{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:20:30Z","timestamp":1792005630150,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,13]],"date-time":"2015-03-13T00:00:00Z","timestamp":1426204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR000040"],"award-info":[{"award-number":["UL1TR000040"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The objective was to determine the minimum and ideal clinically significant differences (<jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> ICSD<\/jats:styled-content>) in pain intensity in children for the Faces Pain Scale\u2013Revised (<jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2010R) and the Color Analog Scale (<jats:styled-content style=\"fixed-case\">CAS<\/jats:styled-content>) and to identify any differences in these estimates based on patient characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective study of children aged 4 to 17\u00a0years with acute pain presenting to two urban pediatric emergency departments. Participants self\u2010reported their pain intensity using the <jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2212R and <jats:styled-content style=\"fixed-case\">CAS<\/jats:styled-content> and qualitatively described their changes in pain. Changes in pain score reported using the <jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2010R and <jats:styled-content style=\"fixed-case\">CAS<\/jats:styled-content> that were associated with \u201ca little less\u201d and \u201cmuch less\u201d pain (<jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content>, respectively) were identified using a receiver operating characteristic\u2013based method and expressed as raw change score and percent reductions. Estimates of <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content> were determined for each category of initial pain intensity (mild, moderate, and severe) and patient characteristics (age, sex, and ethnicity). Post hoc exploratory analyses evaluated categories of race, primary language, and etiology of pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 314 children with acute pain were enrolled; mean (\u00b1<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) age was 9.8 (\u00b13.8) years. The <jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2010R raw change score and percent reduction <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> estimates were 2\/10 and 25%, with <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content> estimates of 3\/10 and 60%. For the <jats:styled-content style=\"fixed-case\">CAS<\/jats:styled-content>, raw change score and percent reduction <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> estimates were 1\/10 and 15%, with <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content> estimates of 2.75\/10 and 52%. For both scales, raw change score and percent reduction estimates of the <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> remained unchanged in children with either moderate or severe pain. For both scales, estimates of <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content> were not stable across categories of initial pain intensity. There was no difference in <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content> based on age, sex, ethnicity, race, primary language, or etiology of pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content> estimates can be expressed as raw change score and percent reductions for the <jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2010R and <jats:styled-content style=\"fixed-case\">CAS<\/jats:styled-content>. These estimates appear stable for children with moderate to severe pain, irrespective of age, sex, and ethnicity. Estimates of <jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content> were not stable across different categories of initial pain intensity, therefore limiting their potential generalizability.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12620","type":"journal-article","created":{"date-parts":[[2015,3,13]],"date-time":"2015-03-13T17:46:18Z","timestamp":1426268778000},"page":"415-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Clinically Significant Differences in Acute Pain Measured on Self\u2010report Pain Scales in Children"],"prefix":"10.1111","volume":"22","author":[{"given":"Daniel S.","family":"Tsze","sequence":"first","affiliation":[{"name":"Department of Pediatrics Columbia University College of Physicians and Surgeons New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerrit","family":"Hirschfeld","sequence":"additional","affiliation":[{"name":"Faculty of 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