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Definitions for estimating magnitude of effects in low back pain

Definitions for estimating magnitude of effects in low back pain
Size of effect Definition
Small/slight Pain scales: Mean 5 to 10 mm improvement on a 100 mm visual analogue scale (VAS), or equivalent
Back-specific functional status: Mean 5 to 10 mm improvement on the Oswestry Disability Index (ODI), 1 to 2 points on the Roland Morris Disability Questionnaire (RMDQ), or equivalent
All outcomes: Standardized mean difference (SMD) 0.2 to 0.5
Moderate Pain scales: Mean 10 to 20 mm improvement on a 100 mm VAS, or equivalent
Back-specific functional status: Mean 10 to 20 mm improvement on the ODI, 2 to 5 points on the RMDQ, or equivalent
All outcomes: SMD 0.5 to 0.8
Large/substantial Pain scales: Mean >20 mm improvement on a 100 mm VAS, or equivalent
Back-specific functional status: Mean >20 mm improvement on the ODI, >5 points on the RMDQ, or equivalent
All outcomes: SMD >0.8
From Annals of Internal Medicine, Chou R, Qaseem A, Snow V, et al, Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society, 147, 7, 478-91. Copyright © 2007 American College of Physicians. All Rights Reserved. Reprinted with the permission of American College of Physicians, Inc.
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