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Table 2 Studies determining minimal clinically important difference as a threshold valuea (7 studies, 2602 patients)

From: Pain relief that matters to patients: systematic review of empirical studies assessing the minimum clinically important difference in acute pain

Study n Patient characteristics Methodological characteristics MCID
   Clinical condition Age, yearsb Male sex, % Baseline pain, mm Pain scale Transition scale (directionality, categories) Anchor question Categories defining responders Absolute, mm (sensitivity, specificity) Relative, % (sensitivity, specificity)
Aicher [25] 1743 Headache 38b (16–72) 24 64 VAS 1-sided, 4 cat (0 to +4 points) "How do you assess the efficacy of your tablets?" Good (+3) or very good (+4) 35 (76%, 76%) NR
Grotle [41] 54 Acute low back pain 38 27 39 VAS + NRS 2-sided, 6 cat (–1 to +4 points) "To which extent has your back problem changed?" Slightly improved (+1), much better (+2), very much better (+3), or completely gone (+4) 10 (87%, 81%) NR
Martin [49] 63 Post-operation pain (third molar extraction) 30 40 33 VAS 2-sided, 7 cat (–3 to +3 points) Assessment of recovery following treatment Much improved (+2) or best ever (+3) 10 (70%, 82%) 50 (82%, 82%)
Martin [49] 62 Post-operation pain (third molar extraction) 25 40 35 Do Do Do Do 10 (71%, 71%) 50 (83%, 86%)
Martin [49] 95 Post-operation pain (third molar extraction) 27 50 30 Do Do Do Do 10 (87%, 69%) 50 (97%, 82%)
Tsze [57] 314 Mixedd 10 50 NR VAS 2-sided, 5 cat (–2 to +2 points) Assessment of change in pain following treatment A little better (+1) 10 (76%, 74%) 15 (78%, 79%)
Tubach [58] 271 Rotator cuff syndrome 48 38 68 NRS 2-sided, 15 cat (–7 to +7 points) Assessment of response to treatment A good deal better (+5) or a great deal better (+6) 34–63c (75%, NR) NR
  1. MCID minimum clinically important difference (mm change on a 100 mm scale), VAS visual analogue scale, NRS numeric rating scale, NR not reported
  2. aThreshold in pain reduction associated with the best accuracy (sensitivity and specificity) for identifying improved patients
  3. bData is median (range)
  4. cEstimates for subgroups with different baseline pain
  5. cMixed patient population recruited at Hospital Emergency Department