{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:17:11Z","timestamp":1792124231788,"version":"4.4.0"},"reference-count":50,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"vor","delay-in-days":365,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["bjanaesthesia.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["British Journal of Anaesthesia"],"published-print":{"date-parts":[[2017,3]]},"DOI":"10.1093\/bja\/aew466","type":"journal-article","created":{"date-parts":[[2016,12,19]],"date-time":"2016-12-19T23:06:22Z","timestamp":1482188782000},"page":"424-429","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":958,"title":["Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state"],"prefix":"10.1016","volume":"118","author":[{"given":"P.S.","family":"Myles","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.B.","family":"Myles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Galagher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Boyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Chew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Dennis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1093\/bja\/aew466_bib1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0304-3959(86)90228-9","article-title":"The measurement of clinical pain intensity: a comparison of six methods","volume":"27","author":"Jensen","year":"1986","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib2","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1111\/j.1365-2044.1976.tb11971.x","article-title":"The reliability of a linear analogue for evaluating pain","volume":"31","author":"Revill","year":"1976","journal-title":"Anaesthesia"},{"key":"10.1093\/bja\/aew466_bib3","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1136\/ard.37.4.378","article-title":"Studies with pain rating scales","volume":"37","author":"Downie","year":"1978","journal-title":"Ann Rheum Dis"},{"key":"10.1093\/bja\/aew466_bib4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/0304-3959(94)90097-3","article-title":"A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales","volume":"56","author":"Price","year":"1994","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib5","first-page":"102","article-title":"The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale","volume":"86","author":"DeLoach","year":"1998","journal-title":"Anesth Analg"},{"key":"10.1093\/bja\/aew466_bib6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1046\/j.1365-2044.1998.00294.x","article-title":"Quantifying meaningful changes in pain","volume":"53","author":"Campbell","year":"1998","journal-title":"Anaesthesia"},{"key":"10.1093\/bja\/aew466_bib7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/0310057X0503300108","article-title":"The linearity of the visual analogue scale in patients with severe acute pain","volume":"33","author":"Myles","year":"2005","journal-title":"Anaesth Intensive Care"},{"key":"10.1093\/bja\/aew466_bib8","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1097\/00000542-200112000-00013","article-title":"The visual analog scale for pain: clinical significance in postoperative patients","volume":"95","author":"Bodian","year":"2001","journal-title":"Anesthesiology"},{"key":"10.1093\/bja\/aew466_bib9","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1097\/EJA.0b013e32834592a8","article-title":"Measuring pain and analgesic response","volume":"28","author":"Myles","year":"2011","journal-title":"Eur J Anaesthesiol"},{"key":"10.1093\/bja\/aew466_bib10","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1093\/bja\/aew101","article-title":"Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis","volume":"116","author":"Weibel","year":"2016","journal-title":"Br J Anaesth"},{"key":"10.1093\/bja\/aew466_bib11","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1097\/00000542-200306000-00017","article-title":"Relationships between measurement of pain using visual analog score and morphine requirements during postoperative intravenous morphine titration","volume":"98","author":"Aubrun","year":"2003","journal-title":"Anesthesiology"},{"key":"10.1093\/bja\/aew466_bib12","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S0304-3959(03)00176-3","article-title":"What decline in pain intensity is meaningful to patients with acute pain?","volume":"105","author":"Cepeda","year":"2003","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib13","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0304-3959(00)00339-0","article-title":"Defining the clinically important difference in pain outcome measures","volume":"88","author":"Farrar","year":"2000","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib14","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.pain.2009.08.019","article-title":"Interpreting the clinical importance of group differences in chronic pain clinical trials: IMMPACT recommendations","volume":"146","author":"Dworkin","year":"2009","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib15","first-page":"2025","article-title":"Minimal clinically important difference, low disease activity state, and patient acceptable symptom state: methodological issues","volume":"32","author":"Tubach","year":"2005","journal-title":"J Rheumatol"},{"key":"10.1093\/bja\/aew466_bib16","first-page":"406","article-title":"Minimal clinically important differences: review of