Editorial  |   June 2020
Minimal Clinically Important Difference, Maximum Impact
Author Notes
  • From the Division of Anesthesiology, Intensive Care, and Emergency Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
  • This editorial accompanies the article on p. 1362.
    This editorial accompanies the article on p. 1362.×
  • Accepted for publication March 2, 2020.
    Accepted for publication March 2, 2020.×
  • Address correspondence to Dr. Kalkman: c.j.kalkman@umcutrecht.nl
Article Information
Editorial
Editorial   |   June 2020
Minimal Clinically Important Difference, Maximum Impact
Anesthesiology 6 2020, Vol.132, 1296-1298. doi:https://doi.org/10.1097/ALN.0000000000003285
Anesthesiology 6 2020, Vol.132, 1296-1298. doi:https://doi.org/10.1097/ALN.0000000000003285
Patients consent to undergoing surgery in the hope that the procedure will decrease pain and disability and/or improve prognosis and quality of life. Optimizing the entire perioperative trajectory should contribute to high-quality patient outcomes and is the aim of perioperative medicine.
In this issue of Anesthesiology, Shulman et al.1  have undertaken the huge task of trying to identify what constitutes a meaningful change in disability—from the patient’s perspective—after surgery. The same authors previously demonstrated that a brief 12-item disability questionnaire, the World Health Organization’s Disability Assessment Schedule (WHODAS 2.0), can accurately capture changes in disability after surgery and thus can be used as a valid primary endpoint for perioperative clinical trials.2  WHODAS 2.0 has been internationally validated, can be completed by the patient in 5 min, and is widely used in all areas of medicine. The level of disability is measured on six dimensions: cognition, mobility, self-care, interpersonal relationships, work and household roles, and participation in society. It can be used on paper, online, and in a telephone interview; should the patient be incapacitated, a proxy (caregiver) can complete the questionnaire.