Minimal Clinically Important Difference and Patient Acceptable Symptom State After Total Abdominal Hysterectomy:...

Area of Science:

• Anesthesiology and Pain Management
• Patient-Reported Outcomes Research

Background:

• Modern anesthesia prioritizes patient-perceived pain relief over statistical significance.
• Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS) are key patient-reported outcome measures.
• These metrics define clinically significant pain relief and guide postoperative pain management targets.

Purpose of the Study:

• To determine the MCID for Numeric Rating Scale (NRS) pain scores.
• To establish the PASS threshold for patients undergoing total abdominal hysterectomy (TAH).

Main Methods:

• Secondary analysis of a randomized controlled trial (RCT) involving quadratus lumborum block (QLB) for TAH.
• Distribution-based methods (proportion of SD, SEM, 10% scale range) calculated MCID.
• Receiver operating characteristic (ROC) curve analysis identified the PASS threshold using the 'threshold approach'.

Main Results:

• The MCID for pain intensity was determined to be 1.5 on the NRS scale.
• A PASS threshold of ≤3.5 was identified, indicating a high likelihood of patient satisfaction.
• These values provide clinically meaningful improvement benchmarks and treatment targets.

Conclusions:

• Established MCID of 1.5 and PASS of ≤3.5 for NRS pain scores post-TAH.
• These findings define clinically meaningful pain improvement and set targets for personalized pain management.
• Supports anesthesiologists in achieving patient-centered postoperative pain relief goals.