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 .
Setting the benchmark for research in the management of acute pain in emergency departments.
OBJECTIVE The aim of this study was to define the degree of change on a visual analogue scale that corresponded to a clinical ly meaningful reduction in the level of pain reported by patients experiencing acute pain . METHOD Secondary analysis of data was performed from prospect i ve , descriptive studies of 152 adults and 73 children presenting to emergency departments with acute pain . At presentation and at 20 min intervals to a maximum of three measurements , patients marked the level of their pain on a 100 mm , non-hatched visual analogue scale . At each follow up , they also gave a verbal rating of their pain as ' a lot better ' , ' a little better ' , ' much the same ' , ' a little worse ' or ' much worse ' . Data from the groups reporting that pain was ' a lot better ' and ' about the same ' were analysed for mean and median absolute change in visual analogue scale and compared . RESULTS Of 559 pain comparisons , 60 were rated as ' a lot better ' and 257 as ' about the same ' . The mean absolute change in visual analogue scale for the group reporting that pain was ' a lot better ' was 24 mm ( median = 19 mm , 95 % confidence interval = 17 - 31 mm ) . For the group reporting that pain was ' about the same ' , the mean visual analogue scale change was 0 mm ( median = 0 mm , 95 % confidence interval = -1 to 1 mm ) . CONCLUSION When evaluating treatments for acute pain , a difference in visual analogue scale pain score of less than about 20 mm is unlikely to be clinical ly meaningful . Studies should be design ed and reported relative to this benchmark rather than the minimum clinical ly significant difference in visual analogue scale pain score
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 .