CoChat
Sign Up
Cited by 211Musculoskeletal pain and rehabilitationPain Mechanisms and TreatmentsMedical Practices and Rehabilitation

Minimal Clinically Important Change for Pain Intensity and Disability in Patients With Nonspecific Low Back Pain

Kovacs, Francisco M., Abraira, Víctor, Royuela, Ana, Corcoll, Josep, Alegre, Luis, Cano, Alejandra, Muriel, Alfonso, Zamora, Javier +3 more·2007·Spine
DOI 10.1097/brs.0b013e31815b75ae
Open this paper in CoChat — free account

Abstract

In Brief Study Design. Cohort study. Objective. To estimate the minimal clinically important change (MCIC) on the pain intensity numerical rating scale (PI-NRS) and the Roland Morris Disability Questionnaire (RMQ) in subacute and chronic patients with low back pain (LBP), with and without referred pain to the leg (LP), seen in the routine clinical practice of the Spanish National Health Service. Summary of Background Data. MCIC have been explored in Anglo-Saxon and Northern European LBP patients. No data on the influence of LP on MCIC are available. In Southern European patients, determinants of disability have shown to be different, and MCIC for pain and disability are unknown. Methods. Data from the postmarketing surveillance of 1349 LBP subacute and chronic patients treated in routine clinical practice were used for this study. Three different methods were used to estimate the MCIC over a 12-week period: the mean change score (MCS), the minimal detectable change (MDC), and the optimal cutoff point in receiver operant curves (OCP). Patients' own “global perceived effect” was used as the external criterion. The effect on MCIC of initial scores, duration of pain, and existence of LP were assessed. Results. Different methods led to different MCIC values, with those deriving from OCP being the smallest. Depending on the methods which were used, the MCIC for LBP ranged from 1.5 to 3.2 PI-NRS points in patients with a baseline score below 7 points, and from 2.5 to 4.3 in patients with a baseline score ≥9 points. The MCIC for disability ranged from 2.5 to 6.8 RMQ points in those with baseline scores below 10 points, and from 5.5 to 13.8 inthose baseline scores ≥15 points. These values were similar for patients with LP, and were not influenced by the duration of pain. Conclusion. In subacute and chronic patients, improvements in LBP of ≤1.5 PI-NRS points, or in disability of ≤2.5 RMQ points should be seen as irrelevant. In those patients, MCIC range values are similar in patients with LP, are consistent across different cultural settings and remain stable no matter what the duration of pain is. Data on 1349 subacute and chronic LBP patients seen in routine practice were used to estimate minimal clinically important changes (MCIC) over a 3-month period. Improvements in pain of ≤1.5 PI-NRS points and improvements in disability of ≤2.5 RMQ points should be seen as irrelevant. Ranges of what constitutes a “relevant” (MCIC) change in pain and disability depend on the method that is used to estimate them and the baseline intensity of symptoms. Those values are similar in patients with referred pain and are consistent across different cultural settings. In subacute and chronic patients, MCIC remains stable regardless of the duration of pain.

Integrity signals

Registry

Crossref · 10.1097/brs.0b013e31815b75ae

Cites

20 of 20 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Kovacs, F. M., Abraira, V., Royuela, A., Corcoll, J., Alegre, L., Cano, A., Muriel, A., Zamora, J., Gil del Real, M. T., Gestoso, M., & Mufraggi, N.
Affiliations
  • Fundación Kovacs (ES)
  • Hospital Universitario Ramón y Cajal (ES)
  • Servei de Salut de les Illes Balears (ES)
  • Govern de les Illes Balears (ES)
Corresponding author
  • Kovacs, Francisco M.
  • Gestoso, Mario
  • Mufraggi, Nicole
ORCID
Venue
Spine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2007-12
Volume
32
Issue
25
Pages
2915-2920
ISSN
0362-2436 (ISSN-L)
DOI
10.1097/brs.0b013e31815b75ae
OpenAlex
W2059808083
Cited by
211
References
20
Citations by year
2026: 15 · 2025: 14 · 2024: 16 · 2023: 9 · 2022: 12 · 2021: 13 · 2020: 5 · 2019: 12 · 2018: 10 · 2017: 8 · 2016: 13 · 2015: 4 · 2014: 11 · 2013: 16 · 2012: 12
FWCI
6.43
Type
journal article
Language
en
Open access
closed
Locations
  • Spine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
non-specific low back pain, minimal clinically important change, pain intensity, disability, Roland-Morris Disability Questionnaire, numerical rating scale, subacute low back pain, chronic low back pain, minimal detectable change, receiver operating characteristic, global perceived effect, post-marketing surveillance, routine clinical practice, Spanish National Health System, pain duration
MeSH terms
Adult, Aged, Chronic Disease, Disability Evaluation, Female, Humans, Male, Middle Aged, Pain Measurement, Patients, Perception, Product Surveillance, Postmarketing, Surveys and Questionnaires, ROC Curve, Severity of Illness Index, Spain, Time Factors, Cohort Studies, Treatment Outcome, Low Back Pain

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review