A considerable variety of outcome measurement tools are used in the foot and ankle clinical literature , with a small proportion used consistently .
The AOFAS scales continue to be used at a high rate relative to other scales that have been vali date d. Data from the present study underscore the need for a paradigm shift toward the use of consistent , valid , and reliable outcome measures for studies of foot and ankle procedures and disorders .
It is not clear which existing vali date d outcome instruments will emerge as widely used and clinical ly meaningful .
BACKGROUND In the orthopaedic literature , there is a wide range of clinical outcome measurement tools that have been used in evaluating foot and ankle procedures , disorders , and outcomes , with no broadly accepted consensus as to which tools are preferred .
The purpose of this study was to determine the frequency and distribution of the various outcome instruments used in the foot and ankle literature , and to identify trends for use of these instruments over time .
Clinically important change in the visual analog scale after adequate pain control.
OBJECTIVES To define the minimum clinical ly important difference ( MCID ) for the visual analog scale ( VAS ) of pain severity by measuring the change in VAS associated with adequate pain control . METHODS The authors conducted a prospect i ve , observational study . Adult emergency department ( ED ) patients with acute pain ( < 72 hours ) were eligible . Patients rated their pain severity on a 100-mm VAS on presentation and at discharge . Patients were asked if they would accept any analgesic , then if they would accept a parenteral analgesic before treatment . At discharge , they were asked whether they had received adequate pain control . RESULTS The authors enrolled 143 patients ( mean age , 36 years ; 54 % female ) . The mean decrease in VAS was -30.0 mm ( 95 % confidence interval [ CI ] = -36.4 to -23.6 ) for the 116 of 143 ( 81 % ) patients with adequate pain control at discharge vs. -5.7 ( 95 % CI = -11.2 to -0.3 ) for the 27 with inadequate pain control ( p < 0.001 ) . At discharge , the mean VAS was 31.3 mm for those with adequate pain control vs. 55.1 for those without . Mean VAS for the 114 of 143 patients who would accept any analgesics initially was 64.7 vs. 47.1 for the 29 reporting no analgesic need . Initially , 77 patients would accept parenteral analgesics ( mean VAS = 72.5 mm ) . CONCLUSIONS A mean reduction in VAS of 30.0 mm represents a clinical ly important difference in pain severity that corresponds to patients ' perception of adequate pain control . Defining MCID based on adequate analgesic control rather than minimal detectable change may be more appropriate for future analgesic trials , when effective treatments for acute pain exist
A considerable variety of outcome measurement tools are used in the foot and ankle clinical literature , with a small proportion used consistently .
The AOFAS scales continue to be used at a high rate relative to other scales that have been vali date d. Data from the present study underscore the need for a paradigm shift toward the use of consistent , valid , and reliable outcome measures for studies of foot and ankle procedures and disorders .
It is not clear which existing vali date d outcome instruments will emerge as widely used and clinical ly meaningful .
BACKGROUND In the orthopaedic literature , there is a wide range of clinical outcome measurement tools that have been used in evaluating foot and ankle procedures , disorders , and outcomes , with no broadly accepted consensus as to which tools are preferred .
The purpose of this study was to determine the frequency and distribution of the various outcome instruments used in the foot and ankle literature , and to identify trends for use of these instruments over time .