ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024
Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide.
Article in 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, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it.
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- Establishing the minimum clinically important difference of the Quality of Life in Childhood Epilepsy Questionnaire.Epilepsia · 2024Trial
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- Migraine and Work-Disability: New Treatments Reduce Work-Related Burden Among Migraine Population.European journal of neurology · 2026Article
- The impact of abutment manufacturing techniques on reverse torque after cyclic loading and implant-abutment interface fitting: an in vitro study.BMC oral health · 2026Article
- Associations between metabolic dysfunction-associated steatotic liver disease and physical and mental health-related quality of life in older adults.GeroScience · 2026Article
- A summer reflection.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 · 2026Article
- Sexual and Psychological Outcomes After Vaginal Surgery for Pelvic Organ Prolpase and Stress Urinary Incontinence.International urogynecology journal · 2026Observational
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Corrections and comments
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Authors and funding
4 authors.
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Abstract
introductionEstablishing thresholds of change that are actually meaningful for the patient in an outcome measurement instrument is paramount. This concept is called the minimum clinically important difference (MCID). We summarize available MCID calculation methods relevant to spine surgery, and outline key considerations, followed by a step-by-step working example of how MCID can be calculated, using publicly available data, to enable the readers to follow the calculations themselves.
methodsThirteen MCID calculations methods were summarized, including anchor-based methods, distribution-based methods, Reliable Change Index, 30% Reduction from Baseline, Social Comparison Approach and the Delphi method. All methods, except the latter two, were used to calculate MCID for improvement of Zurich Claudication Questionnaire (ZCQ) Symptom Severity of patients with lumbar spinal stenosis. Numeric Rating Scale for Leg Pain and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire Walking Ability domain were used as anchors.
resultsThe MCID for improvement of ZCQ Symptom Severity ranged from 0.8 to 5.1. On average, distribution-based methods yielded lower MCID values, than anchor-based methods. The percentage of patients who achieved the calculated MCID threshold ranged from 9.5% to 61.9%.
conclusionsMCID calculations are encouraged in spinal research to evaluate treatment success. Anchor-based methods, relying on scales assessing patient preferences, continue to be the "gold-standard" with receiver operating characteristic curve approach being optimal. In their absence, the minimum detectable change approach is acceptable. The provided explanation and step-by-step example of MCID calculations with statistical code and publicly available data can act as guidance in planning future MCID calculation studies.
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