PMID- 35644742
OWN - NLM
STAT- MEDLINE
DCOM- 20220712
LR  - 20230703
IS  - 1531-6564 (Electronic)
IS  - 0363-5023 (Print)
IS  - 0363-5023 (Linking)
VI  - 47
IP  - 7
DP  - 2022 Jul
TI  - Establishing the Minimal Clinically Important Difference and Substantial Clinical 
      Benefit for the Pain Visual Analog Scale in a Postoperative Hand Surgery 
      Population.
PG  - 645-653
LID - S0363-5023(22)00164-2 [pii]
LID - 10.1016/j.jhsa.2022.03.009 [doi]
AB  - PURPOSE: Although the pain visual analog scale (VAS-pain) is a ubiquitous 
      patient-reported outcome instrument, it remains unclear how to interpret changes 
      or differences in scores. Therefore, our purpose was to calculate the minimal 
      clinically important difference (MCID) and substantial clinical benefit (SCB) for 
      the VAS-pain instrument in a nonshoulder hand and upper extremity postoperative 
      population. METHODS: Adult postoperative patients treated by 1 of 5 
      fellowship-trained orthopedic hand surgeons at a single tertiary academic medical 
      center were identified. Inclusion required VAS-pain scores at baseline (up to 3 
      months before surgery) and follow-up (up to 4 months after surgery), in addition 
      to a response to a pain-specific anchor question at follow-up. The MCID estimates 
      were calculated with (1) the 1/2 standard deviation method; and (2) an 
      anchor-based approach. The SCB estimates were calculated with (1) an anchor-based 
      approach; and (2) a receiver operator curve method that maximized the sensitivity 
      and specificity for detecting a "much improved" pain status. RESULTS: There were 
      667 and 148 total patients included in the MCID and SCB analyses, respectively. 
      The 1/2 standard deviation MCID estimate was 1.6, and the anchor-based estimate 
      was 1.9. The anchor-based SCB estimate was 2.2. The receiver operator curve 
      analysis yielded an SCB estimate of 2.6, with an area under the curve of 0.72, 
      consistent with acceptable discrimination. CONCLUSIONS: We propose MCID values in 
      the range of 1.6 to 1.9 and SCB values in the range of 2.2 to 2.6 for the 
      VAS-pain instrument in a nonshoulder hand and upper extremity postoperative 
      population. CLINICAL RELEVANCE: These MCID and SCB estimates may be useful for 
      powering clinical studies and when interpreting VAS-pain score changes or 
      differences reported in the hand surgery literature. These values are to be 
      applied at a population level, and should not be applied to assess the 
      improvement, or lack thereof, for individual patients.
CI  - Copyright (c) 2022. Published by Elsevier Inc.
FAU - Randall, Dustin J
AU  - Randall DJ
AD  - Oakland University William Beaumont School of Medicine, Rochester, MI; Department 
      of Orthopaedics, University of Utah, Salt Lake City, UT.
FAU - Zhang, Yue
AU  - Zhang Y
AD  - Division of Public Health, University of Utah, Salt Lake City, UT.
FAU - Li, Haojia
AU  - Li H
AD  - Division of Public Health, University of Utah, Salt Lake City, UT.
FAU - Hubbard, James C
AU  - Hubbard JC
AD  - Department of Orthopaedics, University of Utah, Salt Lake City, UT.
FAU - Kazmers, Nikolas H
AU  - Kazmers NH
AD  - Department of Orthopaedics, University of Utah, Salt Lake City, UT. Electronic 
      address: nkazmers@gmail.com.
LA  - eng
GR  - UL1 RR025764/RR/NCRR NIH HHS/United States
GR  - UL1 TR000105/TR/NCATS NIH HHS/United States
GR  - UL1 TR001067/TR/NCATS NIH HHS/United States
GR  - UL1 TR002538/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220527
PL  - United States
TA  - J Hand Surg Am
JT  - The Journal of hand surgery
JID - 7609631
SB  - IM
MH  - Adult
MH  - *Hand/surgery
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - Pain
MH  - Treatment Outcome
MH  - Visual Analog Scale
PMC - PMC9271584
MID - NIHMS1794404
OTO - NOTNLM
OT  - Minimal clinically important difference (MCID)
OT  - patient-reported outcomes
OT  - substantial clinical benefit (SCB)
OT  - visual analog pain (VAS-pain) score
EDAT- 2022/06/02 06:00
MHDA- 2022/07/14 06:00
PMCR- 2023/07/01
CRDT- 2022/06/01 10:45
PHST- 2021/07/09 00:00 [received]
PHST- 2022/01/27 00:00 [revised]
PHST- 2022/03/09 00:00 [accepted]
PHST- 2022/06/02 06:00 [pubmed]
PHST- 2022/07/14 06:00 [medline]
PHST- 2022/06/01 10:45 [entrez]
PHST- 2023/07/01 00:00 [pmc-release]
AID - S0363-5023(22)00164-2 [pii]
AID - 10.1016/j.jhsa.2022.03.009 [doi]
PST - ppublish
SO  - J Hand Surg Am. 2022 Jul;47(7):645-653. doi: 10.1016/j.jhsa.2022.03.009. Epub 
      2022 May 27.