Two large emergency analgesia trials this period reported statistically significant differences, and in both the authors immediately pointed out that the difference was below 1.3 points on the numerical rating scale. That number is worth carrying.
Roughly 1.3 points is the smallest change in an 11-point pain score that patients reliably report as meaningful. Below it, a difference can be real, reproducible and completely imperceptible to the person in the bed. Emergency analgesia trials are often large enough to detect differences far smaller than that, which is why a significant p-value in this literature says almost nothing on its own.
So when reading, go straight to the size of the pain difference before the p-value, and look for the outcomes that cannot be shaved this way: how many patients needed rescue analgesia, how many were discharged, how many were satisfied. Those are events rather than scale points, and they are what should change your practice.
- About 1.3 points on an 11-point scale is the smallest difference patients notice
- Large trials detect differences far below that and report them as significant
- Check the size of the pain difference before the p-value
- Prefer event outcomes: rescue analgesia, discharge, satisfaction
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