Jeyaraman N, Jeyaraman M, Ramasubramanian S, Balaji S, Muthu S. Beyond statistical significance: Embracing minimal clinically important difference for better patient care. World J Methodol 2025; 15(1): 97814 [DOI: 10.5662/wjm.v15.i1.97814]
Corresponding Author of This Article
Madhan Jeyaraman, MS, PhD, Assistant Professor, Research Associate, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Naveen Jeyaraman, Madhan Jeyaraman, Sathish Muthu, Department of Research Methods, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
Swaminathan Ramasubramanian, Sangeetha Balaji, Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nadu, India
Sathish Muthu, Department of Biotechnology, Faculty of Engineering, Karpagam Academy of Higher Education, Coimbatore 641021, Tamil Nadu, India
Sathish Muthu, Department of Orthopaedics, Government Medical College, Karur 639004, Tamil Nadu, India
Author contributions: Jeyaraman M conceptualized the manuscript; Jeyaraman N, Ramasubramanian S, and Balaji S performed data analysis and wrote the manuscript; Muthu S performed image analysis. All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Madhan Jeyaraman, MS, PhD, Assistant Professor, Research Associate, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com
Received: June 9, 2024 Revised: September 9, 2024 Accepted: September 13, 2024 Published online: March 20, 2025 Processing time: 111 Days and 18.4 Hours
Abstract
The minimal clinically important difference (MCID) represents a pivotal metric in bridging the gap between statistical significance and clinical relevance, addressing the direct impact of medical interventions from the patient's perspective. This comprehensive review analyzes the evolution, applications, and challenges of MCID across medical specialties, emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs. We discuss the evolution of MCID since its inception in the 1980s, its current applications across various medical specialties, and the methodologies used in its calculation, highlighting both anchor-based and distribution-based approaches. Furthermore, the paper delves into the challenges associated with the application of MCID, such as methodological variability and the interpretation difficulties that arise in clinical settings. Recommendations for the future include standardizing MCID calculation methods, enhancing patient involvement in setting MCID thresholds, and extending research to incorporate diverse global perspectives. These steps are critical to refining the role of MCID in patient-centered healthcare, addressing existing gaps in methodology and interpretation, and ensuring that medical interventions lead to significant, patient-perceived improvements.
Core Tip: The minimal clinically important difference (MCID) is crucial for assessing the real-world impact of medical treatments from a patient’s viewpoint. It ensures clinical outcomes are both statistically significant and beneficial in practice. Future directions involve standardizing MCID methods, increasing patient participation in setting thresholds, and broadening research for global applicability, enhancing MCID’s role in delivering meaningful, patient-valued healthcare outcomes.
