Abstract
PurposeIt is difficult for clinicians to inform patients about the success rate of a treatment as a cervical anterior discectomy procedure. Ideally, a proportion of good outcome as rated by patients is known. Patient-reported outcome measurements are helpful. The purpose is to relate the difference in Neck Disability Index (NDI) after a cervical anterior discectomy procedure for single level cervical degenerative disc disease with the patients’ rating of their actual clinical situation after long‐term follow-up to define the substantial clinical benefit (SCB).MethodsAfter completion of the NDI, patients who were surgically treated for cervical single level degenerative disease were asked to complete a five‐item Likert scale to rate their clinical situation. After dichotomisation of the outcome in good versus less than good, a cut‐off value was defined by determining the value of the difference of NDI with the highest specificity and sensitivity. Funding was not obtained.ResultsSCB for NDI after surgery for cervical single level degenerative disease should be set at ten with area under the curve (AUC) of 0.71 for sensitivity as well specificity.ConclusionsThe goal for each treatment is a good outcome. While comparing treatments for cervical degenerative disc disease only those with an SCB of ten will be relevant for the patient, as patients who achieved this difference in NDI rated their actual situation at long‐term follow‐up as good.
Highlights
Minimal clinically important difference (MCID) has been introduced to incorporate clinical relevance in the interpretation of the results of clinical trials
After completion of the Neck Disability Index (NDI), patients who were surgically treated for cervical single level degenerative disease were asked to complete a five-item Likert scale to rate their clinical situation
Minimal clinically important difference (MCID) has been introduced in medical literature to define a threshold of improvement that is clinically important for relativizing the statistically significant differences
Summary
Minimal clinically important difference (MCID) has been introduced to incorporate clinical relevance in the interpretation of the results of clinical trials. It was defined as ‘‘the smallest difference in score in the domain of interest which patients perceive as beneficial and would mandate, in the absence of troublesome side effects and excessive cost, a change in the patient’s management’’ [1]. They rate their outcome according to predefined terms and relative to their pre-treatment situation Statements such as much better, somewhat better, about the same, somewhat worse and much worse are used for the comparison of patient’s ratings and clinical outcome to estimate MCID.
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