Evidence map›Paper›PMID 24421616›Full record

ArticleThe Journal of manual & manipulative therapy2013

Different minimally important clinical difference (MCID) scores lead to different clinical prediction rules for the Oswestry disability index for the same sample of patients.

Julie Schwind, Kenneth Learman, Bryan O'Halloran, Christopher Showalter, Chad Cook

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Article in The Journal of manual & manipulative therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  19. Modic Changes and Tumor Necrosis Factor Inhibition: Is the Door Shut?Arthritis & rheumatology (Hoboken, N.J.) · 2025
    Article
  20. Analysis of the factors associated with sexual health improvement in patients who underwent surgical management for adult spine deformity.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Julie SchwindWalsh University, North Canton, OH, USA.
Kenneth LearmanWalsh University, North Canton, OH, USA.
Bryan O'HalloranWalsh University, North Canton, OH, USA.
Christopher ShowalterWalsh University, North Canton, OH, USA.
Chad CookWalsh University, North Canton, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimal clinically important difference (MCID) scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. There are numerous outcome instruments used for analyzing pain, disability, and dysfunction of the low back; perhaps the most common of these is the Oswestry disability index (ODI). A single agreed-upon MCID score for the ODI has yet to be established. What is also unknown is whether selected baseline variables will be universal predictors regardless of the MCID used for a particular outcome measure.

objectiveTo explore the relationship between predictive models and the MCID cutpoint on the ODI.

settingData were collected from 16 outpatient physical therapy clinics in 10 states.

designSecondary database analysis using backward stepwise deletion logistic regression of data from a randomized controlled trial (RCT) to create prognostic clinical prediction rules (CPR). PARTICIPANTS AND

interventionsOne hundred and forty-nine patients with low back pain (LBP) were enrolled in the RCT. All were treated with manual therapy, with a majority also receiving spine-strengthening exercises.

resultsThe resultant predictive models were dependent upon the MCID used and baseline sample characteristics. All CPR were statistically significant (P < 001). All six MCID cutpoints used resulted in completely different significant predictor variables with no predictor significant across all models. LIMITATIONS: The primary limitations include sub-optimal sample size and study design.

conclusionsThere is extreme variability among predictive models created using different MCIDs on the ODI within the same patient population. Our findings highlight the instability of predictive modeling, as these models are significantly affected by population baseline characteristics along with the MCID used. Clinicians must be aware of the fragility of CPR prior to applying each in clinical practice.

Indexed as

Clinical prediction ruleLow back painMinimal clinically important differencePrognosis

Identifiers

PMID24421616
PMCPMC3649353

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.