Evidence map›Paper›PMID 14525749›Full record

Trial reportAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2003

Clinically important change in the visual analog scale after adequate pain control.

Jacques Simon Lee, Elisabeth Hobden, Ian G Stiell, George A Wells

4 registry-linked trialsAbstract readClinical TrialRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 169 papers, 20 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
169citing papers in PubMed, 20 pooled it
9.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01636999 nawithdrawnnot on this mapstarted 2012, after this paper: background citation

Comparing Pain Relief in Early Labor: Nitrous Oxide Versus Butorphonol Study

TypeinterventionalSponsorWest Penn Allegheny Health SystemRan2012 to 2014Enrolled0ConditionsLabor PainArms50% Nitrous Oxide/50% Oxygen
NCT02046317 phase4terminatednot on this mapstarted 2011, after this paper: background citation

Trial of Ultrasound Guided Femoral Nerve Block on Isolated Femur Fracture Using Echo Friendly Needles

TypeinterventionalSponsorThe University of Texas Health Science Center, HoustonRan2011 to 2016Enrolled12ConditionsPainArmsFemoral Nerve Block, Echogenic needle, Standard of care needle, Ultrasound
NCT04449341 nacompletednot on this mapstarted 2020, after this paper: background citation

Can Virtual Reality Reduce Patient's Pain, Improve Patient's Experience, and Reduce Procedure Related Anxiety With Venipuncture? A Randomized Control Trial

TypeinterventionalSponsorC.R.Darnall Army Medical CenterRan2020 to 2020Enrolled59ConditionsProcedural Anxiety, Procedural PainArmsOculus Go headset with Ocean Rift application
NCT04658784 nacompletednot on this mapstarted 2020, after this paper: background citation

Barbed Suture Versus Non-Barbed Suture for Posterior Colporrhaphy: A Randomized Controlled Trial

TypeinterventionalSponsorWake Forest University Health SciencesRan2020 to 2022Enrolled72ConditionsRectoceleArms2-0 dioxanone, glycolide and trimethylene carbonate, 2-0 polydioxanone
3 · Its place in the literature

Who cites it

169 citing papers in PubMed, 20 syntheses or guidelines pooled it, 373 citations in OpenAlex.

  1. Ketamine versus morphine for musculoskeletal trauma pain: a meta-analysis of randomized controlled trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026
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  3. Nonsteroidal anti-inflammatory drugs (NSAIDs) for acute renal colic.The Cochrane database of systematic reviews · 2025
    Pooled it
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  5. Are combined conservative interventions effective in reducing pain, disability and/or global rating of pain in people with sciatica with known neuropathic pain mechanisms?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024
    Pooled it
  6. Gastrocnemius release is an effective management option for Achilles tendinopathy: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022
    Pooled it
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  10. Interventions for treating fractures of the patella in adults.The Cochrane database of systematic reviews · 2021
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  13. Impact of pedicle subtraction osteotomy on health-related quality of life (HRQOL) measures in patients undergoing surgery for adult spinal deformity: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2020
    Pooled it
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  19. Knee orthoses for treating patellofemoral pain syndrome.The Cochrane database of systematic reviews · 2015
    Pooled it
  20. Pooled it

109 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Jacques Simon LeeFaculty of Medicine, University of Toronto, Toronto, Ontario, Canada. jacques.lee@ices.on.ca
Elisabeth Hobden
Ian G Stiell
George A Wells
Dalhousie University · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo define the minimum clinically important difference (MCID) for the visual analog scale (VAS) of pain severity by measuring the change in VAS associated with adequate pain control.

methodsThe authors conducted a prospective, observational study. Adult emergency department (ED) patients with acute pain (<72 hours) were eligible. Patients rated their pain severity on a 100-mm VAS on presentation and at discharge. Patients were asked if they would accept any analgesic, then if they would accept a parenteral analgesic before treatment. At discharge, they were asked whether they had received adequate pain control.

resultsThe authors enrolled 143 patients (mean age, 36 years; 54% female). The mean decrease in VAS was -30.0 mm (95% confidence interval [CI] = -36.4 to -23.6) for the 116 of 143 (81%) patients with adequate pain control at discharge vs. -5.7 (95% CI = -11.2 to -0.3) for the 27 with inadequate pain control (p < 0.001). At discharge, the mean VAS was 31.3 mm for those with adequate pain control vs. 55.1 for those without. Mean VAS for the 114 of 143 patients who would accept any analgesics initially was 64.7 vs. 47.1 for the 29 reporting no analgesic need. Initially, 77 patients would accept parenteral analgesics (mean VAS = 72.5 mm).

conclusionsA mean reduction in VAS of 30.0 mm represents a clinically important difference in pain severity that corresponds to patients' perception of adequate pain control. Defining MCID based on adequate analgesic control rather than minimal detectable change may be more appropriate for future analgesic trials, when effective treatments for acute pain exist.

Indexed as

Pain ManagementPain MeasurementAdolescentAdultCohort StudiesEmergency Medical ServicesFemaleHumansMalePain ClinicsProspective Studies

Identifiers

PMID14525749
OpenAlexW2079044470

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.