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Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions
OBJECTIVES: Considering the heterogeneity of cancer entities and the associated disease progression, personalized care of patients is increasingly emphasized in psycho‐oncology. This individualization makes the use of measurements of individual clinically significant change important when studying t...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301279/ https://www.ncbi.nlm.nih.gov/pubmed/32090408 http://dx.doi.org/10.1002/mpr.1821 |
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author | Vaganian, Lusine Bussmann, Sonja Gerlach, Alexander L. Kusch, Michael Labouvie, Hildegard Cwik, Jan C. |
author_facet | Vaganian, Lusine Bussmann, Sonja Gerlach, Alexander L. Kusch, Michael Labouvie, Hildegard Cwik, Jan C. |
author_sort | Vaganian, Lusine |
collection | PubMed |
description | OBJECTIVES: Considering the heterogeneity of cancer entities and the associated disease progression, personalized care of patients is increasingly emphasized in psycho‐oncology. This individualization makes the use of measurements of individual clinically significant change important when studying the efficacy and effectiveness of psycho‐oncological care. Two conceptualizations for the measurement of clinical significance are critically contrasted in this study: the Reliable Change Index (RCI) and the Minimal Important Difference (MID) method. METHODS: In total, 2,121 cancer patients participated in the study and a subsample of 708 patients was reassessed about 4 months later. Psychological distress was measured using the Hospital Anxiety and Depression Scale. We evaluated two measures of clinical significance (RCI, MID) by comparing the respective numbers of improved, unimproved, and deteriorated patients. RESULTS: Individually significant changes were observed with both methods; however, determined rates of improvement differed substantially: MID (66.67%) and RCI (48.23%). Most importantly, according to MID, 17.93% of patients were identified as being improved, although their respective improvements were not statistically significant and thus unreliable. CONCLUSIONS: The benefits of RCI outweigh MID, and therefore, the RCI is recommended as a measure to assess change. |
format | Online Article Text |
id | pubmed-7301279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-73012792020-06-19 Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions Vaganian, Lusine Bussmann, Sonja Gerlach, Alexander L. Kusch, Michael Labouvie, Hildegard Cwik, Jan C. Int J Methods Psychiatr Res Original Articles OBJECTIVES: Considering the heterogeneity of cancer entities and the associated disease progression, personalized care of patients is increasingly emphasized in psycho‐oncology. This individualization makes the use of measurements of individual clinically significant change important when studying the efficacy and effectiveness of psycho‐oncological care. Two conceptualizations for the measurement of clinical significance are critically contrasted in this study: the Reliable Change Index (RCI) and the Minimal Important Difference (MID) method. METHODS: In total, 2,121 cancer patients participated in the study and a subsample of 708 patients was reassessed about 4 months later. Psychological distress was measured using the Hospital Anxiety and Depression Scale. We evaluated two measures of clinical significance (RCI, MID) by comparing the respective numbers of improved, unimproved, and deteriorated patients. RESULTS: Individually significant changes were observed with both methods; however, determined rates of improvement differed substantially: MID (66.67%) and RCI (48.23%). Most importantly, according to MID, 17.93% of patients were identified as being improved, although their respective improvements were not statistically significant and thus unreliable. CONCLUSIONS: The benefits of RCI outweigh MID, and therefore, the RCI is recommended as a measure to assess change. John Wiley and Sons Inc. 2020-02-23 /pmc/articles/PMC7301279/ /pubmed/32090408 http://dx.doi.org/10.1002/mpr.1821 Text en © 2020 The Authors. International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Vaganian, Lusine Bussmann, Sonja Gerlach, Alexander L. Kusch, Michael Labouvie, Hildegard Cwik, Jan C. Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
title | Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
title_full | Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
title_fullStr | Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
title_full_unstemmed | Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
title_short | Critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
title_sort | critical consideration of assessment methods for clinically significant changes of mental distress after psycho‐oncological interventions |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301279/ https://www.ncbi.nlm.nih.gov/pubmed/32090408 http://dx.doi.org/10.1002/mpr.1821 |
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