Clinimetrics corner: a closer look at the minimal clinically important difference (MCID)

Statistics In Brief: Minimum Clinically Important Difference—Availability of Reliable Estimates

“…Wright et al [35] enumerates nine possible methods that can be divided in two possible Each author certifies that he, or a member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request.…”

“…The American Association of Hip and Knee Surgeons has recommended the use of patient-reported outcome measures to evaluate the results of knee and hip arthroplasties [16]. Studies have focused on statistically detectable (sometimes called statistically significant) differences [35]; however, it can be possible to detect statistical differences between interventions that are so small as not to be discernible to patients. Such small differences may not justify the cost or risk of the intervention.…”

Criteria for failure and worsening after surgery for lumbar disc herniation: a multicenter observational study based on data from the Norwegian Registry for Spine Surgery

“…In large cohorts, even small and clinically irrelevant PROM changes tend to reach statistical significance [4]. To provide cutoffs on PROM changes that are perceived as meaningful and important by the patients, the ''minimal important change'' (MIC) has been defined by various methods [5][6][7]. A recent review proposed an MIC cutoff for the ODI of ten points, or 30% improvement from baseline [8].…”

Association of Improvement in Pain With Therapeutic Response as Determined by Individual Improvement Criteria in Patients With Rheumatoid Arthritis

“…This method is fundamentally different from those used to evaluate minimum clinically important differences (MCIDs). The goal of MCID assessments is to identify the smallest change perceived as beneficial by patients 5, whereas the d crit method is based on the premise that significant individual responses should, at minimum, result in changes that exceed within‐subject, measurement‐associated variability over periods of time relevant to a clinical setting 4. In this respect, the d crit method is similar to assessments of the smallest detectable difference (SDD) 6 or the reliable change index 7.…”