From analyses of individual patient data ( seven studies , 918 patients ) , we found baseline pain strongly associated with absolute , but not relative , MCID as patients with higher baseline pain needed larger pain reduction to perceive relief .
Conclusions The MCID in acute pain varied greatly between studies and was influenced by baseline pain , definitions of improved patients and study design .
Background The minimum clinical ly important difference ( MCID ) is used to interpret the clinical relevance of results reported by trials and meta-analyses as well as to plan sample sizes in new studies .
However , there is a lack of consensus about the size of MCID in acute pain , which is a core symptom affecting patients across many clinical conditions .
Identifying the minimum clinically significant difference in acute pain in the elderly.
STUDY OBJECTIVE To identify the minimum clinical ly significant difference in pain in elderly emergency department ( ED ) patients . METHODS This was an observational , prospect i ve study of a convenience sample of patients aged 65 years or older with acute pain . Patients rated their pain on an 11-point numeric rating scale ( NRS ) on entering the study and every 30 minutes for 2 hours . The arithmetic minimum clinical ly significant difference was defined as the mean difference between current and preceding NRS scores when the subject described his or her pain as " a little less pain " or " a little more pain . " The proportional minimum clinical ly significant difference was change in NRS in a 30-minute interval divided by the NRS at the beginning of the interval . We used generalized estimating equations to adjust for nonindependence of pain scores and to test trend over time . RESULTS One hundred ninety-five patients were enrolled ( mean age 74 years ; 73 % women ; 51 % Hispanic ; 33 % black ) . The arithmetic minimum clinical ly significant difference averaged over all periods was 1.5 ( 95 % confidence interval 1.3 to 1.6 ) , the proportional minimum clinical ly significant difference was 25 % ( 95 % confidence interval 20 % to 29 % ) . The arithmetic minimum clinical ly significant difference unexpectedly decreased over time : 2.1 from baseline to 30 minutes , 1.4 from 30 to 60 minutes , 1.3 from 60 to 90 minutes , and 1.0 from 90 to 120 minutes ( P<.001 ) . In contrast , the proportional differences were more stable : 27 % from baseline to 30 minutes , 22 % from 30 to 60 minutes , 22 % from 60 to 90 minutes , and 28 % from 90 to 120 minutes ( P=.89 ) . CONCLUSION The arithmetic minimum clinical ly significant difference in older ED patients was 1.5 NRS units and decreased over time , whereas the proportional change was 25 % and more stable
From analyses of individual patient data ( seven studies , 918 patients ) , we found baseline pain strongly associated with absolute , but not relative , MCID as patients with higher baseline pain needed larger pain reduction to perceive relief .
Conclusions The MCID in acute pain varied greatly between studies and was influenced by baseline pain , definitions of improved patients and study design .
Background The minimum clinical ly important difference ( MCID ) is used to interpret the clinical relevance of results reported by trials and meta-analyses as well as to plan sample sizes in new studies .
However , there is a lack of consensus about the size of MCID in acute pain , which is a core symptom affecting patients across many clinical conditions .