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Table 5 Relationship between baseline pain and the minimum clinically important differencea

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

Study Subgroups by baseline pain, mm Absolute MCID mm (95% CI) Relative MCID % (95% CI)
Studies assessing MCID stratified by baseline pain
Stahmer [55] ≤50 > 50 NR NR 25 (SE: 10)b 35 (SE: 6)b
Voepel-Lewis [59] <50 ≥ 50 0 (−30 to 20) 20 (13 to 25) NR NR
Bird [31] <34 34–66 > 66 11 (7 to 15) 17 (13 to 21) 30 (17 to 43) NR NR NR
Cepeda [33] Moderate (median: 60) Severe (median: 80) 13 (12 to 14) 18 (17 to 19) 20 (18 to 22) 20 (19 to 22)
Tsze [57] <40 40–69 ≥ 70 NR NR NR 13 (0 to 29) 16 (10 to 23) 18 (11 to 29)
Tubach [58] Low (mean: 55) Intermediate (mean: 70) High (mean: 85) 34 (29 to 38)c 45c 63 (54 to 68)c NR NR NR
Studies assessing correlation between MCID and baseline pain
Barton 2002 (reported in Jensen 2002 [43]) Correlation with baseline pain 0.48 (P < 0.001) 0.35 (P < 0.01)
Rasmussen 2002 (reported in Jensen 2002 [43]) Correlation with baseline pain 0.52 (P < 0.001) 0.34 (P < 0.01)
Farrar [36] Correlation with baseline pain Patients with higher baseline pain reported greater relief (e.g. 90 vs. 40 mm, P = 0.048) No significant differences in degree of pain relief
  1. aTwo additional studies are not included, since they did not differentiate between pain relief and worsening when assessing the relationship between baseline pain and MCID (Kelly [46] and Lopez [21])
  2. bPatients answering ‘some’ or ‘partial’ relief
  3. cData is 75th percentile among patients answering ‘a great deal better’ (13) or ‘a good deal better’ (14) on a 15 category scale
  4. MCID minimum clinically important difference, NR not reported, CI confidence interval