The Minimum Clinically Significant Difference in Acute Nontraumatic Thoracoabdominal Pain in Adult Emergency Department Patients in Turkey

Objectives To determine the minimum clinically significant difference (MCSD) in visual analog scale (VAS) pain scores for acute non-traumatic thoracoabdominal pain (TAP) in the emergency department (ED) and to determine its association with sociodemographic features, location and duration of pain. Methods An observational survey of adult ED patients with TAP lasting less than 48 hours was conducted over a six-week period. Demographic information and the duration and location of pain were recorded. Patients indicated their pain level on a 100-mm VAS at baseline and at 20, 40, and 60 minutes thereafter. Subjects were also asked to rate their pain as ‘much less’, ‘a little less’, ‘about the same’, ‘a little more’, or ‘much more’ at the 20-, 40-, and 60-minute time points. MCSD was calculated as the difference between the subsequent and preceding VAS scores if a patient reported pain as ‘a little less’ or ‘a little more’. Results Data was available for 306 of the 374 patients with TAP who presented during the study period. For pain comparisons (n=428) categorised as ‘a little less’ or ‘a little more’, the MCSD was 24.2 mm (95% CI 22.6-25.7 mm). The MCSD value was not significantly different among the factors of gender, age, level of education, duration, or location of pain. Conclusions The MCSD of ED patients with nontraumatic thoracoabominal pain in Turkey is 24.2 mm. The MCSD is not affected by gender, age, level of education, location, or duration of pain.