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Minimal clinically important difference
In the field of medical statistics, the minimal clinically important difference (also known as MCID), is a statistical model which tries to define the smallest change in a treatment outcome that a patient would identify as important.
== Purpose ==
Over the years great steps have been taken in reporting what really matters in clinical research. As was still common in the sixties a clinical researcher might report: “in my own experience treatment X does not do well for condition Y”. Conversely, as early as 1950 significance testing through the use of a P value cut off point of 0.05 was introduced by R.A. Fisher; this resulted in studies being either significant or non-significant. Although this P value objectified research outcome, retaining to such a rigid cut off point can have two potentially serious consequences: (i) possibly clinically important differences observed in studies can be denoted as statistically non-significant and therefore be unfairly ignored as a result of having a small number of subjects studied (type II errors); (ii) even the smallest difference in measurements can be proved statistically significant by increasing the number of subjects in a study. Such a small difference could be irrelevant (i.e. of no clinical importance) to patients or clinicians. Thus, statistical significance does not necessarily imply clinical importance.
Over the years clinicians and researchers have moved away from physical and radiological endpoints towards patient reported outcome. However, using patient reported outcome measurements does not solve the problem of small differences being statistical significance but possibly clinically irrelevant.
In order to study clinical importance, the concept of minimal clinically important difference (MCID) has been proposed by Jaesche et al. in 1989. MCID is the smallest change in an outcome that a patient would identify as important. MCID therefore offers a threshold above which outcome is experienced as relevant by the patient; this avoids the problem of mere statistical significance.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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