TY - JOUR T1 - MCID — The Minimal Clinically Important Difference Assigns Significance to Outcome Effects JF - The Journal of Rheumatology JO - J Rheumatol SP - 258 LP - 259 DO - 10.3899/jrheum.151415 VL - 43 IS - 2 AU - FELIX ANGST Y1 - 2016/02/01 UR - http://www.jrheum.org/content/43/2/258.abstract N2 - At medical school we were taught that 70–80% of the information that leads to diagnosis comes from the patient’s anamnesis. The severity of the subjective symptoms and disabilities drives the patient to seek medical help and has a major influence on treatment and intervention, despite “objective” findings such as alterations on a radiograph, for example, in a knee affected by osteoarthritis (OA)1. Based on this insight, a huge number of patient-rated outcome instruments have been developed in the past 2 decades2. Nevertheless, the significance of therapeutic effects is still quantified by statistical methods alone in many study reports, especially in pharmacological ones, even if the effects are labeled as “clinically significant”3.Beyond statistically and distribution-based quantification of effect significance, the dimension of an effect’s importance and significance, which includes the patient’s subjective perception of pain and function, reaches a higher sphere because it is closer to the central subject of interest in medicine, the patient. “It is recommended that the patient’s perspective be given the most weight, because these are patient-related outcome measures, although the clinician’s perspective is considered important as well”4. The founders of the concepts developed consequently to give this alternative meaning for outcome effects were Jaeschke and Redelmeier5,6.Jaeschke was the first investigator to ask patients to rate their subjectively perceived change of health or symptoms between baseline and followup5. The responses on this “transition” item were related to the score differences of an outcome instrument within the same time period … Address correspondence to Dr. F. Angst, RehaClinic, Quellenstr. 34, 5330 Bad Zurzach, Switzerland; E-mail: fangst{at}vtxmail.ch, f.angst{at}rehaclinic.ch ER -