{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:45:18Z","timestamp":1792691118597,"version":"4.5.0"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The landscape of healthcare policies has undergone significant reforms, with a notable shift toward a patient-centered basis. This change has prioritized the use of metrics reflecting subjective patient-reported outcome measures (PROMs). However, these metrics are often limited, especially in terms of determining clinically relevant changes over time. The concept of the minimal clinically important difference (MCID) has been introduced to address this limitation. In this study, the authors aimed to assess the predictive capability of relative change and its corresponding threshold value, the minimal clinically important relative change (MCIRC), as an alternative to the absolute difference and MCID.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Prospectively collected data from 2006 to 2021 were obtained from the Swedish Spine Registry (Swespine). PROMs included the numeric rating scale (NRS) neck and arm pain scores, the EQ-5D index and EQ visual analog scale (VAS), and the Neck Disability Index (NDI). Anchor-based methods were used to determine MCID and MCIRC. Absolute differences and relative changes were compared in terms of predictive power using the area under the receiver operating characteristic curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 5323 patients were included. The chosen MCID values were \u22123 for NRS neck pain, \u22123 for NRS arm pain, 0.08 for EQ-5D index, 13 for EQ VAS, and \u221230 for NDI scores. The chosen MCIRC values were \u221240% for NRS neck pain, \u221250% for arm pain, 323% for EQ-5D index, 55% for EQ VAS, and \u221233% for NDI scores. Relative change was superior for NRS neck and arm pain scores and NDI, while absolute difference was superior for EQ-5D and EQ VAS scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Relative change and its corresponding MCIRC were found to be more appropriate as a surrogate of subjective satisfaction when studying the NRS and NDI scores, whereas absolute difference and MCID was more appropriate when addressing EQ-5D index and EQ VAS scores.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.4.spine2598","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:34:30Z","timestamp":1757687670000},"page":"464-471","source":"Crossref","is-referenced-by-count":9,"title":["Minimally clinically important relative change instead of difference following surgery for degenerative cervical radiculopathy: a nationwide study on 5300 patients using prospectively collected data"],"prefix":"10.3171","volume":"43","author":[{"given":"Victor Gabriel","family":"El-Hajj","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita M.","family":"Klukowska","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Bialystok, Poland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor E.","family":"Staartjes","sequence":"additional","affiliation":[{"name":"Machine Intelligence in Clinical Neuroscience (MICN) Laboratory, Department of Neurosurgery, University Hospital Zurich, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Atallah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Gerdhem","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Edstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;"},{"name":"Capio Spine Center Stockholm, L\u00f6wenstr\u00f6mska Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Elmi-Terander","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;"},{"name":"Capio Spine Center Stockholm, L\u00f6wenstr\u00f6mska Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Semin Spine Surg","first-page":"62","article-title":"The pathophysiology and biological mechanisms of cervical spondylotic myelopathy","volume":"26","author":"Etheridge J","year":"2014","unstructured":"Etheridge J, Kalantar SB. The pathophysiology and biological mechanisms of cervical spondylotic myelopathy. Semin Spine Surg. 2014;26(2):62\u201367."},{"issue":"1","key":"b2","series-title":"Sci Rep","first-page":"12856","article-title":"A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals","volume":"12","author":"Danielsen E","year":"2022","unstructured":"Danielsen E, Mj\u00e5set C, Ingebrigtsen T,  A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals. Sci Rep. 2022;12(1):12856."},{"issue":"1","key":"b3","series-title":"Health Qual Life Outcomes","first-page":"136","article-title":"How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods","volume":"18","author":"Mouelhi Y","year":"2020","unstructured":"Mouelhi Y, Jouve E, Castelli C, Gentile S. How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods. Health Qual Life Outcomes. 2020;18(1):136."},{"key":"b4","series-title":"Health Serv Insights","first-page":"61","article-title":"Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs)","volume":"6","author":"Weldring T","year":"2013","unstructured":"Weldring T, Smith SMS. Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs). Health Serv Insights. 2013;6:61\u201368."