BackgroundDefining the minimally clinically important difference (MCID) is important for the design and analysis of clinical trials and ensures that findings are clinically meaningful. Studies in adult populations have investigated the MCID of The Short Form 36 physical function sub-scale (SF-36-PFS). However, to our knowledge no studies have defined the MCID of the SF-36-PFS in a paediatric population. We aimed to triangulate findings from distribution, anchor and qualitative methods to identify the MCID of the SF-36-PFS for children and adolescents with CFS/ME.MethodsQuantitative methods: We analysed routinely-collected data from a specialist paediatric CFS/ME service in South-West England using: 1) the anchor method, based on Clinical Global Impression (CGI) outcomes at 6 months’ follow-up; 2) the distribution method, based on the standard deviation of baseline SF-36-PFS scores.Qualitative methods: Young people (aged 12–17 years) and parents were asked to complete the SF-36-PFS, marking each question twice: once for where they would currently rate themselves/their child and a second time to show what they felt would be the smallest amount of change for them/their child to feel treatment had made a difference. Semi-structured interviews were designed to explore what factors were deemed important to patients and to what extent an improvement was considered satisfactory. We thematically analysed qualitative interviews from 21 children and their parents.ResultsQuantitative results: Six-month follow-up data were available for 198 children with a mean age of 14 years. Most were female (74%, 146/198) and 95% gave their ethnicity as “White British”.Half the standard deviation of the baseline SF-36-PFS scores was 11.0. “A little better” on the CGI equated to a mean difference on the SF-36-PFS from baseline to 6-month follow-up of 9.0.Qualitative results: Twenty-one children with CFS/ME participated: 16 females (76.2%) with a mean age of 14.4 years. Twenty mothers and two fathers were also interviewed.The median minimal improvement in the SF-36-PFS was 10. Participants indicated that small changes in physical function can lead to important improvements in valued social and family function. Patients and parents were positive about improvement even in the presence of persisting symptoms.Triangulation: The MCID based on the mean score from the three methods was 10.ConclusionsConverging evidence indicates future studies in paediatric CFS/ME should use an MCID of 10 on the SF-36-PFS.Electronic supplementary materialThe online version of this article (10.1186/s12955-018-1028-2) contains supplementary material, which is available to authorized users.
To determine the methods used in veterinary practice to maintain the temperature of intravenous fluids, and the users' impression of their efficacy, data were collected from a survey of 150 veterinary practices. Of the 99 per cent of the practices that warmed intravenous fluids, the use of a heat retention bag cover was most popular and was considered most effective. In a laboratory experiment, four methods of maintaining the temperature of intravenous fluids were compared. The results showed that there was a significant loss of heat through the giving set. A heat retention cover was an effective device for maintaining the temperature of the prewarmed fluid in its bag. The use of ;hot hands' (a sealed surgical glove containing warmed water) was most effective in reducing heat loss from the delivered fluid, and was aided by prewarming the giving set.
With the growing demand for animal-sourced foods and a serious concern over climate impacts associated with livestock farming, the sheep industry worldwide faces the formidable challenge of increasing the overall product supply while improving its resource use efficiency. As an evidence base for research to identify key drivers behind animal growth and carcass quality, longitudinal matched data of 741 ewes and 2978 lambs were collected at the North Wyke Farm Platform, a farm-scale grazing trial in Devon, UK, between 2011 and 2019. A subset of these data was subsequently analysed in a study to assess the feasibility of using a lamb's early-life liveweight as a predictor of carcass quality
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. The data also have the potential to offer insight into key performance indicators (KPIs) for the sheep industry, or what variables farmers should measure and target to increase profitability.
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