The following is a summary of “Application of Minimal Clinically Important Differences in Palliative Research: Interpretation of Results of a Systematic Review,” published in the December 2022 issue of Pain & Symptom Management by Chyr, et al.

In evidence-based practice, it was crucial to interpreting the clinical significance of patient-reported outcomes (PROs) from studies on palliative care. It was possible to determine if changes in PROs have any significance for patients using minimal clinically important differences (MCIDs). For a study, researchers sought to investigate the use of MCIDs and their impact on the interpretation of important PROs in a recent systematic review on the integration of palliative care into ambulatory care for U.S. people with significant chronic noncancer disease.

From PubMed, tool-specific websites, and Google Scholar, paired investigators abstracted MCIDs for each PRO in the systematic review. They compared their findings, and disagreements were settled by consensus. MCIDs were evaluated in conjunction with findings from individual trials or meta-analyses to assess the efficacy of therapies.

MCIDs could be found for 10 of the 23 items that impacted seven of the nine outcomes. The most apparent impact was on depression symptoms. Three studies indicated statistically significant changes that were not clinically significant, according to the MCIDs in statistical significance, and MCIDs for other outcomes were found. They were either taken into account in meta-analyses or only had a minor impact on several studies within the outcome category.

The systematic review’s interpretation of nearly all PROs was impacted by The inclusion of MCIDs impacted the systematic review’s interpretation of nearly all PRO-based palliative care studies. When MCIDs were accessible, the study group should include them in study design and interpretation and think about employing instruments with well-established MCIDs.

Reference: jpsmjournal.com/article/S0885-3924(22)00861-2/fulltext