},{"issue":"2","key":"b5","series-title":"J Neurosurg Spine","first-page":"154","article-title":"Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article","volume":"18","author":"Parker SL","year":"2013","unstructured":"Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18(2):154\u2013160."},{"issue":"6","key":"b6","series-title":"PLoS One","first-page":"e67408","article-title":"Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference","volume":"8","author":"Auffinger BM","year":"2013","unstructured":"Auffinger BM, Lall RR, Dahdaleh NS,  Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference. PLoS One. 2013;8(6):e67408."},{"issue":"6","key":"b7","series-title":"Spine J","first-page":"469","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10(6):469\u2013474."},{"key":"b8","series-title":"J Clin Epidemiol","first-page":"128","article-title":"The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies","volume":"82","author":"Angst F","year":"2017","unstructured":"Angst F, Aeschlimann A, Angst J. The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies. J Clin Epidemiol. 2017;82:128\u2013136."},{"issue":"5","key":"b9","series-title":"Spine J","first-page":"541","article-title":"Understanding the minimum clinically important difference: a review of concepts and methods","volume":"7","author":"Copay AG","year":"2007","unstructured":"Copay AG, Subach BR, Glassman SD, Polly DW Jr, Schuler TC. Understanding the minimum clinically important difference: a review of concepts and methods. Spine J. 2007;7(5):541\u2013546."},{"issue":"4","key":"b10","series-title":"Qual Life Res","first-page":"293","article-title":"Individual-patient monitoring in clinical practice: are available health status surveys adequate?","volume":"4","author":"McHorney CA","year":"1995","unstructured":"McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4(4):293\u2013307."},{"issue":"9","key":"b11","series-title":"Eur Spine J","first-page":"3388","article-title":"Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide","volume":"33","author":"Klukowska AM","year":"2024","unstructured":"Klukowska AM, Vandertop WP, Schr\u00f6der ML, Staartjes VE. Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide. Eur Spine J. 2024;33(9):3388\u20133400."},{"issue":"3","key":"b12","series-title":"Spine J","first-page":"419","article-title":"Machine learning models for predicting dysphonia following anterior cervical discectomy and fusion: a Swedish Registry Study","volume":"25","author":"Buwaider A","year":"2025","unstructured":"Buwaider A, El-Hajj VG, MacDowall A,  Machine learning models for predicting dysphonia following anterior cervical discectomy and fusion: a Swedish Registry Study. Spine J. 2025;25(3):419\u2013428."},{"issue":"8","key":"b13","series-title":"Spine J","first-page":"1182","article-title":"Evolution of patient-reported outcome measures, 1, 2, and 5 years after surgery for subaxial cervical spine fractures, a nation-wide registry study","volume":"23","author":"El-Hajj VG","year":"2023","unstructured":"El-Hajj VG, Singh A, Blixt S, Edstr\u00f6m E, Elmi-Terander A, Gerdhem P. Evolution of patient-reported outcome measures, 1, 2, and 5 years after surgery for subaxial cervical spine fractures, a nation-wide registry study. Spine J. 2023;23(8):1182\u20131188."},{"issue":"6","key":"b14","series-title":"Arch Phys Med Rehabil","first-page":"1069","article-title":"The effect of concomitant spinal cord injury on postoperative health-related quality of life after traumatic subaxial cervical spine injuries: a nationwide registry study","volume":"105","author":"El-Hajj VG","year":"2024","unstructured":"El-Hajj VG, Stenimahitis V, Singh A,  The effect of concomitant spinal cord injury on postoperative health-related quality of life after traumatic subaxial cervical spine injuries: a nationwide registry study. Arch Phys Med Rehabil. 2024;105(6):1069\u20131075."},{"issue":"6","key":"b15","series-title":"Spine J","first-page":"847","article-title":"Measuring clinically relevant improvement after lumbar spine surgery: is it time for something new?","volume":"20","author":"Asher AM","year":"2020","unstructured":"Asher AM, Oleisky ER, Pennings JS,  Measuring clinically relevant improvement after lumbar spine surgery: is it time for something new? Spine J. 2020;20(6):847\u2013856."},{"issue":"4","key":"b16","series-title":"Eur J Pain","first-page":"283","article-title":"Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale","volume":"8","author":"Salaffi F","year":"2004","unstructured":"Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8(4):283\u2013291."},{"issue":"1","key":"b17","series-title":"BMC Musculoskelet Disord","first-page":"31","article-title":"Follow-up score, change score or percentage change score for determining clinical important outcome following surgery? An observational study from the Norwegian registry for Spine surgery evaluating patient reported outcome measures in lumbar spinal stenosis and lumbar degenerative spondylolisthesis","volume":"20","author":"Austevoll IM","year":"2019","unstructured":"Austevoll IM, Gjestad R, Grotle M,  Follow-up score, change score or percentage change score for determining clinical important outcome following surgery? An observational study from the Norwegian registry for Spine surgery evaluating patient reported outcome measures in lumbar spinal stenosis and lumbar degenerative spondylolisthesis. BMC Musculoskelet Disord. 