82 Eliciting the Minimal Clinically Important Difference in the Pain Response from Parents of Newborn Infants and Nurses
Bibliographic record
Abstract
The minimal clinically important difference (MCID) is the smallest difference in an attribute of health that signifies an important effect on a patients well being. For studies of infant pain, a 20% reduction in pain is regarded by clinicians and researchers as the MCID when comparing two treatments. This value has not been empirically determined and does not consider consumers values. To determine parental and nurses views of the MCID when comparing heel lance and venipuncture techniques of blood collection in newborn infants. Prospective interview study of parents of newly born infants and nurses from the NICU and postnatal floor. Using a structured interview, parents and nurses were told that both techniques are associated with the same success rate for sample retrieval, adverse effects and quantity of pain but that the heel lance technique is the standard method used. Parents and nurses were asked to indicate their preferred technique. The strength of their preference was determined by identifying the probability of reduced pain they would require before considering the alternative technique. Then parents and nurses were informed that venipuncture is less painful than heel lance and their preference was again solicited. Finally, they were asked about their willingness to pay to have the less painful procedure for newborn infants. 94 parents and 98 nurses were interviewed. Heel lance was initially preferred by 86% of parents. Venipuncture was preferred by 79% of parents after a median MCID in pain of 13% (interquartile range, 6%–38%). 90% parents preferred venipuncture when told it was less painful and were willing to pay $25 ($10–$81) to decrease infant pain. Heel lance was initially preferred by 79% of nurses. Venipuncture was preferred by 68% of nurses after a median MCID in pain of 19% (interquartile range, 13%–38%). 85% preferred venipuncture when told it was less painful and were willing to pay $10 ($0–$50) to decrease infant pain. Parents and nurses prefer venipuncture to heel lance for blood collection in newborn infants if it is associated with a median decrease of 13% and 19% in infant pain scores respectively. Parents are willing to accept smaller MCID values compared to clinicians and researchers and are willing to pay more to alleviate their infant pain.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".