What is the threshold for a clinically relvent effect? The case of major depressive disorders

Publikation: Beiträge in ZeitschriftenÜbersichtsarbeitenForschung

Authors

  • Pim Cuijpers
  • Erick H. Turner
  • Sander L. Koole
  • Annemiek van Dijke
  • Filip Smit
Background
Randomized trials can show whether a treatment effect is statistically significant and can describe the size of the effect. There are, however, no validated methods available for establishing the clinical relevance of these outcomes. Recently, it was proposed that a standardized mean difference (SMD) of 0.50 be used as cutoff for clinical relevance in the treatment of depression.
Methods
We explore what the effect size means and why the size of an effect has little bearing on its clinical relevance. We will also examine how the “minimally important difference,” as seen from the patient perspective, may be helpful in deciding where the cutoff for clinical relevance should be placed for a given condition.
Results
Effect sizes in itself cannot give an indication of the clinical relevance of an intervention because the outcome itself determines the clinical relevance and not only the size of the effects. The “minimal important difference” (MID) could be used as a starting point for pinpointing the cutoff for clinical relevance. A first, rough attempt to implement this approach for depression resulted in a tentative clinical relevance cutoff of SMD = 0.24. Using this cutoff, psychotherapy, pharmacotherapy, and combined treatment have effect sizes above this cutoff.
Discussion
Statistical outcomes cannot be equated with clinical relevance. The “MID” may be used for pinpointing the cutoff for clinical relevance, but more work in this area is needed.
OriginalspracheEnglisch
ZeitschriftDepression and Anxiety
Jahrgang31
Ausgabenummer5
Seiten (von - bis)374-378
Anzahl der Seiten5
ISSN1091-4269
DOIs
PublikationsstatusErschienen - 05.2014

DOI

Zuletzt angesehen

Publikationen

  1. Protecting older workers' employability
  2. Comparison of different in vitro tests for biocompatibility screening of Mg alloys
  3. Intentionalisten vs. Strukturalisten
  4. Do limiting factors at Alaskan treelines shift with climatic regimes?
  5. Assessing teachers' educational knowledge
  6. Application of Machine Learning on Transport Spot Rate Prediction In the Recycling Industry
  7. Standards und Kompetenzentwicklung in Fremd- und Zweitsprachen
  8. Knowledge Production in Consulting Teams
  9. Where is cinema (today)?
  10. Efficacy of an Internet-based problem-solving training for teachers
  11. Boundaryless working hours and recovery in Germany
  12. Anton Schnack: Werke in zwei Bänden
  13. Rechtschreiben
  14. Schreiben in der Sekundarstufe II
  15. Testing Lazear's jack-of-all-trades view of entrepreneurship with German micro data
  16. „Why Do Intellectuals Oppose Capitalism?“
  17. Modell „Juniorprofessur“
  18. Rechtskonformität
  19. Is Ego Depletion Real?
  20. The online inverted classroom model (oICM). A blueprint to adapt the inverted classroom to an online learning setting in medical and health education
  21. What if this was a piece of art
  22. Diagnosebegleiter - Einzeltestkartei
  23. Sudoko mathematics for and done by younger students
  24. "When in Rome, do as the Romans do?"
  25. Teaching TetR to recognize a new inducer
  26. Strategy execution in higher education
  27. The negative interplay between national custodial sanctions and leniency
  28. Transition management as an approach to deal with climate change
  29. Evaluation and sustaining factors of machidukuri groups organized in relation with the 'hope plan'
  30. The Good have a Website