Minimal Clinically Important Difference (MCID) and Long-Term Prospective Validation of the AO Spine PROST (Patient Reported Outcome Spine Trauma).
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 41999491.
- Also identified by DOI 10.1177/21925682261445019 and PMC identifier 13091905.
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Abstract
Study designProspective observational multicenter cohort study.ObjectivesTo determine Minimal Clinically Important Difference (MCID) of AO Spine PROST (Patient Reported Outcome Spine Trauma) and conducting a long-term prospective validation.MethodsData were collected from a prospective observational international multicenter cohort study. Adults (18-65) with acute thoracolumbar (TL) burst fractures without neurologic deficits were enrolled, and followed for up to 2 years. Patients completed the AO Spine PROST, Oswestry Disability Index (ODI), EQ-5D, and Pain NRS. Characteristics were analyzed using descriptive statistics, MCID for PROST with distribution-based approach using the standard deviation (SD) of change in scores. Floor and ceiling effects were also evaluated. Internal consistency (Cronbach's alpha, item-total correlation coefficient (ITCC) and pairwise Spearman correlation), construct validity (Pearson correlations (r<sub>s</sub>) with ODI, EQ-5D, Pain NRS), and responsiveness (effect sizes (ES) and standardized response mean (SRM)) were assessed.ResultsNinety-three patients were included. MCID for a moderate change (0.5*SD) in PROST score was 10.6. No floor or ceiling effects were observed. Internal consistency was high (Cronbach's α = 0.9-1.0 and acceptable ITCC). PROST scores strongly correlated with ODI (rs = -0.67 to -0.89; <i>P</i> < .001), but correlations with EQ-5D were weak (r<sub>s</sub> = -0.29 to 0.05; <i>P</i> > .005), except at 1-year follow-up. No consistent pattern was found with Pain NRS. Responsiveness was very good (ES = 3.2, SRM = 3.1; <i>P</i> < .001).ConclusionsThe AO Spine PROST identified an MCID of 10.6 as indicative of a moderate clinically meaningful change. The instrument also showed strong internal consistency, construct validity, and excellent responsiveness in long-term follow-up.