TY - JOUR
T1 - The Substantial Clinical Benefit Threshold for SRS-22R Domains After Surgical Treatment of Adult Spinal Deformity
AU - Crawford, Charles H.
AU - Glassman, Steven D.
AU - Bridwell, Keith H.
AU - Carreon, Leah Y.
N1 - Publisher Copyright:
© 2016 Scoliosis Research Society
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Study Design Longitudinal cohort. Objectives To determine Substantial Clinical Benefit (SCB) thresholds for the SRS22R domains in patients undergoing adult spinal deformity surgery. Summary of Background Data The Scoliosis Research Society 22R (SRS22R) has been shown to be reliable, valid, and responsive to change in adult spinal deformity patients. Although the minimal clinically important difference (MCID) is commonly used to quantify a threshold of improvement, it could be considered a floor value rather than a goal. Methods Patients enrolled in a prospective database of adult spinal deformity undergoing surgery with complete SRS22R preoperation and the SRS30 one-year after surgery were identified. One-year postoperative answers to the last 8 questions of the SRS30 were used as anchors to determine the SCB for the Appearance and Activity domains, Subtotal and Total Score using ROC Curve analysis. Results The sample population consisted of 1,422 patients; 83% were females. Mean age was 53 ± 16 years. Mean preoperative SRS22R Appearance score was 2.50 ± 0.73 improving to 3.62 ± 0.84 at one year postoperative. Mean preoperative SRS22R Activity score was 2.96 ± 0.59 improving to 3.33 ± 0.80 at one year postoperative. Mean preoperative SRS22R Pain score was 2.73 ± 0.92 improving to 3.60 ± 0.93 at one year postoperative. Mean preoperative SRS22R Subtotal was 2.56 ± 0.66 improving to 3.11 ± 0.80 at one year postoperative. There was a statistically significant difference in domain scores among the responses to the anchors (p < .001). Based on ROC analysis, SCB was 1.60 for Appearance, 0.87 for Activity, 0.69 for Subtotal, and 0.94 for Total score. Conclusion The results of the current study in an adult spinal deformity population undergoing surgical treatment show SRS22R SCB values of 1.60 for Appearance, 0.87 for Activity, 0.69 for Subtotal, and 0.94 for Total score. These SCB thresholds can be used to quantify the clinical significance of health status change in the surgical management of adult spinal deformity. Level of Evidence Level II.
AB - Study Design Longitudinal cohort. Objectives To determine Substantial Clinical Benefit (SCB) thresholds for the SRS22R domains in patients undergoing adult spinal deformity surgery. Summary of Background Data The Scoliosis Research Society 22R (SRS22R) has been shown to be reliable, valid, and responsive to change in adult spinal deformity patients. Although the minimal clinically important difference (MCID) is commonly used to quantify a threshold of improvement, it could be considered a floor value rather than a goal. Methods Patients enrolled in a prospective database of adult spinal deformity undergoing surgery with complete SRS22R preoperation and the SRS30 one-year after surgery were identified. One-year postoperative answers to the last 8 questions of the SRS30 were used as anchors to determine the SCB for the Appearance and Activity domains, Subtotal and Total Score using ROC Curve analysis. Results The sample population consisted of 1,422 patients; 83% were females. Mean age was 53 ± 16 years. Mean preoperative SRS22R Appearance score was 2.50 ± 0.73 improving to 3.62 ± 0.84 at one year postoperative. Mean preoperative SRS22R Activity score was 2.96 ± 0.59 improving to 3.33 ± 0.80 at one year postoperative. Mean preoperative SRS22R Pain score was 2.73 ± 0.92 improving to 3.60 ± 0.93 at one year postoperative. Mean preoperative SRS22R Subtotal was 2.56 ± 0.66 improving to 3.11 ± 0.80 at one year postoperative. There was a statistically significant difference in domain scores among the responses to the anchors (p < .001). Based on ROC analysis, SCB was 1.60 for Appearance, 0.87 for Activity, 0.69 for Subtotal, and 0.94 for Total score. Conclusion The results of the current study in an adult spinal deformity population undergoing surgical treatment show SRS22R SCB values of 1.60 for Appearance, 0.87 for Activity, 0.69 for Subtotal, and 0.94 for Total score. These SCB thresholds can be used to quantify the clinical significance of health status change in the surgical management of adult spinal deformity. Level of Evidence Level II.
KW - Adult spinal deformity
KW - Clinical outcomes
KW - SRS-22R
KW - Substantial clinical benefit
UR - http://www.scopus.com/inward/record.url?scp=84994607466&partnerID=8YFLogxK
U2 - 10.1016/j.jspd.2016.05.001
DO - 10.1016/j.jspd.2016.05.001
M3 - Article
C2 - 27927495
AN - SCOPUS:84994607466
SN - 2212-134X
VL - 4
SP - 373
EP - 377
JO - Spine deformity
JF - Spine deformity
IS - 5
ER -