2019;20(1):31."},{"issue":"1","key":"b18","series-title":"Spine (Phila Pa 1976)","first-page":"90","article-title":"Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change","volume":"33","author":"Ostelo RWJG","year":"2008","unstructured":"Ostelo RWJG, Deyo RA, Stratford P,  Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976). 2008;33(1):90\u201394."},{"issue":"11","key":"b19","series-title":"Spine (Phila Pa 1976)","first-page":"717","article-title":"Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values","volume":"46","author":"Khan I","year":"2021","unstructured":"Khan I, Pennings JS, Devin CJ,  Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values. Spine (Phila Pa 1976). 2021;46(11):717\u2013725."},{"issue":"5","key":"b20","series-title":"Phys Ther","first-page":"675","article-title":"Baseline dependency of minimal clinically important improvement","volume":"91","author":"Wang YC","year":"2011","unstructured":"Wang YC, Hart DL, Stratford PW, Mioduski JE. Baseline dependency of minimal clinically important improvement. Phys Ther. 2011;91(5):675\u2013688."},{"issue":"2","key":"b1","series-title":"Semin Spine Surg","first-page":"62","article-title":"The pathophysiology and biological mechanisms of cervical spondylotic myelopathy","volume":"26","author":"Etheridge J","year":"2014","unstructured":"Etheridge J, Kalantar SB. The pathophysiology and biological mechanisms of cervical spondylotic myelopathy. Semin Spine Surg. 2014;26(2):62\u201367."},{"issue":"1","key":"b2","series-title":"Sci Rep","first-page":"12856","article-title":"A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals","volume":"12","author":"Danielsen E","year":"2022","unstructured":"Danielsen E, Mj\u00e5set C, Ingebrigtsen T,  A nationwide study of patients operated for cervical degenerative disorders in public and private hospitals. Sci Rep. 2022;12(1):12856."},{"issue":"1","key":"b3","series-title":"Health Qual Life Outcomes","first-page":"136","article-title":"How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods","volume":"18","author":"Mouelhi Y","year":"2020","unstructured":"Mouelhi Y, Jouve E, Castelli C, Gentile S. How is the minimal clinically important difference established in health-related quality of life instruments? Review of anchors and methods. Health Qual Life Outcomes. 2020;18(1):136."},{"key":"b4","series-title":"Health Serv Insights","first-page":"61","article-title":"Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs)","volume":"6","author":"Weldring T","year":"2013","unstructured":"Weldring T, Smith SMS. Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs). Health Serv Insights. 2013;6:61\u201368."},{"issue":"2","key":"b5","series-title":"J Neurosurg Spine","first-page":"154","article-title":"Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article","volume":"18","author":"Parker SL","year":"2013","unstructured":"Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18(2):154\u2013160."},{"issue":"6","key":"b6","series-title":"PLoS One","first-page":"e67408","article-title":"Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference","volume":"8","author":"Auffinger BM","year":"2013","unstructured":"Auffinger BM, Lall RR, Dahdaleh NS,  Measuring surgical outcomes in cervical spondylotic myelopathy patients undergoing anterior cervical discectomy and fusion: assessment of minimum clinically important difference. PLoS One. 2013;8(6):e67408."},{"issue":"6","key":"b7","series-title":"Spine J","first-page":"469","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA. Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J. 2010;10(6):469\u2013474."},{"key":"b8","series-title":"J Clin Epidemiol","first-page":"128","article-title":"The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies","volume":"82","author":"Angst F","year":"2017","unstructured":"Angst F, Aeschlimann A, Angst J. The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies. J Clin Epidemiol. 2017;82:128\u2013136."},{"issue":"5","key":"b9","series-title":"Spine J","first-page":"541","article-title":"Understanding the minimum clinically important difference: a review of concepts and methods","volume":"7","author":"Copay AG","year":"2007","unstructured":"Copay AG, Subach BR, Glassman SD, Polly DW Jr, Schuler TC. Understanding the minimum clinically important difference: a review of concepts and methods. Spine J. 2007;7(5):541\u2013546."},{"issue":"4","key":"b10","series-title":"Qual Life Res","first-page":"293","article-title":"Individual-patient monitoring in clinical practice: are available health status surveys adequate?","volume":"4","author":"McHorney CA","year":"1995","unstructured":"McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4(4):293\u2013307."},{"issue":"9","key":"b11","series-title":"Eur Spine J","first-page":"3388","article-title":"Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide","volume":"33","author":"Klukowska AM","year":"2024","unstructured":"Klukowska AM, Vandertop WP, Schr\u00f6der ML, Staartjes VE. Calculation of the minimum clinically important difference (MCID) using different methodologies: case study and practical guide. Eur Spine J. 2024;33(9):3388\u20133400."