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 .
Defining substantial clinical benefit following lumbar spine arthrodesis.
BACKGROUND Vali date d health-related quality -of-life measures have become important st and ards in the evaluation of the outcomes of lumbar spine surgery . However , there are few well-defined criteria for clinical success based on these measures . The minimum clinical ly important difference is an important demarcation , but it could be considered a floor value rather than a goal in defining clinical success . Therefore , we sought to define thresholds of substantial clinical benefit for commonly used health-related quality -of-life measures following lumbar spine arthrodesis . METHODS Prospect ively collected preoperative and one-year postoperative health-related quality -of-life measures from 357 patients who were managed with lumbar spine arthrodesis for the treatment of degenerative conditions were identified . C and i date substantial clinical benefit thresholds for the Short Form-36 physical component score , Oswestry Disability Index , and back and leg pain numeric rating scales were identified with use of receiver operating characteristic curve analysis . Receiver operating characteristic curves were used to discriminate between patients who reported being " much better " or " about the same " with use of the vali date d Short Form-36 health transition item and between those who reported being " mostly satisfied " or " unsure " with use of a nonvali date d but more surgery-specific satisfaction-with- results survey . For each health-related quality -of-life measure , three response parameters were used : net change , percent change , and raw score at the time of the one-year follow-up . RESULTS Substantial clinical benefit thresholds for the Short Form-36 physical component score were a 6.2-point net improvement , a 19.4 % improvement , or a final raw score of > or = 35.1 points . Substantial clinical benefit thresholds for the Oswestry Disability Index were an 18.8-point net improvement , a 36.8 % improvement , or a final raw score of < 31.3 points . Substantial clinical benefit thresholds for the back pain and leg pain numeric rating scales were a 2.5-point net improvement or a final raw score of < 3.5 points . Substantial clinical benefit thresholds for percent change were 41.4 % for the back pain numeric rating scale and 38.8 % for the leg pain numeric rating scale . CONCLUSIONS We believe that thresholds of substantial clinical benefit for commonly used health-related quality -of-life measures following lumbar spine arthrodesis are important as they describe a magnitude of change that the patient recognizes as a major improvement
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 .