The Minimal Clinically Important Difference in Vestibular Schwannoma Quality-of-Life Assessment: An Important Step beyond P

Matthew L. Carlson, Øystein Vesterli Tveiten, Kathleen J Yost, Christine M. Lohse, Morten Lund-Johansen, Michael J. Link

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective. Several studies have demonstrated small but statistically significant differences in quality-of-life (QOL) scores among vestibular schwannoma (VS) treatment modalities. However, does a several-point difference on a 100-point scale really matter? The minimal clinically important difference (MCID)∗defined as the smallest difference in scores that patients perceive as important and that could lead to a change in management-was developed to answer this important question. While the MCID has been determined for QOL measures used in other diseases, it remains undefined in the VS literature. Study Design. Distribution- and anchor-based techniques were utilized to define the MCID for the Penn Acoustic Neuroma Quality of Life (PANQOL) and 36-Item Short Form Health Survey (SF-36). Setting. Two academic referral centers. Patients. Patients with VS (N = 538). Intervention. Cross-sectional postal survey. Main Outcome Measures. MCID for PANQOL domains and total score and SF-36 Physical and Mental Health Component Summary scores. Results. The MCID (median, interquartile range) for the PANQOL total score was 11 points (10-12); the MCIDs for individual domains were as follows: hearing, 6 (5-8); balance, 16 (14-19); facial, 10 (no interquartile range); pain, 11 (10- 13); energy, 13 (10-17); anxiety, 11 (5-22); and general, 15 (11-19). The MCID was 7 points (6-11) for the SF-36 Mental Health Component Summary score and 8 points (6- 10) for the Physical Health Component Summary score. Conclusions. The MCIDs determined in the current study generally exceed differences reported in previous prospective studies, in which conclusions about QOL benefit (or harm) among VS treatment modalities were based on statistical significance alone. Moving forward, these MCIDs should be considered when interpreting results of VS QOL studies.

Original languageEnglish (US)
Pages (from-to)202-208
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume153
Issue number2
DOIs
StatePublished - Aug 25 2015

Fingerprint

Acoustic Neuroma
Quality of Life
Mental Health
Minimal Clinically Important Difference
Health Surveys
Hearing
Referral and Consultation
Anxiety
Cross-Sectional Studies
Outcome Assessment (Health Care)
Prospective Studies
Pain
Health
Therapeutics

Keywords

  • acoustic neuroma
  • cerebellopontine angle
  • gamma knife radiosurgery
  • microsurgery
  • minimal clinically important difference
  • patient-reported outcome measures
  • quality of life
  • stereotactic radiosurgery
  • vestibular schwannoma

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery
  • Medicine(all)

Cite this

The Minimal Clinically Important Difference in Vestibular Schwannoma Quality-of-Life Assessment : An Important Step beyond P. / Carlson, Matthew L.; Tveiten, Øystein Vesterli; Yost, Kathleen J; Lohse, Christine M.; Lund-Johansen, Morten; Link, Michael J.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 153, No. 2, 25.08.2015, p. 202-208.

