Minimum detectable and minimal clinically important changes for pain in patients with nonspecific neck pain
2008

Detecting Changes in Neck Pain Severity

Sample size: 658 publication Evidence: moderate

Author Information

Author(s): Kovacs Francisco M, Abraira Víctor, Royuela Ana, Corcoll Josep, Alegre Luis, Tomás Miquel, Mir María Antonia, Cano Alejandra, Muriel Alfonso, Zamora Javier, Gil del Real María Teresa, Gestoso Mario, Mufraggi Nicole

Primary Institution: Fundación Kovacs

Hypothesis

What are the minimal detectable change (MDC) and minimal clinically important changes (MCIC) for pain severity in patients with nonspecific neck pain?

Conclusion

Improvements in neck pain severity of less than 1.5 points are generally considered irrelevant, while clinically meaningful changes depend on the patient's baseline severity of pain.

Supporting Evidence

  • MDC for neck pain was found to be 4.0 PI-NRS points.
  • MCS was 4.1 PI-NRS points for neck pain.
  • ROC for neck pain was 1.5 PI-NRS points.
  • Improvements of pain severity ≤ 1.5 points are considered clinically irrelevant.
  • MDC and MCIC values for neck pain are similar to those for low back pain.

Takeaway

This study helps doctors understand how much pain improvement is important for patients with neck pain, showing that small changes might not matter.

Methodology

Patients with subacute and chronic neck pain were assessed for changes in pain severity over three months using a pain intensity numerical rating scale.

Limitations

The study's findings may not apply to patients with acute neck pain or those with mild pain, as inclusion criteria required pain severity to be at least 3 points.

Participant Demographics

The study included mostly middle-aged working women, with a mean age of 54.1 years, and 74% reported referred pain.

Statistical Information

Confidence Interval

95% CI for MDC was 4.0 (3.4–5.0) for neck pain.

Digital Object Identifier (DOI)

10.1186/1471-2474-9-43

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