PMID- 28186223
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20220409
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Linking)
VI  - 118
IP  - 3
DP  - 2017 Mar 1
TI  - Measuring acute postoperative pain using the visual analog scale: the minimal 
      clinically important difference and patient acceptable symptom state.
PG  - 424-429
LID - 10.1093/bja/aew466 [doi]
AB  - BACKGROUND: The 100 mm visual analog scale (VAS) score is widely used to measure 
      pain intensity after surgery. Despite this widespread use, it is unclear what 
      constitutes the minimal clinically important difference (MCID); that is, what 
      minimal change in score would indicate a meaningful change in a patient's pain 
      status. METHODS: We enrolled a sequential, unselected cohort of patients 
      recovering from surgery and used a VAS to quantify pain intensity. We compared 
      changes in the VAS with a global rating-of-change questionnaire using an 
      anchor-based method and three distribution-based methods (0.3 sd , standard error 
      of the measurement, and 5% range). We then averaged the change estimates to 
      determine the MCID for the pain VAS. The patient acceptable symptom state (PASS) 
      was defined as the 25th centile of the VAS corresponding to a positive patient 
      response to having made a good recovery from surgery. RESULTS: We enrolled 224 
      patients at the first postoperative visit, and 219 of these were available for a 
      second interview. The VAS scores improved significantly between the first two 
      interviews. Triangulation of distribution and anchor-based methods resulted in an 
      MCID of 9.9 for the pain VAS, and a PASS of 33. CONCLUSIONS: Analgesic 
      interventions that provide a change of 10 for the 100 mm pain VAS signify a 
      clinically important improvement or deterioration, and a VAS of 33 or less 
      signifies acceptable pain control (i.e. a responder), after surgery.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the British 
      Journal of Anaesthesia. All rights reserved. For Permissions, please email: 
      journals.permissions@oup.com
FAU - Myles, P S
AU  - Myles PS
AD  - Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash 
      University, Melbourne, Victoria, Australia.
AD  - Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, 
      Victoria, Australia.
FAU - Myles, D B
AU  - Myles DB
AD  - Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, 
      Victoria, Australia.
FAU - Galagher, W
AU  - Galagher W
AD  - Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash 
      University, Melbourne, Victoria, Australia.
FAU - Boyd, D
AU  - Boyd D
AD  - Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash 
      University, Melbourne, Victoria, Australia.
FAU - Chew, C
AU  - Chew C
AD  - Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash 
      University, Melbourne, Victoria, Australia.
FAU - MacDonald, N
AU  - MacDonald N
AD  - Department of Anaesthesia, Royal Women's Hospital, Parkville, Victoria, 
      Australia.
FAU - Dennis, A
AU  - Dennis A
AD  - Department of Anaesthesia, Royal Women's Hospital, Parkville, Victoria, 
      Australia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
SB  - IM
MH  - Acute Pain/*diagnosis
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Minimal Clinically Important Difference
MH  - Pain Measurement/*methods
MH  - Pain, Postoperative/*diagnosis
MH  - Patient Satisfaction/*statistics & numerical data
MH  - Prospective Studies
MH  - Surgical Procedures, Operative
MH  - Surveys and Questionnaires
MH  - *Visual Analog Scale
MH  - Young Adult
OTO - NOTNLM
OT  - analgesia
OT  - pain measurement
OT  - surgery
EDAT- 2017/02/12 06:00
MHDA- 2018/12/12 06:00
CRDT- 2017/02/11 06:00
PHST- 2016/12/19 00:00 [accepted]
PHST- 2017/02/12 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2017/02/11 06:00 [entrez]
AID - S0007-0912(17)30212-X [pii]
AID - 10.1093/bja/aew466 [doi]
PST - ppublish
SO  - Br J Anaesth. 2017 Mar 1;118(3):424-429. doi: 10.1093/bja/aew466.