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 .
The end of the line? The Visual Analogue Scale and Verbal Numerical Rating Scale as pain assessment tools in the emergency department
Objectives To compare the Visual Analogue Scale ( VAS ) and the Verbal Numerical Rating Scale ( VNRS ) , in the assessment of acute pain in the emergency department ( ED ) . Furthermore , to determine the influence of demographics on this agreement and practical limitations of the scales . Setting St Vincent 's University Hospital , Dublin ; a 479-bed teaching hospital ; annual ED census 36 000 adult patients . Methods A prospect i ve observational study was conducted on ED patients with acute pain as a component of their presenting complaint . Eligible patients scored their pain on both VAS and VNRS within 1 hour of arrival . They rescored their pain every 30 minutes for 2 hours using both scales . The primary outcome measure was agreement between VAS and VNRS .  Secondary outcomes were ease of pain scale use and effect of patient demographics on pain scores . Agreement between scores was evaluated using the Bl and -Altman method . Results 123 patients were included ( median age 35 ; 43.9 % male ) . There was a strong correlation between VAS and VNRS  ( rs=0.93 ) . However , there was not perfect agreement between the two scales . Patient age ( older age , p<0.005 , t=−4.448 ) , gender ( female sex , p<0.005 , t=4.903 ) and educational level attained ( third level education , p<0.005 , t=5.575 ) had a statistically significant influence on the agreement between VAS and VNRS . There was a preference for VNRS in those patients who expressed a preference for one pain scale over the other . Conclusions VAS and VNRS are not interchangeable in assessing an individual patient 's pain over time in the ED setting . VNRS has practical advantages over VAS in this setting
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 .