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 .
Feeling good rather than feeling better matters more to patients.
OBJECTIVE To determine the most appropriate means to assess the response to treatment in terms of  pain and functional impairment in a chronic rheumatic condition ( knee osteoarthritis [ OA ] ) and an acute rheumatic condition ( rotator cuff syndrome [ RCS ] ) . METHODS Two prospect i ve studies were conducted consisting of 1,019 out patients with knee OA and 271 patients with acute RCS . The minimal clinical ly important improvement and the patient acceptable symptom state were determined for knee OA pain using a visual analog scale , and for knee OA function using the Western Ontario and McMaster Universities Osteoarthritis Index function subscale ; for acute RCS pain , a numeral rating scale was used , and the Neer function subscale was used for RCS function . RESULTS The minimal clinical ly important improvement was shown to be the change required to achieve the patient acceptable symptom state , whatever the baseline level of symptom , the outcome ( pain or function ) , or type of condition ( chronic or acute ) . This acceptable state for pain was higher for chronic ( 27.0 - 36.4 across the baseline score ) than acute ( 16.7 - 24.1 ) conditions . The level of functional impairment considered satisfactory by patients with knee OA was higher for more disabled patients ( 43.1 ) than for less disabled patients ( 20.4 ) . CONCLUSION Patients consider that they experienced an important improvement only if this improvement allowed them to achieve a state they consider satisfactory . The most appropriate means to assess the response to therapy seems to be to assess whether patients feel good ( i.e. , achieve the patient acceptable symptom state )
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 .