Stauffer Melissa E, Taylor Stephanie D, Watson Douglas J, Peloso Paul M, Morrison Alan
Scribco Pharmaceutical Writing, P.O. Box 1525, Blue Bell, PA 19422, USA.
Int J Inflam. 2011;2011:231926. doi: 10.4061/2011/231926. Epub 2011 May 5.
Our objective was to develop a working definition of nonresponse to analgesic treatment of arthritis, focusing on the measurement of pain on the 0-100 mm pain visual analog scale (VAS). We reviewed the literature to assess the smallest detectable difference (SDD), the minimal detectable change (MDC), and the minimal clinically important difference (MCID). The SDD for improvement reported in three studies of rheumatoid arthritis was 18.6, 19.0, and 20.0. The median MDC was 25.4 for 7 studies of osteoarthritis and 5 studies of rheumatoid arthritis (calculated for a reliability coefficient of 0.85). The MCID increased with increasing baseline pain score. For baseline VAS tertiles defined by scores of 30-49, 50-65, and >65, the MCID for improvement was, respectively, 7-11 units, 19-27 units, and 29-37 units. Nonresponse can thus be defined in terms of the MDC for low baseline pain scores and in terms of the MCID for high baseline scores.
我们的目标是制定一个关于关节炎镇痛治疗无反应的实用定义，重点是在0 - 100毫米疼痛视觉模拟量表（VAS）上对疼痛进行测量。我们查阅了文献，以评估最小可检测差异（SDD）、最小可检测变化（MDC）和最小临床重要差异（MCID）。三项类风湿性关节炎研究报告的改善的SDD分别为18.6、19.0和20.0。7项骨关节炎研究和5项类风湿性关节炎研究的MDC中位数为25.4（针对可靠性系数0.85计算）。MCID随基线疼痛评分增加而升高。对于由30 - 49、50 - 65和>65的评分定义的基线VAS三分位数，改善的MCID分别为7 - 11个单位、19 - 27个单位和29 - 37个单位。因此，对于低基线疼痛评分，无反应可以根据MDC来定义；对于高基线评分，则可以根据MCID来定义。
