Minimal clinically important difference for chest discomfort in patients undergoing pleural interventions

Area of Science:

• Pulmonology
• Medical Procedures
• Pain Management

Background:

• Therapeutic thoracentesis is a common procedure with chest discomfort as a frequent complication.
• Visual analogue scales (VAS) are used to measure discomfort, but the minimal clinically important difference (MCID) for thoracentesis-related chest discomfort was undetermined.
• Establishing the MCID is crucial for interpreting study results and designing clinical trials.

Purpose of the Study:

• To determine the minimal clinically important difference (MCID) for chest discomfort experienced by patients undergoing therapeutic thoracentesis.
• To provide a quantitative measure for assessing the clinical significance of changes in chest discomfort.
• To inform future research and clinical practice related to pleural interventions.

Main Methods:

• Prospective data from 262 thoracenteses in adult patients with symptomatic pleural effusions were analyzed.
• Patients rated chest discomfort using a 100 mm VAS before, during, and after the procedure.
• A 7-point Likert scale assessed the significance of change in discomfort, correlating with VAS score differences.

Main Results:

• A mean increase of 16 mm on the VAS was observed in patients reporting a 'small but significant increase' in chest discomfort (n=23).
• This 16 mm VAS increase represents the smallest change associated with a patient-reported significant change in symptom.
• Thirty-four patients reported a significant increase in discomfort post-procedure.

Conclusions:

• The minimal clinically important difference (MCID) for thoracentesis-related chest discomfort, measured by a 100 mm VAS, is 16 mm.
• This established MCID provides a benchmark for future studies on pleural interventions.
• The findings will aid in the design, analysis, and interpretation of clinical trials involving thoracentesis.