Authors: Vollert, Jan et al.
Anesthesiology October 2025 | DOI: 10.1097/ALN.0000000000005792
This large multicenter European study established reference values for the minimal clinically important difference (MCID) in postoperative pain and physical function using patient-reported outcome measures (PROMs). The MCID defines the smallest change in a score that patients perceive as meaningful—crucial for interpreting clinical trial results and evaluating treatment efficacy.
The analysis included 2,661 surgical patients from 18 centers across 10 countries who had undergone sternotomy, total knee arthroplasty, breast surgery, or surgery for endometriosis. Eight PROMs were collected on postoperative days 1 and 3, assessing pain (at rest, average, worst, during movement, during physiotherapy) and physical function (in bed, during movement, during physiotherapy). MCIDs were determined through both distribution-based and anchor-based methods, including patient self-rated “global impression of change” scales.
Across all domains, MCID estimates for pain intensity ranged from 1.2 (at rest) to 1.6 (during activity) on an 11-point numeric scale. For physical function, the MCID was similarly consistent—between 1.5 and 1.6. Importantly, baseline pain levels influenced perceived meaningful change: patients starting with severe pain required roughly twice the numerical reduction (e.g., 2.1 vs 1.0) to consider the improvement significant. No differences were found between improvement and worsening thresholds.
These data establish standardized MCID benchmarks for postoperative pain and functional outcomes and highlight the contextual role of baseline pain intensity in patient perception. Incorporating such thresholds can refine trial design, sample-size calculations, and individualized patient-centered pain management strategies.
What You Should Know
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MCIDs for postoperative pain and function generally range from 1 to 2 points on an 11-point scale.
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Patients with more severe baseline pain require larger reductions to perceive meaningful improvement.
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Standardized MCIDs strengthen interpretation of clinical pain studies and enhance personalized postoperative care.
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