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Table 3 Clinically important differences in acute pain

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

   Analysis of mediansa Analysis of pooled average
Clinically important difference Range Number of studies (patientsb) MCID median (IQR) Number of studies (patientsb) MCID pooled average (95% CI), I2 c
Minimum clinically important difference for pain relief
 Absolute change, mm
  Mean change approach 8 to 40 29 (6517) 17 (14 to 23) 23 (6024) 17 (15 to 19), 93%
  Threshold approach 10 to 35 6 (2331) 10 (10 to 10) NA NA
 Relative change, %
  Mean change approach 13 to 85 14 (1617) 23 (18 to 36) 11 (1397) 22 (19 to 26), 75%
  Threshold approach 15 to 50 4 (534) 50 (33 to 50) NA NA
Substantial clinically important difference for pain relief
 Absolute change, mm
  Mean change approach 18 to 54 23 (6114) 32 (24 to 38) 21 (5891) 32 (27 to 38), 97%
 Relative change, %
  Mean change approach 36 to 78 11 (1397) 57 (45 to 65) 11 (1397) 57 (47 to 67), 94%
Minimum clinically important difference for pain worsening
 Absolute change, mm
  Mean change approach −21 to –8 18 (3822) −11 (–13 to –10) 16 (3644) −12 (–14 to –11), 62%
 Relative change, %
  Mean change approach −89 to –17 7 (918) −44 (–90 to –16) 7 (918) −35 (–47 to –23), 67%
Substantial clinically important difference for pain worsening
 Absolute change, mm
  Mean change approach −66 to 0 16 (3663) −21 (–28 to –16) 14 (3464) −24 (–29 to –18), 71%
 Relative change, %
  Mean change approach −292 to –18 7 (918) −83 (–292 to –18) 7 (918) −34 (–49 to –19), 20%
  1. MCID minimum clinically important difference (mm or % reduction on a 100 mm scale), SCID substantial clinically important difference (mm or % reduction on a 100 mm scale), IQR inter-quartile range, NA not applicable
  2. aThe median is based on studies included in the pooled average as well as studies with unavailable standard errors
  3. bTotal number of patients in the included studies
  4. cI2 is the percentage of the variability in results that is due to heterogeneity rather than sampling error (chance); I2 of 0% to 40% might not be important, 30% to 60% may represent moderate heterogeneity, 50% to 90% may represent substantial heterogeneity, and 75% to 100% represents considerable heterogeneity