کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5121831 1486844 2017 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The minimal clinically important difference raised the significance of outcome effects above the statistical level, with methodological implications for future studies
ترجمه فارسی عنوان
تفاوت حداقل بین بالینی مهم، اهمیت اثرات نتیجه بالاتر از سطح آماری، و معیارهای روش شناختی برای مطالعات آینده را افزایش داد
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی

ObjectiveTo illustrate and discuss current and proposed new concepts of effect size (ES) quantification and significance, with a focus on statistical and clinical/subjective interpretation and supported by empirical examples.Study Design and SettingsDifferent methods for determining minimal clinically important differences (MCIDs) are reviewed, applied to practical examples (pain score differences in knee osteoarthritis), and further developed. Their characteristics, advantages, and disadvantages are illustrated and discussed.ResultsEmpirical score differences between verum and placebo become statistically significant if sample sizes are sufficiently large. MCIDs, by contrast, are defined by patients' perceptions. MCIDs obtained by the most common “mean change method” can be expressed as absolute or relative scores, as different ES parameters, and as the optimal cutoff point on the receiver operating characteristic curve. They can further be modeled by linear and logistic regression, adjusting for potential confounders.ConclusionAbsolute and relative MCIDs are easy to interpret and apply to data of investigative studies. MCIDs expressed as effect sizes reduce bias, which mainly results from dependency on the baseline score. Multivariate linear and logistic regression modeling further reduces bias. Anchor-based methods use clinical/subjective perception to define MCIDs and should be clearly differentiated from distribution-based methods that provide statistical significance only.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Clinical Epidemiology - Volume 82, February 2017, Pages 128-136
نویسندگان
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