Reliable change and clinical significance

Author(s):  
Darragh O'Neill
2007 ◽  
Vol 10 (6) ◽  
pp. A456
Author(s):  
T Ortega ◽  
C Valdés ◽  
B Diaz Molina ◽  
M Iscar ◽  
F Ortega

2015 ◽  
Vol 58 (3) ◽  
pp. 728-739 ◽  
Author(s):  
Rachael Unicomb ◽  
Kim Colyvas ◽  
Elisabeth Harrison ◽  
Sally Hewat

Purpose Case-study methodology studying change is often used in the field of speech-language pathology, but it can be criticized for not being statistically robust. Yet with the heterogeneous nature of many communication disorders, case studies allow clinicians and researchers to closely observe and report on change. Such information is valuable and can further inform large-scale experimental designs. In this research note, a statistical analysis for case-study data is outlined that employs a modification to the Reliable Change Index (Jacobson & Truax, 1991). The relationship between reliable change and clinical significance is discussed. Example data are used to guide the reader through the use and application of this analysis. Method A method of analysis is detailed that is suitable for assessing change in measures with binary categorical outcomes. The analysis is illustrated using data from one individual, measured before and after treatment for stuttering. Conclusions The application of this approach to assess change in categorical, binary data has potential application in speech-language pathology. It enables clinicians and researchers to analyze results from case studies for their statistical and clinical significance. This new method addresses a gap in the research design literature, that is, the lack of analysis methods for noncontinuous data (such as counts, rates, proportions of events) that may be used in case-study designs.


2000 ◽  
Vol 86 (1) ◽  
pp. 263-274 ◽  
Author(s):  
Norbert Schmitz ◽  
Norbert Hartkamp ◽  
Gabriele H. Franke

A Symptom Checklist (SCL-90–R) is a potentially useful measure of psychological distress; it is frequently used in psychotherapy research and clinical practice. The purpose of this study was to illustrate the use of the SCL-90–R for determining statistically reliable change and clinical significance outlined by Jacobson and Truax in 1991. This paper describes the concepts of statistical and clinical significance of change. A proposal for obtaining and characterizing samples is made. Then a clinician's perspective is taken. Reliable change estimates and cut-off scores are chosen based on outcome data. Selected data from a single psychotherapeutic process and outcome study then were used to test the estimates of change and cut-off scores.


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