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Determining the minimum clinically significant difference in visual analog pain score for children.

C V Powell1, A M Kelly, A Williams

  • 1Department of Emergency Medicine, Sunshine Hospital, Melbourne, Australia.

Annals of Emergency Medicine
|January 6, 2001
PubMed
Summary

The minimum clinically significant difference in visual analog scale (VAS) pain score for children aged 8-15 is 10 mm. This finding helps determine if pain score changes are meaningful in clinical practice.

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Area of Science:

  • Pediatric Emergency Medicine
  • Pain Assessment
  • Clinical Significance

Background:

  • Assessing pain in children is crucial for effective treatment.
  • The visual analog scale (VAS) is a common tool for pain measurement.
  • Defining a minimum clinically significant difference (MCSD) is essential for interpreting VAS scores.

Purpose of the Study:

  • To determine the MCSD in VAS pain scores for children aged 8 to 15 years.
  • To establish a benchmark for clinically meaningful pain reduction in pediatric patients.

Main Methods:

  • Prospective, repeated-measures study in a pediatric emergency department.
  • Children (8-15 years) with acute pain used a 100-mm VAS and provided verbal pain ratings.
  • MCSD defined as the mean VAS change when patients reported pain as 'a bit better' or 'a bit worse'.

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Main Results:

  • 103 evaluable comparisons from 73 children were analyzed.
  • The MCSD in VAS pain score was found to be 10 mm.
  • The 95% confidence interval for the MCSD was 7 to 12 mm.

Conclusions:

  • A 10-mm change on the 100-mm VAS represents the minimum clinically significant difference for children aged 8-15.
  • Statistically significant VAS changes smaller than 10 mm may not be clinically relevant in pediatric populations.