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JAMA Guide to Statistics and Methods
October 1, 2014

Minimal Clinically Important Difference: Defining What Really Matters to Patients

Author Affiliations
  • 1Berry Consultants, Austin, Texas
  • 2Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California
  • 3Los Angeles Biomedical Research Institute, Torrance, California
  • 4David Geffen School of Medicine at UCLA, Los Angeles, California
JAMA. 2014;312(13):1342-1343. doi:10.1001/jama.2014.13128

When assessing the clinical utility of therapies intended to improve subjective outcomes, the amount of improvement that is important to patients must be determined.1 The smallest benefit of value to patients is called the minimal clinically important difference (MCID). The MCID is a patient-centered concept, capturing both the magnitude of the improvement and also the value patients place on the change. Using patient-centered MCIDs is important for studies involving patient-reported outcomes,2 for which the clinical importance of a given change may not be obvious to clinicians selecting treatments. The MCID defines the smallest amount an outcome must change to be meaningful to patients.1

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