Research output: Contribution to journalArticle

Carlson, Matthew L. ; Tveiten, Øystein Vesterli ; Yost, Kathleen J ; Lohse, Christine M. ; Lund-Johansen, Morten ; Link, Michael J. / The Minimal Clinically Important Difference in Vestibular Schwannoma Quality-of-Life Assessment : An Important Step beyond P. In: Otolaryngology - Head and Neck Surgery (United States). 2015 ; Vol. 153, No. 2. pp. 202-208.
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abstract = "Objective. Several studies have demonstrated small but statistically significant differences in quality-of-life (QOL) scores among vestibular schwannoma (VS) treatment modalities. However, does a several-point difference on a 100-point scale really matter? The minimal clinically important difference (MCID)∗defined as the smallest difference in scores that patients perceive as important and that could lead to a change in management-was developed to answer this important question. While the MCID has been determined for QOL measures used in other diseases, it remains undefined in the VS literature. Study Design. Distribution- and anchor-based techniques were utilized to define the MCID for the Penn Acoustic Neuroma Quality of Life (PANQOL) and 36-Item Short Form Health Survey (SF-36). Setting. Two academic referral centers. Patients. Patients with VS (N = 538). Intervention. Cross-sectional postal survey. Main Outcome Measures. MCID for PANQOL domains and total score and SF-36 Physical and Mental Health Component Summary scores. Results. The MCID (median, interquartile range) for the PANQOL total score was 11 points (10-12); the MCIDs for individual domains were as follows: hearing, 6 (5-8); balance, 16 (14-19); facial, 10 (no interquartile range); pain, 11 (10- 13); energy, 13 (10-17); anxiety, 11 (5-22); and general, 15 (11-19). The MCID was 7 points (6-11) for the SF-36 Mental Health Component Summary score and 8 points (6- 10) for the Physical Health Component Summary score. Conclusions. The MCIDs determined in the current study generally exceed differences reported in previous prospective studies, in which conclusions about QOL benefit (or harm) among VS treatment modalities were based on statistical significance alone. Moving forward, these MCIDs should be considered when interpreting results of VS QOL studies.",
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N2 - Objective. Several studies have demonstrated small but statistically significant differences in quality-of-life (QOL) scores among vestibular schwannoma (VS) treatment modalities. However, does a several-point difference on a 100-point scale really matter? The minimal clinically important difference (MCID)∗defined as the smallest difference in scores that patients perceive as important and that could lead to a change in management-was developed to answer this important question. While the MCID has been determined for QOL measures used in other diseases, it remains undefined in the VS literature. Study Design. Distribution- and anchor-based techniques were utilized to define the MCID for the Penn Acoustic Neuroma Quality of Life (PANQOL) and 36-Item Short Form Health Survey (SF-36). Setting. Two academic referral centers. Patients. Patients with VS (N = 538). Intervention. Cross-sectional postal survey. Main Outcome Measures. MCID for PANQOL domains and total score and SF-36 Physical and Mental Health Component Summary scores. Results. The MCID (median, interquartile range) for the PANQOL total score was 11 points (10-12); the MCIDs for individual domains were as follows: hearing, 6 (5-8); balance, 16 (14-19); facial, 10 (no interquartile range); pain, 11 (10- 13); energy, 13 (10-17); anxiety, 11 (5-22); and general, 15 (11-19). The MCID was 7 points (6-11) for the SF-36 Mental Health Component Summary score and 8 points (6- 10) for the Physical Health Component Summary score. Conclusions. The MCIDs determined in the current study generally exceed differences reported in previous prospective studies, in which conclusions about QOL benefit (or harm) among VS treatment modalities were based on statistical significance alone. Moving forward, these MCIDs should be considered when interpreting results of VS QOL studies.

AB - Objective. Several studies have demonstrated small but statistically significant differences in quality-of-life (QOL) scores among vestibular schwannoma (VS) treatment modalities. However, does a several-point difference on a 100-point scale really matter? The minimal clinically important difference (MCID)∗defined as the smallest difference in scores that patients perceive as important and that could lead to a change in management-was developed to answer this important question. While the MCID has been determined for QOL measures used in other diseases, it remains undefined in the VS literature. Study Design. Distribution- and anchor-based techniques were utilized to define the MCID for the Penn Acoustic Neuroma Quality of Life (PANQOL) and 36-Item Short Form Health Survey (SF-36). Setting. Two academic referral centers. Patients. Patients with VS (N = 538). Intervention. Cross-sectional postal survey. Main Outcome Measures. MCID for PANQOL domains and total score and SF-36 Physical and Mental Health Component Summary scores. Results. The MCID (median, interquartile range) for the PANQOL total score was 11 points (10-12); the MCIDs for individual domains were as follows: hearing, 6 (5-8); balance, 16 (14-19); facial, 10 (no interquartile range); pain, 11 (10- 13); energy, 13 (10-17); anxiety, 11 (5-22); and general, 15 (11-19). The MCID was 7 points (6-11) for the SF-36 Mental Health Component Summary score and 8 points (6- 10) for the Physical Health Component Summary score. Conclusions. The MCIDs determined in the current study generally exceed differences reported in previous prospective studies, in which conclusions about QOL benefit (or harm) among VS treatment modalities were based on statistical significance alone. Moving forward, these MCIDs should be considered when interpreting results of VS QOL studies.

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