PMID- 33461231
OWN - NLM
STAT- MEDLINE
DCOM- 20220401
LR  - 20220607
IS  - 1864-6743 (Electronic)
IS  - 1864-6697 (Linking)
VI  - 160
IP  - 2
DP  - 2022 Apr
TI  - Clinical Relevance of Changes in Pain Intensity in Patients with Specific Back 
      Pain.
PG  - 213-221
LID - 10.1055/a-1304-3677 [doi]
AB  - BACKGROUND: Pain intensity is frequently measured on the 11-point numerical pain 
      rating scale (NRS-PI), ranging from 0 (no pain) to 10 points (worst imaginable 
      pain). However, it is difficult to interpret the clinical importance of changes 
      from baseline to endpoint on this instrument. OBJECTIVES: To estimate the minimal 
      detectable change (MDC) and the minimal clinically important difference (MCID) 
      for average pain intensity in patients with specific back pain. MATERIALS AND 
      METHODS: Data on 1232 subjects with specific back pain from a German hospital 
      were included in this study. A score combining the patient's (PGIC) and the 
      physician's global impression of change (CGIC) over the in-patient length of stay 
      was used as an external criterion. A priori, we considered the score value 
      "slightly improved" as the MCID. MDC was calculated using the standard error of 
      measurement (SEM) and the standard deviation (SD) of the sample. MCID was 
      estimated by the mean value of PI-NRS change in patients who self-assess as 
      "slightly improved", and by sensitivity/specificity analyses, computed by the 
      receiver operating characteristic method (ROC). RESULTS: MDC was 1.77. The MCS 
      and ROC methods consistently showed an MCID of 2 for the total sample. Both 
      methods showed the dependence of the MCID on the initial pain: 1 for mild to 
      moderate pain at baseline (1 - 4 NRS points), 2 for moderate to severe pain 
      (5 - 7) and 3 - 4 for very severe to extreme pain (8 - 10). For patients with 
      lumbosacral intervertebral disc disorders and patients in the acute phase 
      (duration of pain < 6 weeks), the ROC method resulted in a higher limit than the 
      MCS method. CONCLUSIONS: In order to facilitate the interpretation of changes and 
      to take into account the patient's perspective, the global assessment of the 
      success of treatment should be used as an anchor criterion. In addition to 
      dealing with pain measurement, function-related and psychosocial aspects of pain 
      symptoms should be kept in mind.
CI  - Thieme. All rights reserved.
FAU - Haase, Ingo
AU  - Haase I
AD  - Research, Development, Quality Assurance, m&i Hospital Group Enzensberg, Hopfen 
      am See, Germany.
FAU - Kladny, Bernd
AU  - Kladny B
AD  - Department of Orthopaedics and Trauma Surgery, Fachklinik Herzogenaurach, 
      Germany.
LA  - eng
LA  - ger
PT  - Journal Article
TT  - Klinische Bedeutung von Veranderungen der Schmerzstarke bei Patienten mit 
      spezifischen Ruckenschmerzen.
DEP - 20210118
PL  - Germany
TA  - Z Orthop Unfall
JT  - Zeitschrift fur Orthopadie und Unfallchirurgie
JID - 101308227
SB  - IM
MH  - *Back Pain/diagnosis
MH  - *Disability Evaluation
MH  - Humans
MH  - Pain Measurement/methods
MH  - ROC Curve
MH  - Treatment Outcome
COIS- The authors declare that they have no conflict of interest./Die 
      Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
EDAT- 2021/01/19 06:00
MHDA- 2022/04/02 06:00
CRDT- 2021/01/18 20:17
PHST- 2021/01/19 06:00 [pubmed]
PHST- 2022/04/02 06:00 [medline]
PHST- 2021/01/18 20:17 [entrez]
AID - 10.1055/a-1304-3677 [doi]
PST - ppublish
SO  - Z Orthop Unfall. 2022 Apr;160(2):213-221. doi: 10.1055/a-1304-3677. Epub 2021 Jan 
      18.