Between-group minimally important change versus individual treatment responders

Qual Life Res. 2021 Oct;30(10):2765-2772. doi: 10.1007/s11136-021-02897-z. Epub 2021 Jun 15.

Abstract

Purpose: Estimates of the minimally important change (MIC) can be used to evaluate whether group-level differences are large enough to be important. But responders to treatment have been based upon group-level MIC thresholds, resulting in inaccurate classification of change over time. This article reviews options and provides suggestions about individual-level statistics to assess whether individuals have improved, stayed the same, or declined.

Methods: Review of MIC estimation and an example of misapplication of MIC group-level estimates to assess individual change. Secondary data analysis to show how perceptions about meaningful change can be used along with significance of individual change.

Results: MIC thresholds yield over-optimistic conclusions about responders to treatment because they classify those who have not changed as responders.

Conclusions: Future studies need to evaluate the significance of individual change using appropriate individual-level statistics such as the reliable change index or the equivalent coefficient of repeatability. Supplementing individual statistical significance with retrospective assessments of change is desirable.

Keywords: Meaningful change; Minimally important difference; Reliable change index; Responder.

Publication types

  • Review

MeSH terms

  • Humans
  • Quality of Life* / psychology
  • Retrospective Studies