• Thomas M Zervos, Karam Asmaro, and Ellen L Air.
• Neurosurgery. 2021 Mar 15; 88 (4): 713-719.

BackgroundMinimal clinically important difference (MCID) is determined when a patient or physician defines the minimal change that outweighs the costs and untoward effects of a treatment. These measurements are "anchored" to validated quality-of-life instruments or physician-rated, disease-activity indices. To capture the subjective clinical experience in a measurable way, there is an increasing use of MCID.ObjectiveTo review the overall concept, method of calculation, strengths, and weaknesses of MCID and its application in the neurosurgical literature.MethodsRecent articles were reviewed based on PubMed query. To illustrate the strengths and limitations of MCID, studies regarding the measurement of pain are emphasized and their impact on subsequent publications queried.ResultsMCID varies by population baseline characteristics and calculation method. In the context of pain, MCID varied based on the quality of pain, chronicity, and treatment options.ConclusionMCID evaluates outcomes relative to whether they provide a meaningful change to patients, incorporating the risks and benefits of a treatment. Using MCID in the process of evaluating outcomes helps to avoid the error of interpreting a small but statistically significant outcome difference as being clinically important.© Congress of Neurological Surgeons 2020.

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