Introduction: Systematic reviews of randomized trials that include measurements of health-related quality of life (HRQL) potentially provide critical information for patients and clinicians facing challenging health care decisions. When, as is most often the case, individual randomized trials use different measurement instruments for the same construct (such as physical or emotional function), authors typically report differences between intervention and control in standard deviation units (so-called ‘‘standardized mean difference’’). This approach has statistical limitations (it is influenced by the heterogeneity of the population) and is non-intuitive for decision makers. Objective: To present an alternative approach: reporting results in minimal important difference (MID) units (the smallest difference patients experience as important). Methods: Using a Cochrane review of respiratory rehabilitation for COPD, we compared the existing method with our method using 16 trials that employed two widely used disease-specific HRQL instruments: the Chronic Respiratory Disease Questionnaire (CRQ), and the St. Georges Respiratory Questionnaire (SGRQ). Results: For the CRQ and SGRQ, the pooled MD for each of the domains as well as the total score exceeded the MID (see Table 1). Combining all studies yields an overall pooled estimate in SD units of 0.77 (95% CI 0.62, 0.91), I2 = 58% (Figure 1). Applying the new method the pooled estimates in MID units are, for the CRQ, 1.86 (95% CI, 1.45 to 2.27) and for the SGRQ, 1.53 (95% CI, 0.81 to 2.24). Combining all studies in MID units yields an overall pooled estimate of 1.75 (95% CI, 1.37 to 2.13), I2 = 32% (Figure 2). This suggests a large effect: the pooled estimate is almost twice as great as the smallest difference patients perceive as important. Conclusions: The MID approach provides a potential solution to both the statistical and interpretational problems of existing methods.