The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain
Open accessAbstract
OBJECTIVE: To determine whether minimum clinically significant difference in visual analogue scale (VAS) pain score varies according to the severity of pain reported. METHOD: Prospective descriptive study of adult patients in an urban emergency department (ED). On presentation to the ED, patients marked the level of their pain on a 100 mm, non-hatched VAS scale. At 20 minute intervals thereafter they were asked to give a verbal categorical rating of their pain as "a lot better", "a little better", "much the same", "a little worse" or "much worse" and to mark the level of pain on a VAS scale of the same type as used previously. It was pre-defined that patients with VAS pain scores of 30 mm or less would be categorised as having mild pain, those with scores of 70 mm or more were categorised as having severe pain and those from 31 mm to 69 mm, moderate pain. The minimal clinically significant difference (MCSD) in VAS pain score was defined as the mean difference between current and preceding scores when the subject reported "a little worse" or "a little better" pain. RESULTS: 156 patients were enrolled in the study, yielding 88 evaluable comparisons where pain was rated as "a little better" or "a little worse". The MCSD in VAS score in the group overall was 12 mm (95%CI 9 mm to 15 mm). MCSD in VAS score for the "mild pain" group was 11 mm (95%CI 4 mm to 18 mm), for the "moderate pain" group 14 mm (95%CI 10 mm to 18 mm) and for the severe pain group, 10 mm (95%CI 6 mm to 14 mm). There is no statistical difference between the MCSD in VAS score between the severity groups. CONCLUSIONS: The MCSD in VAS pain score does not differ with the severity of pain being experienced.
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The Visual Analogue Scale is a valid and reliable tool that is sensitive in detection.
“VAS is the most widely used tool for pain, and studies showed that VAS is valid and reliable tool that is sensitive in detection [55-57].”
From Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms. (2022) · cites this paper as [55]
The Abstract says the VAS provides reproducible results and is sensitive to treatment effects; the Discussion repeats both points. These support reliability and sensitivity, but our copy does not explicitly establish the VAS as valid. (LLM, conf=0.83)
Experimental — accuracy not yet measuredA minimally clinically important difference was predefined as 10 or greater on a 100-point symptoms scale.
“We predefined a minimally clinically important difference as 10 or greater on a 100-point symptoms scale [9].”
From Intolerance upon statin rechallenge: A systematic review and meta-analysis of randomized controlled trials (2023) · cites this paper as [9]
The Results report a minimum clinically significant difference of 12 mm on a 100 mm visual analogue pain scale, and Table 1 reports estimates of 10–14 mm across pain-severity groups. This supports a roughly 10-point benchmark for pain, but the paper does not establish a predefined threshold of 10 or greater for a general symptoms scale. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe Visual Analogue Scale is the most widely used tool for pain.
“VAS is the most widely used tool for pain, and studies showed that VAS is valid and reliable tool that is sensitive in detection [55-57].”
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Cites
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Research works printed but not linked: 1
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- Authors
- Kelly, A.-M.
- Affiliations
- Western Hospital (AU)
- Corresponding author
- Kelly, A-M
- Venue
- Emergency Medicine Journal
- Publisher
- BMJ
- Published
- 2001-05-01
- Volume
- 18
- Issue
- 3
- Pages
- 205-207
- ISSN
- 1351-0622 (ISSN-L)
- 1472-0205
- 1472-0213
- PMC
- PMC1725574
- OpenAlex
- W2102560768
- Cited by
- 969
- References
- 8
- Citations by year
- 2026: 48 · 2025: 57 · 2024: 60 · 2023: 63 · 2022: 51 · 2021: 65 · 2020: 76 · 2019: 45 · 2018: 47 · 2017: 47 · 2016: 43 · 2015: 55 · 2014: 38 · 2013: 33 · 2012: 40
- FWCI
- 5.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Emergency Medicine Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- visual analogue scale, pain intensity, pain assessment, emergency department patients, patient-reported pain
- MeSH terms
- Adult, Emergency Service, Hospital, Humans, Pain, Pain Measurement, Prospective Studies
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