},{"issue":"3","key":"b12","series-title":"Spine J","first-page":"419","article-title":"Machine learning models for predicting dysphonia following anterior cervical discectomy and fusion: a Swedish Registry Study","volume":"25","author":"Buwaider A","year":"2025","unstructured":"Buwaider A, El-Hajj VG, MacDowall A,  Machine learning models for predicting dysphonia following anterior cervical discectomy and fusion: a Swedish Registry Study. Spine J. 2025;25(3):419\u2013428."},{"issue":"8","key":"b13","series-title":"Spine J","first-page":"1182","article-title":"Evolution of patient-reported outcome measures, 1, 2, and 5 years after surgery for subaxial cervical spine fractures, a nation-wide registry study","volume":"23","author":"El-Hajj VG","year":"2023","unstructured":"El-Hajj VG, Singh A, Blixt S, Edstr\u00f6m E, Elmi-Terander A, Gerdhem P. Evolution of patient-reported outcome measures, 1, 2, and 5 years after surgery for subaxial cervical spine fractures, a nation-wide registry study. Spine J. 2023;23(8):1182\u20131188."},{"issue":"6","key":"b14","series-title":"Arch Phys Med Rehabil","first-page":"1069","article-title":"The effect of concomitant spinal cord injury on postoperative health-related quality of life after traumatic subaxial cervical spine injuries: a nationwide registry study","volume":"105","author":"El-Hajj VG","year":"2024","unstructured":"El-Hajj VG, Stenimahitis V, Singh A,  The effect of concomitant spinal cord injury on postoperative health-related quality of life after traumatic subaxial cervical spine injuries: a nationwide registry study. Arch Phys Med Rehabil. 2024;105(6):1069\u20131075."},{"issue":"6","key":"b15","series-title":"Spine J","first-page":"847","article-title":"Measuring clinically relevant improvement after lumbar spine surgery: is it time for something new?","volume":"20","author":"Asher AM","year":"2020","unstructured":"Asher AM, Oleisky ER, Pennings JS,  Measuring clinically relevant improvement after lumbar spine surgery: is it time for something new? Spine J. 2020;20(6):847\u2013856."},{"issue":"4","key":"b16","series-title":"Eur J Pain","first-page":"283","article-title":"Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale","volume":"8","author":"Salaffi F","year":"2004","unstructured":"Salaffi F, Stancati A, Silvestri CA, Ciapetti A, Grassi W. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8(4):283\u2013291."},{"issue":"1","key":"b17","series-title":"BMC Musculoskelet Disord","first-page":"31","article-title":"Follow-up score, change score or percentage change score for determining clinical important outcome following surgery? An observational study from the Norwegian registry for Spine surgery evaluating patient reported outcome measures in lumbar spinal stenosis and lumbar degenerative spondylolisthesis","volume":"20","author":"Austevoll IM","year":"2019","unstructured":"Austevoll IM, Gjestad R, Grotle M,  Follow-up score, change score or percentage change score for determining clinical important outcome following surgery? An observational study from the Norwegian registry for Spine surgery evaluating patient reported outcome measures in lumbar spinal stenosis and lumbar degenerative spondylolisthesis. BMC Musculoskelet Disord. 2019;20(1):31."},{"issue":"1","key":"b18","series-title":"Spine (Phila Pa 1976)","first-page":"90","article-title":"Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change","volume":"33","author":"Ostelo RWJG","year":"2008","unstructured":"Ostelo RWJG, Deyo RA, Stratford P,  Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine (Phila Pa 1976). 2008;33(1):90\u201394."},{"issue":"11","key":"b19","series-title":"Spine (Phila Pa 1976)","first-page":"717","article-title":"Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values","volume":"46","author":"Khan I","year":"2021","unstructured":"Khan I, Pennings JS, Devin CJ,  Clinically meaningful improvement following cervical spine surgery: 30% reduction versus absolute point-change MCID values. Spine (Phila Pa 1976). 2021;46(11):717\u2013725."},{"issue":"5","key":"b20","series-title":"Phys Ther","first-page":"675","article-title":"Baseline dependency of minimal clinically important improvement","volume":"91","author":"Wang YC","year":"2011","unstructured":"Wang YC, Hart DL, Stratford PW, Mioduski JE. Baseline dependency of minimal clinically important improvement. Phys Ther. 2011;91(5):675\u2013688."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/43\/4\/article-p464.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/43\/4\/article-p464.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/43\/4\/article-p464.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:44:49Z","timestamp":1772804689000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/43\/4\/article-p464.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":40,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2025.4.spine2598","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}