Estimating minimal, moderate, and marked clinically important differences for patient reported outcome measure in randomised controlled trial

In this methodological study, we proposed a pragmatic and scalable operational framework to derive thresholds for minimal, moderate, and marked CIDs. By explicitly distinguishing CIDswithin-group and CIDsbetween-group, the approach clarifies two frequently conflated terms that serve distinct purposes in interpretation and decision-making. This framework offers benchmarks to strengthen inference on treatment response, trial design, and guideline decision thresholds.