Eisen Susan V, Ranganathan Gayatri, Seal Pradipta, Spiro Avron
Center for Health Quality, Outcomes and Economic Research (CHQOER), Edith Nourse Rogers Memorial Veterans Hospital, 200 Springs Road (152), Bedford, MA 01730, USA.
J Behav Health Serv Res. 2007 Jul;34(3):272-89. doi: 10.1007/s11414-007-9066-2. Epub 2007 May 30.
Assessment of clinically meaningful change is useful for treatment planning, monitoring progress, and evaluating treatment response. Outcome studies often assess statistically significant change, which may not be clinically meaningful. Study objectives are to: (1) evaluate responsiveness of the BASIS-24 using three methods for determining clinically meaningful change: reliable change index (RCI), effect size (ES), and standard error of measurement (SEM); and (2) determine which method provides an estimate of clinically meaningful change most concordant with other change measures. BASIS-24 assessments were obtained at two time points for 1,397 inpatients and 850 outpatients. The proportion showing clinically meaningful change using each method was compared to the proportion showing change in global mental health, retrospectively reported change, and clinician-assessed change. BASIS-24 demonstrated responsiveness at both aggregate and individual levels. Regarding clinically meaningful improvement and decline, SEM was most concordant with all three outcome measures; regarding no change, RCI was most concordant with all three measures.
评估具有临床意义的变化对于治疗计划、监测进展和评估治疗反应很有用。结果研究通常评估具有统计学意义的变化，而这可能没有临床意义。研究目的是：(1) 使用三种确定具有临床意义变化的方法评估 BASIS-24 的反应性：可靠变化指数 (RCI)、效应大小 (ES) 和测量标准误差 (SEM)；(2) 确定哪种方法提供的具有临床意义变化的估计与其他变化测量最一致。在两个时间点获取了 1397 名住院患者和 850 名门诊患者的 BASIS-24 评估结果。将使用每种方法显示具有临床意义变化的比例与显示全球心理健康变化、回顾性报告变化和临床医生评估变化的比例进行比较。BASIS-24 在总体和个体水平上均显示出反应性。关于具有临床意义的改善和下降，SEM 与所有三种结果测量最一致；关于无变化，RCI 与所有三种测量最一致。
