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Affiliation
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Professor and Chair, Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Chief Medical Officer, Rehabilitation Hospital of Indiana, Goodman Hall 4700, 355 W. 16th St., Indianapolis, IN 46202. Electronic address: Flora.hammond@rhin.com. |
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Abstract
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OBJECTIVE: To determine the Minimal Clinically Important Difference (MCID) for a Rasch measure derived from the Irritability/Lability and Agitation/Aggression subscales of the Neuropsychiatric Inventory (NPI-TBI-IA).
DESIGN: Distribution-based statistical methods were applied to retrospective data to determine candidates for the MCID. These candidates were evaluated by anchoring the NPI-TBI-IA to Global Impression of Change (GIC) ratings by participants, significant others, and a supervising physician. MAIN OUTCOME MEASURE: NPI-TBI-IA. SETTING: Postacute rehabilitation outpatient clinic. PARTICIPANTS: 274 cases with observer ratings; 232 cases with self-ratings by participants with moderate-severe TBI at least 6 months post-injury.
RESULTS: For observer ratings on the NPI-TBI-IA, anchored comparisons found an improvement of ½ SD was associated with at least minimal general improvement on GIC by a significant majority (69-80%); ½ SD improvement on participant NPI-TBI-IA self-ratings was also associated with at least minimal improvement on the GIC by a substantial majority (77-83%). The percent indicating significant global improvement did not increase markedly on most ratings at higher levels of improvement on the NPI-TBI-IA.
CONCLUSIONS: A ½ SD improvement on the NPI-TBI-IA indicates the MCID for both observer and participant ratings on this measure.
Copyright © 2017. Published by Elsevier Inc.
Language: en |