EFFECT SIZES FOR INTERPRETING CHANGES IN HEALTH-STATUS
EFFECT SIZES FOR INTERPRETING CHANGES IN HEALTH-STATUS
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DOI：
10.1097/00005650-198903001-00015
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发表时间：
1989-03-01
期刊：
影响因子：
3
通讯作者：
MEENAN, RF
中科院分区：
文献类型：
--
作者：
KAZIS, LE;ANDERSON, JJ;MEENAN, RF
健康状况指标在临床研究中的使用频率越来越高。到目前为止，重点一直放在这些措施的可靠性和有效性上。对于这些检测临床变化的方法的敏感度，人们关注较少。随着健康状况测量在临床环境中的应用越来越频繁，我们需要一种有用的方法来估计和沟通健康状况的特定变化是否与临床相关。这份报告认为效应大小是解释健康状况变化的有用方法。效应大小定义为变量的平均变化量除以该变量的标准差。效应大小用于将“一组”情况下的“变化前和变化后”转换为标准测量单位，以便更清楚地了解健康状况结果。使用来自关节炎人群的三个健康状况数据集，从四个不同的角度展示了效果大小的效用。第一个视角展示了如何开发通用的和特定于仪器的基准，以及如何使用它们来翻译临床变化的含义。第二个视角展示了在标准的临床药物试验中，如何使用效果大小来比较传统临床指标和健康状况指标。第三个应用程序演示了在比较在不同药物试验中测试的两种药物时使用效果大小，并展示了它们如何促进这种类型的比较。最后，我们的健康状况结果显示，效应大小如何补充标准的统计测试，以提供更完整和临床相关的健康状况变化的图景。我们的结论是，效应大小是一个重要的工具，将促进在关节炎和其他慢性疾病的临床研究中使用和解释健康状况衡量标准。
Health status measures are being used with increasing frequency in clinical research. Up to now the emphasis has been on the reliability and validity of these measures. Less attention has been given to the sensitivity of these measures for detecting clinical change. As health status measures are applied more frequently in the clinical setting, we need a useful way to estimate and communicate whether particular changes in health status are clinically relevant. This report considers effect sizes as a useful way to interpret changes in health status. Effect sizes are defined as the mean change found in a variable divided by the standard deviation of that variable. Effect sizes are used to translate “the before and after changes” in a “one group” situation into a standard unit of measurement that will provide a clearer understanding of health status results. The utility of effect sizes is demonstrated from four different perspectives using three health status data sets derived from arthritis populations administered the Arthritis Impact Measurement Scales (AIMS). The first perspective shows how general and instrument-specific benchmarks can be developed and how they can be used to translate the meaning of clinical change. The second perspective shows how effect sizes can be used to compare traditional clinical measures with health status measures in a standard clinical drug trial. The third application demonstrates the use of effect sizes when comparing two drugs tested in separate drug trials and shows how they can facilitate this type of comparison. Finally, our health status results show how effect sizes can supplement standard statistical testing to give a more complete and clinically relevant picture of health status change. We conclude that effect sizes are an important tool that will facilitate the use and interpretation of health status measures in clinical research in arthritis and other chronic diseases.