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Yet, considerable confusion regarding terminology remains, leading to potentially erroneous interpretation of COA results. This article sought to provide an updated overview of terminology and an assessment of trends to explore opportunities for harmonizing the field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A targeted literature review was conducted for review articles published 2016-September 2024 discussing terminology related to COA score interpretation thresholds, followed by a review of guidance by regulatory and reimbursement\/payer stakeholders for specific terminology in this context. A targeted review of original research articles that were aimed at deriving interpretation thresholds was undertaken, spanning a five-year period (2016- Apr 2021) to explore potential trends regarding use of terms, acronyms, and definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>As expected, vast heterogeneity in terminology and definitions was observed across review articles and regulatory\/reimbursement\/payer guidelines. Across 318 original research articles, 39 different terms were identified, with \u2018minimal clinically important difference\u2019 (MCID) most frequently used (mentioned in 163 articles), which was more than twice as often as the next term (\u2018minimal important difference\u2019; MID), mentioned in 76 articles, followed by \u2018minimal important change\u2019 (MIC), mentioned in 54 articles. Articles also showed great variation in how thresholds were defined, derived, and applied. Frequently, authors failed to provide sufficient details on methods and application, making it difficult to interpret derived thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COA score interpretation threshold terminology is far from harmonized. Evidence is insufficient to derive specific recommendations on which terms to use. Instead, we present minimum reporting standards for defining thresholds to ensure that they are comprehensible and reproducible, regardless of the specific terms and acronyms used.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41687-025-00966-2","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T15:21:03Z","timestamp":1764170463000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Defining score interpretation thresholds for clinical outcome assessments: a review of terminology and reporting recommendations"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3526-9670","authenticated-orcid":false,"given":"E.","family":"Flood","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9418-9374","authenticated-orcid":false,"given":"B. 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EF is an employee and a stockholder of AstraZeneca. NC was an employee of AstraZeneca at the time the study was conducted and reports no competing interests. BLK Research funding for LUNGevity Foundation Lilly, AstraZeneca, G1 Therapeutics, Bristol-Myers Squibb\/Roche, Merck, Blueprint Medicines, Genentech, Takeda, Jazz Pharmaceuticals, Mirati Therapeutics, Johnson and Johnson and Gilead. Consulting fees AbbVie, Lilly, Shionogi, Adelphi. JM reports no competing interests. SE is a full-time employee of the Critical Path Institute and reports no competing interests. CLW is an employee of Otsuka Pharmaceuticals. JCC is an employee and a stockholder of Pfizer Inc. SN received consulting fees and Advisory Board honoraria from the Movember Foundation and consulting fees from the Mapi Research Trust and Bertelsmann Stiftung, all outside the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"137"}}