Jeyaraman Naveen, Jeyaraman Madhan, Ramasubramanian Swaminathan, Balaji Sangeetha, Muthu Sathish
Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India.
Department of Research Methods, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India.
World J Methodol. 2025 Mar 20;15(1):97814. doi: 10.5662/wjm.v15.i1.97814.
The minimal clinically important difference (MCID) represents a pivotal metric in bridging the gap between statistical significance and clinical relevance, addressing the direct impact of medical interventions from the patient's perspective. This comprehensive review analyzes the evolution, applications, and challenges of MCID across medical specialties, emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs. We discuss the evolution of MCID since its inception in the 1980s, its current applications across various medical specialties, and the methodologies used in its calculation, highlighting both anchor-based and distribution-based approaches. Furthermore, the paper delves into the challenges associated with the application of MCID, such as methodological variability and the interpretation difficulties that arise in clinical settings. Recommendations for the future include standardizing MCID calculation methods, enhancing patient involvement in setting MCID thresholds, and extending research to incorporate diverse global perspectives. These steps are critical to refining the role of MCID in patient-centered healthcare, addressing existing gaps in methodology and interpretation, and ensuring that medical interventions lead to significant, patient-perceived improvements.
最小临床重要差异(MCID)是弥合统计学显著性与临床相关性之间差距的关键指标,从患者角度阐述了医学干预措施的直接影响。这篇综述全面分析了MCID在各医学专科领域的演变、应用及挑战,强调其对于确保临床结果不仅具有统计学显著性,还能提供符合患者期望和需求的真正临床效用的必要性。我们讨论了MCID自20世纪80年代诞生以来的演变过程、目前在各医学专科领域的应用情况以及计算MCID所使用的方法,重点介绍了基于锚定法和基于分布法的方法。此外,本文深入探讨了与MCID应用相关的挑战,例如方法学的变异性以及临床环境中出现的解释困难。对未来的建议包括规范MCID计算方法、加强患者在设定MCID阈值方面的参与度,以及扩展研究以纳入不同的全球视角。这些举措对于完善MCID在以患者为中心的医疗保健中的作用、解决方法学和解释方面的现有差距,以及确保医学干预措施能带来显著的、患者可感知的改善至关重要。