Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale
Calculating clinically significant change in postnatal depression studies using the Edinburgh Postnatal Depression Scale
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DOI：
10.1016/s0165-0327(02)00313-0
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发表时间：
2004-03-01
影响因子：
6.6
通讯作者：
Matthey, S
中科院分区：
文献类型：
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作者：
Matthey, S
背景：有时，即使分数之间的实际差异非常小，也可以获得考试分数之间的统计显著性。因此，研究人员建议在报告干预结果时也要计算临床意义。计算特定试验评分之间的临床显著性时，应考虑试验的可靠性以及临床和非临床样本的规范性数据。Jacobson和Truax（199 1）描述了计算可靠变化指数（RCI）作为计算该临床意义的方法。结果：爱丁堡产后抑郁量表（EPDS）的RCI为4分。这是两个分数之间的差异的大小，临床医生需要该差异的大小来95%确信该变化反映个体情绪的真实的变化，并且不太可能是由于测量误差。使用公认的EPDS截止值为12/13的严重抑郁症（英语为母语的妇女），个人的前-后EPDS评分的临床意义分类的例子。给出了报告23名女性EPDS评分的统计学显著性和临床显著性的另一个例子，突出显示了计算临床显著性时获得的改进信息。临床意义：统计学意义允许解释妇女是否“平均”改善一个条件比另一个。临床意义可以进一步解释有多少女性在每种情况下表现出改善。这种改善可以分为那些谁恢复，那些谁改善，但仍然在痛苦的范围，那些谁没有显示出可靠的变化，在他们的EPDS评分，和那些谁恶化。因此，使用可靠的变化指数和截止分类计算临床意义，增加了我们对产后抑郁症治疗研究影响的理解。(C)2004 Elsevier B. V.保留所有权利。
Background: Statistical significance between test scores can sometimes be obtained even when the actual difference between the scores is very small. Because of this researchers have recommended that clinical significance also be calculated when reporting results of interventions. The calculation of clinical significance between scores on a particular test takes into account the reliability of the test, as well as normative data from clinical and non-clinical samples. Jacobson and Truax (199 1) describe the calculation of the Reliable Change Index (RCI) as a method of calculating this clinical significance. Result: The RCI for the Edinburgh Postnatal Depression Scale (EPDS) is calculated to be four points. This is the size of difference between two scores which is needed for a clinician to be 95% confident that this change reflects a real change in the individual's mood, and is not likely to be due to measurement error. Using the accepted EPDS cut-off score of 12/13 for major depression (English-speaking women), examples are given of the clinical significance classification of individual's pre-post EPDS scores. A further example of reporting both statistical significance and clinical significance on the EPDS scores of 23 women is given, highlighting the improved information that is obtained when this clinical significance is calculated. Clinical implications: Statistical significance allows the interpretation of whether women 'on average' improve more in one condition than another. Clinical significance allows the further interpretation of how many women show improvement in each condition. This improvement can be categorised into those who recover, those who improve but are still in the distressed range, those who show no reliable change in their EPDS score, and those who deteriorate. Calculating clinical significance, using the reliable change index and cut-off classification, therefore adds to our understanding of the impact of postnatal depression treatment studies. (C) 2004 Elsevier B.V. All rights reserved.