Physician - Canada

The idea of a MID or MCID is a very altruistic and valuable topic when investigating and evaluating treatments with the intent to improve patients lives with treatment while minimizing risk. However, I firmly believe the MID varies depending on where the patient starts at baseline. A MID may accurate and valid for higher functioning individuals. However, at lower levels of function, it may not be valid; it may mean the difference between life and death. Good mental health and mobility versus depression and suffering. In those patients, any improvement may start a flow that is much different response from other cohorts; Not sure this has been studied but, if not, I would recommend it. Just a theory I have but think a subgroup analysis (although prime to type 1 and 2 error) are worth performing when validating the MID. - CeeegF.