Assessing the Clinical Importance of Symptomatic Improvements

摘要: Objective: To estimate when a difference in disability symptoms is sufficiently large to be important individual patients. Design: Cross-sectional analysis of two groups: derivation set (n=46) and validation (n=57). Setting: The Arthritis Foundation, Northern California Chapters. Participants: Volunteer sample patients with arthritis who live the community. Main Outcome Measures: We applied Stanford Health Assessment Questionnaire assess functional status individuals. Participants then conductd one-on-one conversations each other rated whether their was "much better," "somewhat "about same," worse," or worse" relative person they met. For every conversation we calculated between participants' health assessment questionnaire scores linked subjective comparison ratings pair. Results: score differences were significantly correlated (correlation coefficient, 41; 95% confidence interval, 0.31 0.50). estimated that needed differ by about 0.19 units for average respondents stop rating themselves as same" start better" (95% 0.10 0.28). Analysis second group revealed similar threshold (mean, 0.23 units; 0.13 0.23). In both groups, imperfect predictors less disabled participants tended lower than more participants. Conclusions: Some statistically significant may so small represent trivial degrees symptom relief. An awareness smallest can provide rough guide help clinicians interpret medical literature. (Arch Intern Med. 1993;153:1337-1342)