MEASUREMENT OF HEALTH-STATUS - ASCERTAINING THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE
MEASUREMENT OF HEALTH-STATUS - ASCERTAINING THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE
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DOI：
10.1016/0197-2456(89)90005-6
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发表时间：
1989-12-01
期刊：
影响因子：
--
通讯作者：
GUYATT, GH
中科院分区：
文献类型：
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作者：
JAESCHKE, R;SINGER, J;GUYATT, GH
近年来，在许多随机试验中，生命质量仪器已被作为主要结果。研究者在使用这些方法时面临的挑战之一是确定观察到的任何差异的重要性，并将这种重要性告知将应用试验结果的临床医生。我们开发了一种方法，通过将生活质量评分与全球变化评级进行比较，来阐明生活质量评分变化的重要性。使用这种方法，我们已经建立了一个合理的范围，其中最小临床重要差异（MCID）下降。在三项研究中，使用仪器测量慢性心肺疾病患者的呼吸困难、疲劳和情绪功能，当反应以7分李克特量表呈现时，MCID的平均变化值约为每项0.5。此外，我们已经建立了问卷得分变化的范围，对应于兴趣领域的中等和较大变化。这一信息将有助于解释参与对照试验的个体和患者群体的问卷得分，并有助于新试验的计划。
In recent years quality of life instruments have been featured as primary outcomes in many randomized trials. One of the challenges facing the investigator using such measures is determining the significance of any differences observed, and communicating that significance to clinicians who will be applying the trial results. We have developed an approach to elucidating the significance of changes in score in quality of life instruments by comparing them to global ratings of change. Using this approach we have established a plausible range within which the minimal clinically important difference (MCID) falls. In three studies in which instruments measuring dyspnea, fatigue, and emotional function in patients with chronic heart and lung disease were applied the MCID was represented by mean change in score of approximately 0.5 per item, when responses were presented on a seven point Likert scale. Furthermore, we have established ranges for changes in questionnaire scores that correspond to moderate and large changes in the domains of interest. This information will be useful in interpreting questionnaire scores, both in individuals and in groups of patients participating in controlled trials, and in the planning of new trials.