ArticleThe Journal of hand surgery2022
Establishing the Minimal Clinically Important Difference and Substantial Clinical Benefit for the Pain Visual Analog Scale in a Postoperative Hand Surgery Population.
Article in The Journal of hand surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06651788 (Does "Freeze Spray" Work? Evaluating the Efficacy of Ethyl Chloride Usage Prior to Orthopaedic Injections), which is not on this map. Cited by 42 papers, 6 of them syntheses that pooled it.
What it found
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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.
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.
Does "Freeze Spray" Work? Evaluating the Efficacy of Ethyl Chloride Usage Prior to Orthopaedic Injections
Who cites it
42 citing papers in PubMed, 6 syntheses or guidelines pooled it, 93 citations in OpenAlex.
- Efficacy and safety of prosthetic arthroplasty of the distal radioulnar joint: a systematic review.The Journal of hand surgery, European volume · 2026Pooled it
- Clinical impact of wide-awake local anesthesia no tourniquet (WALANT) in carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2026Pooled it
- What Are the Most Clinically Effective Nonoperative Interventions for Thumb Carpometacarpal Osteoarthritis? An Up-to-date Systematic Review and Network Meta-analysis.Clinical orthopaedics and related research · 2025Pooled it
- Total joint arthroplasty for thumb carpometacarpal joint osteoarthritis: a systematic review and meta-analysis of randomized controlled trials.Acta orthopaedica · 2024Pooled it
- Patient reported and functional outcome measures after surgical salvage procedures for posttraumatic radiocarpal osteoarthritis - a systematic review.BMC musculoskeletal disorders · 2024Pooled it
- Effectiveness of suture anchor and transosseous suture technique in arthroscopic foveal repair of the triangular fibrocartilage complex: a systematic review.Journal of orthopaedic surgery and research · 2024Pooled it
- Does the addition of peripheral nerve blocks improve analgesia during distal radius fracture reduction? A prospective, randomized, multicenter clinical trial.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Trial
- Efficacy of different nerve block techniques with liposomal bupivacaine for postoperative analgesia in patients undergoing single-port video-assisted thoracoscopic partial lung resection.Frontiers in medicine · 2026Trial
- Clinical and radiographic outcomes following medial collateral ligament-sparing interposition elbow arthroplasty using acellular dermal allograft.JSES reviews, reports, and techniques · 2026Article
- Carpal Tunnel Release Using Ultrasound Guidance: Two-Year Outcomes of a Randomized Controlled Trial Within the Military.Journal of hand surgery global online · 2026Article
- Outcomes of Percutaneous Stabilization for Pelvic Metastatic Bone Disease: A Systematic Review and Meta-Analysis.Cancers · 2026Review
- MCID, SCB, and PASS Thresholds After Percutaneous Trigger Finger Release With or Without Corticosteroid Injection.Journal of clinical medicine · 2026Article
- Factors Associated with Clinically Meaningful Pain Reduction Following Phase-I Complex Decongestive Therapy in Breast Cancer-Related Lymphedema.Medical sciences (Basel, Switzerland) · 2026Observational
- Comprehensive Hand Evaluation Form: Feasibility of Merging the Most Common Hand-Specific Patient-Reported Outcome Measures.Medicina (Kaunas, Lithuania) · 2026Article
- Sex-related differences in pain following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study.Spine deformity · 2026Article
- Outcomes Following Regenerative Peripheral Nerve Interface Surgery and Associations With Preoperative Mental Health: A Retrospective Analysis of Upper-Extremity Neuromas.Journal of hand surgery global online · 2026Article
- Real-World Before-After Study ofNutrients · 2026Article
- Article
- Digital Doses: Virtual Reality Use for Perioperative Pain and Anxiety in Patients Undergoing Hand Surgery.Journal of hand surgery global online · 2025Article
- A comparative study of minimally invasive plate osteosynthesis with t-shaped incision technique and standard volar approach with pronator quadratus preservation in volar plating of distal radius fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
purposeAlthough the pain visual analog scale (VAS-pain) is a ubiquitous patient-reported outcome instrument, it remains unclear how to interpret changes or differences in scores. Therefore, our purpose was to calculate the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) for the VAS-pain instrument in a nonshoulder hand and upper extremity postoperative population.
methodsAdult postoperative patients treated by 1 of 5 fellowship-trained orthopedic hand surgeons at a single tertiary academic medical center were identified. Inclusion required VAS-pain scores at baseline (up to 3 months before surgery) and follow-up (up to 4 months after surgery), in addition to a response to a pain-specific anchor question at follow-up. The MCID estimates were calculated with (1) the 1/2 standard deviation method; and (2) an anchor-based approach. The SCB estimates were calculated with (1) an anchor-based approach; and (2) a receiver operator curve method that maximized the sensitivity and specificity for detecting a "much improved" pain status.
resultsThere were 667 and 148 total patients included in the MCID and SCB analyses, respectively. The 1/2 standard deviation MCID estimate was 1.6, and the anchor-based estimate was 1.9. The anchor-based SCB estimate was 2.2. The receiver operator curve analysis yielded an SCB estimate of 2.6, with an area under the curve of 0.72, consistent with acceptable discrimination.
conclusionsWe propose MCID values in the range of 1.6 to 1.9 and SCB values in the range of 2.2 to 2.6 for the VAS-pain instrument in a nonshoulder hand and upper extremity postoperative population. CLINICAL RELEVANCE: These MCID and SCB estimates may be useful for powering clinical studies and when interpreting VAS-pain score changes or differences reported in the hand surgery literature. These values are to be applied at a population level, and should not be applied to assess the improvement, or lack thereof, for individual patients.
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