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Ilfeld BM. Why science is less scientific than we think (and what to do about it): The 2022 Gaston Labat Award Lecture. Reg Anesth Pain Med 2022; 47:395-400. [PMID: 35365548 PMCID: PMC9132860 DOI: 10.1136/rapm-2021-103331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Brian M Ilfeld
- Department of Anesthesiology, University of California San Diego, La Jolla, California, USA
- Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA
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Simovitch RW, Hernandez T, YaDeau JT, Grant MC, Pociask C, Ouanes JPP. Liposomal Bupivacaine Plus Bupivacaine Versus Ropivacaine Plus Dexamethasone Brachial Plexus Blockade for Arthroscopic Rotator Cuff Repair. JB JS Open Access 2022; 7:JBJSOA-D-21-00122. [PMID: 36147653 PMCID: PMC9484816 DOI: 10.2106/jbjs.oa.21.00122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - Jacques T YaDeau
- Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY
| | - Michael C Grant
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Jean-Pierre P Ouanes
- Hospital for Special Surgery Florida, West Palm Beach, Florida
- Weill Cornell Medicine, New York, NY
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Muñoz-Leyva F, El-Boghdadly K, Chan V. Is the minimal clinically important difference (MCID) in acute pain a good measure of analgesic efficacy in regional anesthesia? Reg Anesth Pain Med 2020; 45:1000-1005. [DOI: 10.1136/rapm-2020-101670] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023]
Abstract
In the field of acute pain medicine research, we believe there is an unmet need to incorporate patient related outcome measures that move beyond reporting pain scores and opioid consumption. The term “minimal clinically important difference” (MCID) defines the clinical benefit of an intervention as perceived by the patient, as opposed to a mathematically determined statistically significant difference that may not necessarily be clinically significant. The present article reviews the concept of MCID in acute postoperative pain research, addresses potential pitfalls in MCID determination and questions the clinical validity of extrapolating MCID determined from chronic pain and non-surgical pain studies to the acute postoperative pain setting. We further suggest the concepts of minimal clinically important improvement, substantial clinical benefit and patient acceptable symptom state should also represent aspirational outcomes for future research in acute postoperative pain management.
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