{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:01:15Z","timestamp":1785870075034,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T00:00:00Z","timestamp":1550534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR000040"],"award-info":[{"award-number":["UL1TR000040"]}],"id":[{"id":"10.13039\/100006108","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":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Identifying changes in pain score associated with clinically meaningful outcomes is necessary when using self\u2010report measures to assess pain in children. We aimed to determine the changes in pain score associated with a minimum clinically significant difference (<jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content>), ideal clinically significant difference (<jats:styled-content style=\"fixed-case\">ICSD<\/jats:styled-content>), and patient\u2010perceived adequate analgesia (<jats:styled-content style=\"fixed-case\">PPAA<\/jats:styled-content>) and to evaluate for differences based on initial pain intensity and patient characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional study of children 6 to 17 and 4 to 17 years old who were assessed using the Verbal Numerical Rating Scale (<jats:styled-content style=\"fixed-case\">VNRS<\/jats:styled-content>) and Faces Pain Scale\u2013Revised (<jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2010R), respectively. Children qualitatively described any endorsed change in pain score; those who received an analgesic were asked if they wanted additional analgesics to decrease their pain intensity. We used a receiver operating characteristic curve\u2013based methodology to identify changes in pain score 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) and patients declining additional analgesics because of adequate analgesia (<jats:styled-content style=\"fixed-case\">PPAA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 431 children with painful conditions. For the <jats:styled-content style=\"fixed-case\">VNRS<\/jats:styled-content>, raw change and percent reductions in pain scores associated with <jats:styled-content style=\"fixed-case\">MCSD<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> ICSD<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">PPAA<\/jats:styled-content> were 2\/10 and 20%, 3\/10 and 44%, and 2\/10 and 29%, respectively, and for the <jats:styled-content style=\"fixed-case\">FPS<\/jats:styled-content>\u2010R, 2\/10 and 33%, 4\/10 and 60%, and 4\/10 and 40%, respectively. Raw change in pain scores increased with increasing initial pain intensity, but percent reductions remained stable. There were no significant differences based on patient characteristics such as age, sex, and race\/ethnicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings provide patient\u2010centered outcomes in children that are suitable for designing trials and are generalizable across patient characteristics.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13683","type":"journal-article","created":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T09:41:02Z","timestamp":1547372462000},"page":"1002-1013","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Changes in Pain Score Associated With Clinically Meaningful Outcomes in Children With Acute Pain"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7567-8743","authenticated-orcid":false,"given":"Daniel S.","family":"Tsze","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Division 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