Nathan Evaniew, Armaan K Malholtra, Raphaële Charest-Morin, Alex Soroceanu, W Bradley Jacobs, David W Cadotte, Greg McIntosh, Nicolas Dea
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We defined appropriate implementation as the congruent magnitude of the scales used for NDI data and the MCID. We evaluated study characteristics associated with appropriate implementation using multivariable logistic regression.</p><p><strong>Results: </strong>Among 163 included studies, twenty (12%) reported a 0 to 50 scale for the NDI, 66 (40%) reported a 0 to 100 scale, and the remaining 77 (47%) did not report which scale was used. Fifty-seven (35%) reported an MCID of 7.5, 37 (23%) reported an MCID of 15, and the remaining 69 (42%) did not report which value of the MCID used. Appropriate implementation of the MCID occurred in 39 studies (24%), whereas implementation was inappropriate in 16 (10%) and uncertain due to poor reporting in 108 (66%). Studies published more recently (OR 1.20 per yr, 95% CI 1.02-1.40, P =0.03) and studies that were RCTs (OR 4.85, 95% CI 1.25-18.79, P =0.02) had greater odds of being associated with appropriate implementation.</p><p><strong>Conclusions: </strong>Inappropriate implementation of the MCID for the NDI is problematic and occurs often, and uncertain implementation due to poor reporting is also common. 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引用次数: 0
摘要
研究设计：系统评价。目的：确定颈部残疾指数（NDI）最小重要临床差异（MCID）实施不当或不确定的发生率。背景资料摘要：NDI由10个项目组成，总分为50分，但一些用户将量表翻倍，以报告总分为100分。NDI最常用的MCID为7.5分（满分50分）。如果用户不注意NDI的规模，MCID的实施可能会出现问题。方法：我们对引用MCID为NDI的研究进行了方法学回顾。我们将适当的实施定义为用于NDI数据和MCID的尺度的一致大小。我们使用多变量逻辑回归评估与适当实施相关的研究特征。结果：在纳入的163项研究中，20项（12%）报告了NDI的0-50量表，66项（40%）报告了0-100量表，其余77项（47%）没有报告使用哪种量表。57例（35%）报告的MCID为7.5,37例（23%）报告的MCID为15，其余69例（42%）没有报告使用的MCID值。39项研究（24%）适当实施了MCID， 16项研究（10%）实施不适当，108项研究（66%）由于报告不准确而不确定。最近发表的研究（OR 1.20 /年，95% CI 1.02 ~ 1.40， P=0.03）和rct研究（OR 4.85, 95% CI 1.25 ~ 18.79， P=0.02）与适当实施相关的几率更大。结论：NDI的MCID执行不当是有问题的，而且经常发生，由于报告不准确而导致执行不确定也很常见。证据使用者在解释实施NDI的研究时应谨慎，并应考虑用于NDI和MCID的量表的大小是否一致。
Implementation of the Minimum Clinically Important Difference for the Neck Disability Index Is Often Problematic: A Methodological Review.
Study design: Systematic review.
Objective: To determine the incidence of inappropriate or uncertain implementation of the minimally important clinical difference (MCID) for the neck disability index (NDI).
Summary of background data: The NDI consists of 10 items that yield a total score out of 50, but some users double the scale to report total scores out of 100. The most used MCID for the NDI is 7.5 out of 50. Implementation of the MCID can be problematic if users are not attentive to the scale of the NDI.
Methods: We performed a methodological review of studies that cited the MCID for the NDI. We defined appropriate implementation as the congruent magnitude of the scales used for NDI data and the MCID. We evaluated study characteristics associated with appropriate implementation using multivariable logistic regression.
Results: Among 163 included studies, twenty (12%) reported a 0 to 50 scale for the NDI, 66 (40%) reported a 0 to 100 scale, and the remaining 77 (47%) did not report which scale was used. Fifty-seven (35%) reported an MCID of 7.5, 37 (23%) reported an MCID of 15, and the remaining 69 (42%) did not report which value of the MCID used. Appropriate implementation of the MCID occurred in 39 studies (24%), whereas implementation was inappropriate in 16 (10%) and uncertain due to poor reporting in 108 (66%). Studies published more recently (OR 1.20 per yr, 95% CI 1.02-1.40, P =0.03) and studies that were RCTs (OR 4.85, 95% CI 1.25-18.79, P =0.02) had greater odds of being associated with appropriate implementation.
Conclusions: Inappropriate implementation of the MCID for the NDI is problematic and occurs often, and uncertain implementation due to poor reporting is also common. Evidence users should be cautious when interpreting studies that implement the NDI, and should consider whether the magnitude of the scales used for the NDI and the MCID are congruent.
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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