Group vs individual approaches to understanding the clinical significance of differences or changes in quality of life

被引:125
作者
Cella, D [1 ]
Bullinger, M
Scott, C
Barofsky, I
机构
[1] Northwestern Univ, Ctr Outcomes Res & Educ, Evanston NW Healthcare, Evanston, IL 60208 USA
[2] Univ Hamburg, Dept Med Psychol, Hamburg, Germany
[3] Amer Coll Radiol, Philadelphia, PA USA
[4] Johns Hopkins Univ, Sch Med, Baltimore, MD USA
关键词
D O I
10.4065/77.4.384
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This article focuses on the traversing of group and individual levels of quality-of-life data. A deductive approach is used to address the extent to which group data can be used to estimate clinical significance at the individual level. An inductive approach is used to evaluate the extent to which individual change data can be brought to the group level to define clinical significance. Both approaches have benefits and drawbacks. This article addresses how clinical significance can be defined for an individual when the threshold for meaningfulness is drawn from group data. It also addresses the condition under which one can use the same threshold difference for group vs individual differences or changes. A sample inductive approach explores the means to identify a clinically significant result or change, with use of insights from cognitive psychology. In most deductive approaches, the identification of a clinically significant difference or change requires identification of a criterion (or at least an interpretable anchor) against which the significance of a change in respondent score is compared.
引用
收藏
页码:384 / 392
页数:9
相关论文
共 41 条
  • [1] BIOBEHAVIORAL VARIABLES AND MORTALITY OR CARDIAC-ARREST IN THE CARDIAC-ARRHYTHMIA PILOT-STUDY (CAPS)
    AHERN, DK
    GORKIN, L
    ANDERSON, JL
    TIERNEY, C
    HALLSTROM, A
    EWART, C
    CAPONE, RJ
    SCHRON, E
    KORNFELD, D
    HERD, JA
    RICHARDSON, DW
    FOLLICK, MJ
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1990, 66 (01) : 59 - 62
  • [2] Barofsky J, 2000, MED CARE, V38, P125
  • [3] AN INVENTORY FOR MEASURING DEPRESSION
    BECK, AT
    ERBAUGH, J
    WARD, CH
    MOCK, J
    MENDELSOHN, M
    [J]. ARCHIVES OF GENERAL PSYCHIATRY, 1961, 4 (06) : 561 - &
  • [4] PREDICTION OF MORTALITY AND MORBIDITY WITH A 6-MINUTE WALK TEST IN PATIENTS WITH LEFT-VENTRICULAR DYSFUNCTION
    BITTNER, V
    WEINER, DH
    YUSUF, S
    ROGERS, WJ
    MCINTYRE, KM
    BANGDIWALA, SI
    KRONENBERG, MW
    KOSTIS, JB
    KOHN, RM
    GUILLOTTE, M
    GREENBERG, B
    WOODS, PA
    BOURASSA, MG
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (14): : 1702 - 1707
  • [5] SIMILARITY EQUIVALENCE TRIALS FOR COMBINATION VACCINES
    BLACKWELDER, WC
    [J]. COMBINED VACCINES AND SIMULTANEOUS ADMINISTRATION: CURRENT ISSUES AND PERSPECTIVES, 1995, 754 : 321 - 328
  • [6] PROVING THE NULL HYPOTHESIS IN CLINICAL-TRIALS
    BLACKWELDER, WC
    [J]. CONTROLLED CLINICAL TRIALS, 1982, 3 (04): : 345 - 353
  • [7] MAJOR DEPRESSIVE DISORDER IN CORONARY-ARTERY DISEASE
    CARNEY, RM
    RICH, MW
    TEVELDE, A
    SAINI, J
    CLARK, K
    JAFFE, AS
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1987, 60 (16) : 1273 - 1275
  • [8] Cancer-related fatigue: Prevalence of proposed diagnostic criteria in a United States sample of cancer survivors
    Cella, D
    Davis, K
    Breitbart, W
    Curt, G
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2001, 19 (14) : 3385 - 3391
  • [9] Cella D, 2000, MED CARE, V38, P66
  • [10] CELLA D, IN PRESS QUAL LIFE R