{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:43Z","timestamp":1787755603999,"version":"build-2784847793"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The smallest worthwhile effect (SWE) enables patients to evaluate the expected value of a treatment by weighing its benefits, risks, and costs. It has emerged as an alternative to the minimal clinically important difference (MCID) for interpreting patient-reported outcome measures (PROMs). The purposes of this study were to determine the SWE estimates and MCID thresholds in patients undergoing surgery for adult idiopathic scoliosis (AdIS) and to verify whether meeting or exceeding the SWE estimates correlates with satisfaction at a minimum of 2 years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with postoperative satisfaction measured at a minimum of 2 years were prospectively recruited between July 2017 and August 2022. The Scoliosis Research Society-22 revised (SRS-22r) questionnaire was preoperatively administered to estimate the SWE thresholds using the benefit-harm trade-off method. The baseline SRS-22r and the SRS-30 at a minimum of 2 years postoperatively were recorded to determine the MCID estimates using the anchor-based approach, with questions 24 to 30 of the SRS-30 used as anchors. A construct validity assessment was performed to evaluate the association between meeting or exceeding the 50th percentile of the SWE (SWE50) threshold and postoperative satisfaction (defined as a score of \u22654 on both SRS-22r satisfaction questions). Race and ethnicity data were collected from the medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 119 Asian participants (19 male and 100 female) with a mean age of 26.5 \u00b1 7.2 years were included. The absolute SWE50 estimates for the SRS-22r were 0.8 (interquartile range [IQR], 0.6 to 1.2) for self-image, 0.0 (IQR, 0.0 to 0.2) for function, 0.0 (IQR, 0.0 to 0.6) for pain, 0.4 (IQR, 0.0 to 0.6) for mental health, and 0.4 (IQR, 0.2 to 0.6) for the total score. The MCID thresholds for the corresponding domains or total score were 0.7, 0.1, 0.1, 0.3, and 0.3, respectively. Achieving or exceeding the absolute SWE50 threshold for the total score (p &lt; 0.001) or the self-image (chi-square, 11.3; p &lt; 0.001), function (chi-square, 6.3; p = 0.012), or pain (chi-square, 5.7; p = 0.017) domain was significantly correlated with postoperative satisfaction at a minimum of 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The SWE could serve as an effective alternative to the MCID for interpreting PROMs at a minimum of 2 years postoperatively in patients with AdIS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.01269","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T18:06:02Z","timestamp":1754417162000},"page":"2023-2030","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Smallest Worthwhile Effect as a Promising Alternative to the MCID in Estimating PROMs for Adult Idiopathic Scoliosis"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5803-7223","authenticated-orcid":false,"given":"Di","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1663-0467","authenticated-orcid":false,"given":"Zhengye","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0356-2418","authenticated-orcid":false,"given":"Guozhuang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5543-4514","authenticated-orcid":false,"given":"Xiangjie","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6365-9981","authenticated-orcid":false,"given":"Yuanpeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2573-1032","authenticated-orcid":false,"given":"Ze","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6126-0533","authenticated-orcid":false,"given":"Jialuo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3129-5190","authenticated-orcid":false,"given":"Terry Jianguo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Key Laboratory of Big Data for Skeletal Deformities, Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Big Data Innovation and Application for Skeletal Health Medical Care, Beijing, People\u2019s Republic of China"},{"name":"State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People\u2019s Republic of 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Deciphering Disorders Involving Scoliosis and Comorbidities Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"issue":"4","key":"bib1-20250917","doi-asserted-by":"crossref","first-page":"447","DOI":"10.2106\/00004623-198365040-00004","article-title":"Curve progression in idiopathic scoliosis","volume":"65","author":"Weinstein","year":"1983","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib2-20250917","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/2017.7.FOCUS17297","article-title":"Evaluation and management of adolescent idiopathic scoliosis: a review","volume":"43","author":"Jada","year":"2017","journal-title":"Neurosurg Focus."},{"issue":"9","key":"bib3-20250917","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1056\/NEJMcp1209063","article-title":"Clinical practice. 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