Minimal clinically important difference: The basics

Apaza, Julieta Aldana Salas; Franco, Juan Víctor Ariel; Meza, Nicolás; Madrid, Eva; Loézar, Cristóbal; Garegnani, Luis

doi:10.5867/medwave.2021.03.8149

Cited by 41 publications

(32 citation statements)

References 18 publications

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“…mean difference of -0.85 in favor of laser [11]. However, both results are lower than the recommended minimally important clinical difference (MCID) for VAS, which suggests a decrease in pain of at least 2.0cm or more [44]. Likewise, it should be noted that the mean difference demonstrates a wide confidence interval, showing a variation of 1.5 cm, resulting in an analgesic response ranging from 0.85 to 2.70.…”

Section: Accepted Manuscriptmentioning

confidence: 75%

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

Ortiz¹,

Liebano²,

Vera³

et al. 2022

areh

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Section: Accepted Manuscriptmentioning

confidence: 75%

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

Ortiz¹,

Liebano²,

Vera³

et al. 2022

areh

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“…The MCID is defined as the smallest difference in score in any outcome that patients can perceive as beneficial or harmful. MCIDs allow for the appreciation of patients’ perspectives on their health and treatments, making MCIDs an important factor in decision-making [ 24 ]. To facilitate the interpretation of the findings, RoB judgements and estimates of outcomes, as well as available data on statistical (P value) and clinical significance (MCIDs) were described in separate summary tables.…”

Section: Methodsmentioning

confidence: 99%

The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis

et al. 2022

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Background Cervicogenic headache is a secondary headache, and manual therapy is one of the most common treatment choices for this and other types of headache. Nonetheless, recent guidelines on the management of cervicogenic headache underlined the lack of trials comparing manual and exercise therapy to sham or no-treatment controls. The main objective of this systematic review and meta-analysis was to assess the effectiveness of different forms of manual and exercise therapy in people living with cervicogenic headache, when compared to other treatments, sham, or no treatment controls. Methods Following the PRISMA guidelines, the literature search was conducted until January 2022 on MEDLINE, CENTRAL, DOAJ, and PEDro. Randomized controlled trials assessing the effects of manual or exercise therapy on patients with cervicogenic headache with headache intensity or frequency as primary outcome measures were included. Study selection, data extraction and Risk of Bias (RoB) assessment were done in duplicate. GRADE was used to assess the quality of the evidence. Results Twenty studies were included in the review, with a total of 1439 patients. Common interventions were spinal manipulation, trigger point therapy, spinal mobilization, scapulo-thoracic and cranio-cervical exercises. Meta-analysis was only possible for six manual therapy trials with sham comparators. Data pooling showed moderate-to-large effects in favour of manual therapy for headache frequency and intensity at short-term, small-to-moderate for disability at short-term, small-to-moderate for headache intensity and small for headache frequency at long-term. A sensitivity meta-analysis of low-RoB trials showed small effects in favor of manual therapy in reducing headache intensity, frequency and disability at short and long-term. Both trials included in the sensitivity meta-analysis studied spinal manipulation as the intervention of interest. GRADE assessment showed moderate quality of evidence. Conclusion The evidence suggests that manual and exercise therapy may reduce headache intensity, frequency and disability at short and long-term in people living with cervicogenic headache, but the overall RoB in most included trials was high. However, a sensitivity meta-analysis on low-RoB trials showed moderate-quality evidence supporting the use of spinal manipulation compared to sham interventions. More high-quality trials are necessary to make stronger recommendations, ideally based on methodological recommendations that enhance comparability between studies. Trial registration The protocol for this meta-analysis was pre-registered on PROSPERO under the registration number CRD42021249277.

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“…For relative error comparisons, a corridor of accepted measurement deviation was deducted from the deviation extremes measured with gold standard VOG after outlier testing in order to reduce the chance of misinterpreting an outlier as an acceptable deviation margin. These inferences were based on established methods to determine minimal meaningful effects in clinical studies 38,41 and are in line with heuristic frameworks of SESOI definition 42,43 .…”

Section: Methodsmentioning

confidence: 99%

Convolutional neural networks for quantitative smartphone video nystagmography: ConVNG

Friedrich

Schneider

Buerklein

et al. 2022

Preprint

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Background Eye movement abnormalities are paramount in neurological disorders. However, unaided eye movement assessments lack granularity. Although videooculography (VOG) improves diagnostic accuracy, resource intensiveness preclude its broad use. To bridge this care gap, we here validate a framework for smartphone video-based nystagmography capitalizing on recent computer vision advances. Methods A recurrent convolutional network was fine-tuned for pupil tracking using >550 annotated frames: ConVNG. Slow phase velocity of optokinetic nystagmus was calculated in 10 subjects using both ConVNG and VOG. Equivalence of accuracy and precision was assessed using the two one-sample t-test (TOST) and Bayesian interval-null approaches. Results ConVNG tracking accuracy reached 9-15% of an average pupil diameter. SPV measurement accuracy was equivalent to VOG (p< .017; Bayes factors (BF) > 24). Average precision was 0.30 deg. for ConVNG and 0.12 deg. for VOG. Conclusions ConVNG enables smartphone video nystagmography with an accuracy comparable to VOG and precision approximately one order of magnitude higher than comparable ARKit applications. This serves as a blueprint for highly accessible tools with potential to accelerate progress toward precise and personalized Medicine.

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Minimal clinically important difference: The basics

Cited by 41 publications

References 18 publications

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

Effectiveness of high-intensity laser therapy added to a physical therapy program for the treatment of myofascial pain syndrome - a systematic review and meta-analysis

The effectiveness of manual and exercise therapy on headache intensity and frequency among patients with cervicogenic headache: a systematic review and meta-analysis

Convolutional neural networks for quantitative smartphone video nystagmography: ConVNG

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