methods","volume":"28","author":"Wells","year":"2001","journal-title":"J Rheumatol"},{"key":"10.1093\/bja\/aew466_bib17","doi-asserted-by":"crossref","first-page":"371","DOI":"10.4065\/77.4.371","article-title":"Methods to explain the clinical significance of health status measures","volume":"77","author":"Guyatt","year":"2002","journal-title":"Mayo Clin Proc"},{"key":"10.1093\/bja\/aew466_bib18","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S0304-3959(96)03306-4","article-title":"Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics: use of pain intensity and visual analogue scales","volume":"69","author":"Moore","year":"1997","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib19","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1553-2712.1996.tb03402.x","article-title":"The minimum clinically important difference in physician-assigned visual analog pain scores","volume":"3","author":"Todd","year":"1996","journal-title":"Acad Emerg Med"},{"key":"10.1093\/bja\/aew466_bib20","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1227\/NEU.0000000000000247","article-title":"Measuring surgical outcomes in subaxial degenerative cervical spine disease patients: minimum clinically important difference as a tool for determining meaningful clinical improvement","volume":"74","author":"Auffinger","year":"2014","journal-title":"Neurosurgery"},{"key":"10.1093\/bja\/aew466_bib21","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0304-3959(01)00349-9","article-title":"Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale","volume":"94","author":"Farrar","year":"2001","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib22","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1097\/01.brs.0000164099.92112.29","article-title":"Responsiveness of the numeric pain rating scale in patients with low back pain","volume":"30","author":"Childs","year":"2005","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1093\/bja\/aew466_bib23","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1016\/j.pain.2011.06.003","article-title":"Clinically important difference thresholds of the visual analog scale: a conceptual model for identifying meaningful intraindividual changes for pain intensity","volume":"152","author":"Emshoff","year":"2011","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib24","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1136\/emj.18.3.205","article-title":"The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain","volume":"18","author":"Kelly","year":"2001","journal-title":"Emerg Med J"},{"key":"10.1093\/bja\/aew466_bib25","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1067\/mem.2001.118863","article-title":"Prospective validation of clinically important changes in pain severity measured on a visual analog scale","volume":"38","author":"Gallagher","year":"2001","journal-title":"Ann Emerg Med"},{"key":"10.1093\/bja\/aew466_bib26","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.jse.2009.03.021","article-title":"Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease","volume":"18","author":"Tashjian","year":"2009","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1093\/bja\/aew466_bib27","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1002\/acr.21747","volume":"64","author":"Tubach","year":"2012","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"10.1093\/bja\/aew466_bib28","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/j.1526-4637.2012.01529.x","article-title":"The patient acceptable symptom state of chronic musculoskeletal pain measured on a visual analog scale in Moroccan patients","volume":"14","author":"Wariaghli","year":"2013","journal-title":"Pain Med"},{"key":"10.1093\/bja\/aew466_bib29","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/ALN.0000000000001158","article-title":"Minimal clinically important difference for three quality of recovery scales","volume":"125","author":"Myles","year":"2016","journal-title":"Anesthesiology"},{"key":"10.1093\/bja\/aew466_bib30","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care"},{"key":"10.1093\/bja\/aew466_bib31","doi-asserted-by":"crossref","first-page":"141","DOI":"10.2165\/00019053-199915020-00003","article-title":"Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II","volume":"15","author":"Samsa","year":"1999","journal-title":"Pharmacoeconomics"},{"key":"10.1093\/bja\/aew466_bib32","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.jclinepi.2004.01.012","article-title":"A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale","volume":"57","author":"Eton","year":"2004","journal-title":"J Clin Epidemiol"},{"key":"10.1093\/bja\/aew466_bib33","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/S0895-4356(99)00071-2","article-title":"Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life","volume":"52","author":"Wyrwich","year":"1999","journal-title":"J Clin Epidemiol"},{"key":"10.1093\/bja\/aew466_bib34","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1002\/cncr.22799","article-title":"Interpreting clinically significant changes in patient-reported outcomes","volume":"110","author":"Ringash","year":"2007","journal-title":"Cancer"},{"key":"10.1093\/bja\/aew466_bib35","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1093\/annonc\/mdq726","article-title":"Minimal clinically meaningful differences for the EORTC QLQ-C30 and EORTC