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Defining the Minimal Important Difference for the Visual Analogue Scale Assessing Dyspnea in Patients with Malignant Pleural Effusions

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  • Eleanor K Mishra
  • John P Corcoran
  • Robert J Hallifax
  • John Stradling
  • Nicholas A Maskell
  • Najib M Rahman

Abstract

Background: The minimal important difference (MID) is essential for interpreting the results of randomised controlled trials (RCTs). Despite a number of RCTs in patients with malignant pleural effusions (MPEs) which use the visual analogue scale for dyspnea (VASD) as an outcome measure, the MID has not been established. Methods: Patients with suspected MPE undergoing a pleural procedure recorded their baseline VASD and their post-procedure VASD (24 hours after the pleural drainage), and in parallel assessed their breathlessness on a 7 point Likert scale. Findings: The mean decrease in VASD in patients with a MPE reporting a ‘small but just worthwhile decrease’ in their dyspnea (i.e. equivalent to the MID) was 19mm (95% CI 14-24mm). The mean drainage volume required to produce a change in VASD of 19mm was 760ml. Interpretation: The mean MID for the VASD in patients with a MPE undergoing a pleural procedure is 19mm (95% CI 14-24mm). Thus choosing an improvement of 19mm in the VASD would be justifiable in the design and analysis of future MPE studies.

Suggested Citation

  • Eleanor K Mishra & John P Corcoran & Robert J Hallifax & John Stradling & Nicholas A Maskell & Najib M Rahman, 2015. "Defining the Minimal Important Difference for the Visual Analogue Scale Assessing Dyspnea in Patients with Malignant Pleural Effusions," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-9, April.
    • Handle: RePEc:plo:pone00:0123798
    DOI: 10.1371/journal.pone.0123798
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