We describe currently available approaches for estimating the minimally important difference (MID) and their associated strengths and weaknesses. Specifically, we show that anchor-based methods should be the primary method of estimating the MID because of the limitations of distribution-based methods. In addition, we provide recommendations for estimating the MID in future research.

In addition to statistical significance, it is important to evaluate the magnitude of differences in health-related quality of life over time. Interest in establishing the minimal difference that is clinically important or the minimally important difference has burgeoned over the last few years. This review summarizes some of the leading approaches to estimating the minimally important difference, offers caveats on the minimally important difference estimation based on existing literature and provides recommendations for future work. The authors recommend using multiple anchors to estimate the minimally important difference, using only anchors that correspond to minimal change in health-related quality of life, reporting information about the variation around the estimates, and providing bounded estimates to reflect the uncertainty.

Physicians should openly ask HIV-infected patients about CAM use to prevent adverse effects and to identify CAM substitution for conventional HIV therapy.

Long-term viral suppression requires consistent and high percent adherence accompanied by optimal interdose intervals. Efforts to improve viral outcomes should address not only missed doses but excessive variation in dose timing and prevention of adherence decline over time. Preventing the development and transmission of resistant variants is also critically important.

Patient attitudes about living permanently in a nursing home can be elicited, cannot be reliably predicted from demographic and clinical variables, and are frequently misunderstood by surrogates and physicians. Elicitation of patient preferences regarding permanent nursing home placement should be explored before patients become unable to participate in decision making in order to enhance the concordance of patient preference with the way they spend the end of their lives.