QLQ-BN20 scales in brain cancer patients","volume":"22","author":"Maringwa","year":"2011","journal-title":"Ann Oncol"},{"key":"10.1093\/bja\/aew466_bib36","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/0895-4356(94)90036-1","article-title":"Determining a minimal important change in a disease-specific quality of life questionnaire","volume":"47","author":"Juniper","year":"1994","journal-title":"J Clin Epidemiol"},{"key":"10.1093\/bja\/aew466_bib37","first-page":"1115","article-title":"MCID\/Low Disease Activity State Workshop: summary, recommendations, and research agenda","volume":"30","author":"Wells","year":"2003","journal-title":"J Rheumatol"},{"key":"10.1093\/bja\/aew466_bib38","doi-asserted-by":"crossref","first-page":"h2464","DOI":"10.1136\/bmj.h2464","article-title":"How to read a receiver operating characteristic curve","volume":"350","author":"Sedgwick","year":"2015","journal-title":"Br Med J"},{"key":"10.1093\/bja\/aew466_bib39","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/0021-9681(85)90005-0","article-title":"A methodological framework for assessing health indices","volume":"38","author":"Kirshner","year":"1985","journal-title":"J Chronic Dis"},{"key":"10.1093\/bja\/aew466_bib40","doi-asserted-by":"crossref","first-page":"S178","DOI":"10.1097\/00005650-198903001-00015","article-title":"Effect sizes for intepreting changes in health status","volume":"27","author":"Kazis","year":"1989","journal-title":"Med Care"},{"key":"10.1093\/bja\/aew466_bib41","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.pain.2012.10.017","volume":"154","author":"Perrot","year":"2013","journal-title":"Pain"},{"key":"10.1093\/bja\/aew466_bib42","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/S1526-5900(03)00716-8","article-title":"Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain","volume":"4","author":"Jensen","year":"2003","journal-title":"J Pain"},{"key":"10.1093\/bja\/aew466_bib43","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/j.1530-7085.2003.03034.x","article-title":"The numeric rating scale for clinical pain measurement: a ratio measure?","volume":"3","author":"Hartrick","year":"2003","journal-title":"Pain Pract"},{"key":"10.1093\/bja\/aew466_bib44","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1007\/BF03022623","article-title":"Patient-controlled versus nurse-controlled analgesia after cardiac surgery \u2013 a meta-analysis","volume":"53","author":"Bainbridge","year":"2006","journal-title":"Can J Anaesth"},{"key":"10.1093\/bja\/aew466_bib45","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1001\/jama.2016.1912","article-title":"Zero pain is not the goal","volume":"315","author":"Lee","year":"2016","journal-title":"JAMA"},{"key":"10.1093\/bja\/aew466_bib46","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.wneu.2015.09.072","article-title":"Can a minimal clinically important difference be achieved in elderly patients with adult spinal deformity who undergo minimally invasive spinal surgery?","volume":"86","author":"Park","year":"2016","journal-title":"World Neurosurg"},{"key":"10.1093\/bja\/aew466_bib47","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1097\/00000542-200403000-00042","article-title":"The pain visual analog scale: linear or nonlinear?","volume":"100","author":"Myles","year":"2004","journal-title":"Anesthesiology"},{"key":"10.1093\/bja\/aew466_bib48","unstructured":"Committee for Medicinal Products for Human Use: Guideline on the Choice of the Non-Inferiority Margin. London. 2005. Available from http:\/\/wwwemaeuropaeu\/docs\/en_GB\/document_library\/Scientific_guideline\/2009\/09\/WC500003636pdf (accessed 1 July 2016)."},{"key":"10.1093\/bja\/aew466_bib49","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1213\/ANE.0b013e31823d2ab7","article-title":"Beyond effect size: consideration of the minimum effect size of interest in anesthesia trials","volume":"114","author":"Gibbs","year":"2012","journal-title":"Anesth Analg"},{"key":"10.1093\/bja\/aew466_bib50","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.pmn.2006.09.001","article-title":"Determination of clinically meaningful levels of pain reduction in patients experiencing acute postoperative pain","volume":"7","author":"Sloman","year":"2006","journal-title":"Pain Manag Nurs"}],"container-title":["British Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S000709121730212X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S000709121730212X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bja\/article-pdf\/118\/3\/424\/14060157\/aew466.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T18:30:15Z","timestamp":1757788215000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S000709121730212X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":50,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["S000709121730212X"],"URL":"https:\/\/doi.org\/10.1093\/bja\/aew466","relation":{},"ISSN":["0007-0912"],"issn-type":[{"value":"0007-0912","type":"print"}],"subject":[],"published":{"date-parts":[[2017,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state","name":"articletitle","label":"Article Title"},{"value":"British Journal of Anaesthesia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1093\/bja\/aew466","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2017 The Author(s). Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}