorca-Palomera, R., Pardo-Hervás, P., & Martín-Pariente, O. S.
- Affiliations
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Complutense University, Madrid, Spain
- Universidad de Alcalá (ES)
- Hospital Universitario Puerta de Hierro Majadahonda (ES)
- Universidad Complutense de Madrid (ES)
- Nurse and Physical Therapy Department. University of Alcalá, Alcalá de Henares, Spain
- Spanish Back Pain Research Network
- Corresponding author
- Kovacs, Francisco M.
- Llorca-Palomera, Rosa
- Venue
- Spine
- Published
- 2017-12-15
- Volume
- 42
- Issue
- 24
- Pages
- 1908-1916
- ISSN
- 0362-2436 (ISSN-L)
- 1528-1159
- OpenAlex
- W2724099969
- Cited by
- 184
- References
- 59
- Citations by year
- 2026: 19 · 2025: 24 · 2024: 26 · 2023: 15 · 2022: 21 · 2021: 32 · 2020: 25 · 2019: 9 · 2018: 11 · 2017: 2
- FWCI
- 8.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Spine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- minimal clinically important difference, low back pain, quality of life, SF-12, physical component summary, mental component summary, anchor-based methods, minimal detectable change, receiver operating characteristic, subacute low back pain, chronic low back pain, pain duration, baseline quality of life
- MeSH terms
- Minimal Clinically Important Difference, Conservative Treatment, Adult, Disability Evaluation, Female, Health Status, Humans, Male, Middle Aged, Pain Measurement, Prospective Studies, Quality of Life, ROC Curve, Treatment Outcome, Low Back Pain, Area Under Curve, Self Report, Chronic Pain
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