Phillips Rachel, Qi Gao, Collinson Simon Lowes, Ling Audrey, Feng Lei, Cheung Yin Bun, Ng Tze-Pin
a Biostatistics Department , Singapore Clinical Research Institute , Singapore , Singapore.
b Gerontological Research Programme, Faculty of Medicine , National University of Singapore , Singapore , Singapore.
Clin Neuropsychol. 2015;29(7):905-23. doi: 10.1080/13854046.2015.1107137. Epub 2015 Nov 7.
There is no established minimum clinically important difference (MCID) for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) index and total scale scores. This study aimed to estimate the MCID for the RBANS index scores and total scale score.
Participants included 1,856 ethnic Chinese, older adults. Distribution- and anchor-based methods were used to estimate values for the MCID. Distribution-based estimates were calculated as the standard error of measurement (SEM) and .5 standard deviations (SD). For anchor-based estimates, we compared RBANS scores between the clinical dementia rating (CDR) scale no dementia and very mild dementia groups and between the clinical assessment of dementia (CAD) cognitively normal and mild cognitive impairment groups using regression models adjusting for demographic characteristics.
Estimates from the CDR anchor were 7.79, 8.63, 10.74, 9.74, 5.61, and 3.77 for the total scale score, language, immediate memory, delayed memory, visuospatial/constructional, and the attention index, respectively. Estimates from the distribution-based methods were similar to the estimates based on the CDR, except for the language and attention indexes. Estimates from the CAD anchor were larger.
We estimated the MCID for the total scale score, language, immediate memory, delayed memory, visuospatial/constructional, and attention indexes of the RBANS as 8, 9, 10, 10, 6, and 4 points, respectively. These estimates are best suited to discriminate between patient groups, for example, in a clinical trial setting. Further research is needed using longitudinal data to assess their applicability to assess within patient differences.
用于评估神经心理状态的可重复性成套测验（RBANS）指数和总量表分数尚无既定的最小临床重要差异（MCID）。本研究旨在估计RBANS指数分数和总量表分数的MCID。
参与者包括1856名华裔老年人。采用基于分布和锚定的方法来估计MCID值。基于分布的估计值计算为测量标准误（SEM）和0.5个标准差（SD）。对于基于锚定的估计，我们使用调整了人口统计学特征的回归模型，比较了临床痴呆评定量表（CDR）无痴呆组和极轻度痴呆组之间以及痴呆临床评估（CAD）认知正常组和轻度认知障碍组之间的RBANS分数。
CDR锚定法对总量表分数、语言、即时记忆、延迟记忆、视觉空间/结构和注意力指数的估计值分别为7.79、8.63、10.74、9.74、5.61和3.77。基于分布的方法的估计值与基于CDR的估计值相似，但语言和注意力指数除外。CAD锚定法的估计值更大。
我们估计RBANS总量表分数、语言、即时记忆、延迟记忆、视觉空间/结构和注意力指数的MCID分别为8分、9分、10分、10分、6分和4分。这些估计值最适合用于区分患者组，例如在临床试验环境中。需要进一步使用纵向数据进行研究，以评估它们在评估患者内部差异方面的适用性。
