Score distributions of deteriorating, stable, and improving patients. Figure one shows the distributions of RMDQ score decrease in patients who were classified as having deteriorated, remaining stable, or having improved on the transition question. One can see that patients who deteriorated (those who reported being 'much worse' or 'vastly worse') have a score change distribution with a mean close to zero (0.4). The MIC cut-off of 4.0 points and the consensus threshold of 5.0 points well separate improved patients from stable patients, in these data. Further research and debate on the MIC cut-off for deterioration is needed.