PMID- 14525749
OWN - NLM
STAT- MEDLINE
DCOM- 20040315
LR  - 20240109
IS  - 1069-6563 (Print)
IS  - 1069-6563 (Linking)
VI  - 10
IP  - 10
DP  - 2003 Oct
TI  - Clinically important change in the visual analog scale after adequate pain 
      control.
PG  - 1128-30
AB  - OBJECTIVES: To define the minimum clinically important difference (MCID) for the 
      visual analog scale (VAS) of pain severity by measuring the change in VAS 
      associated with adequate pain control. METHODS: The authors conducted a 
      prospective, observational study. Adult emergency department (ED) patients with 
      acute pain (<72 hours) were eligible. Patients rated their pain severity on a 
      100-mm VAS on presentation and at discharge. Patients were asked if they would 
      accept any analgesic, then if they would accept a parenteral analgesic before 
      treatment. At discharge, they were asked whether they had received adequate pain 
      control. RESULTS: The authors enrolled 143 patients (mean age, 36 years; 54% 
      female). The mean decrease in VAS was -30.0 mm (95% confidence interval [CI] = 
      -36.4 to -23.6) for the 116 of 143 (81%) patients with adequate pain control at 
      discharge vs. -5.7 (95% CI = -11.2 to -0.3) for the 27 with inadequate pain 
      control (p < 0.001). At discharge, the mean VAS was 31.3 mm for those with 
      adequate pain control vs. 55.1 for those without. Mean VAS for the 114 of 143 
      patients who would accept any analgesics initially was 64.7 vs. 47.1 for the 29 
      reporting no analgesic need. Initially, 77 patients would accept parenteral 
      analgesics (mean VAS = 72.5 mm). CONCLUSIONS: A mean reduction in VAS of 30.0 mm 
      represents a clinically important difference in pain severity that corresponds to 
      patients' perception of adequate pain control. Defining MCID based on adequate 
      analgesic control rather than minimal detectable change may be more appropriate 
      for future analgesic trials, when effective treatments for acute pain exist.
FAU - Lee, Jacques Simon
AU  - Lee JS
AD  - Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 
      jacques.lee@ices.on.ca
FAU - Hobden, Elisabeth
AU  - Hobden E
FAU - Stiell, Ian G
AU  - Stiell IG
FAU - Wells, George A
AU  - Wells GA
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Acad Emerg Med
JT  - Academic emergency medicine : official journal of the Society for Academic 
      Emergency Medicine
JID - 9418450
SB  - IM
CIN - Acta Orthop. 2016 Jun;87(3):274-9. PMID: 27212102
MH  - Adolescent
MH  - Adult
MH  - Cohort Studies
MH  - Emergency Medical Services
MH  - Female
MH  - Humans
MH  - Male
MH  - Pain Clinics
MH  - *Pain Management
MH  - *Pain Measurement/standards
MH  - Prospective Studies
EDAT- 2003/10/04 05:00
MHDA- 2004/03/17 05:00
CRDT- 2003/10/04 05:00
PHST- 2003/10/04 05:00 [pubmed]
PHST- 2004/03/17 05:00 [medline]
PHST- 2003/10/04 05:00 [entrez]
AID - 10.1111/j.1553-2712.2003.tb00586.x [doi]
PST - ppublish
SO  - Acad Emerg Med. 2003 Oct;10(10):1128-30. doi: 10.1111/j.1553-2712.2003.tb00586.x.