Is the minimal clinically important difference (MCID) in acute pain a good measure of analgesic efficacy in regional anesthesia?
Felipe Muñoz-LeyvaKariem El-BoghdadlyVincent ChanPublished in: Regional anesthesia and pain medicine (2020)
In the field of acute pain medicine research, we believe there is an unmet need to incorporate patient related outcome measures that move beyond reporting pain scores and opioid consumption. The term "minimal clinically important difference" (MCID) defines the clinical benefit of an intervention as perceived by the patient, as opposed to a mathematically determined statistically significant difference that may not necessarily be clinically significant. The present article reviews the concept of MCID in acute postoperative pain research, addresses potential pitfalls in MCID determination and questions the clinical validity of extrapolating MCID determined from chronic pain and non-surgical pain studies to the acute postoperative pain setting. We further suggest the concepts of minimal clinically important improvement, substantial clinical benefit and patient acceptable symptom state should also represent aspirational outcomes for future research in acute postoperative pain management.
Keyphrases
- chronic pain
- pain management
- liver failure
- postoperative pain
- respiratory failure
- drug induced
- aortic dissection
- neuropathic pain
- randomized controlled trial
- hepatitis b virus
- physical activity
- intensive care unit
- patients undergoing
- extracorporeal membrane oxygenation
- spinal cord injury
- preterm infants
- mental health
- human health
- risk assessment
- emergency department
- metabolic syndrome
- climate change
- solid phase extraction