Minimal clinically important difference on the Beck Depression Inventory - II according to the patient's perspective

最小临床重要差异 贝克抑郁量表 萧条(经济学) 医学 物理疗法 随机对照试验 接收机工作特性 评定量表 基线(sea) 焦虑 精神科 统计 外科 内科学 数学 海洋学 经济 宏观经济学 地质学
作者
Katherine S. Button,Daphne Kounali,Laura Thomas,Nicola Wiles,T. J. Peters,Nicky J. Welton,A. E. Ades,Glyn Lewis
出处
期刊:Psychological Medicine [Cambridge University Press]
卷期号:45 (15): 3269-3279 被引量:252
标识
DOI:10.1017/s0033291715001270
摘要

Background The Beck Depression Inventory, 2nd edition (BDI-II) is widely used in research on depression. However, the minimal clinically important difference (MCID) is unknown. MCID can be estimated in several ways. Here we take a patient-centred approach, anchoring the change on the BDI-II to the patient's global report of improvement. Method We used data collected ( n = 1039) from three randomized controlled trials for the management of depression. Improvement on a ‘global rating of change’ question was compared with changes in BDI-II scores using general linear modelling to explore baseline dependency, assessing whether MCID is best measured in absolute terms (i.e. difference) or as percent reduction in scores from baseline (i.e. ratio), and receiver operator characteristics (ROC) to estimate MCID according to the optimal threshold above which individuals report feeling ‘better’. Results Improvement in BDI-II scores associated with reporting feeling ‘better’ depended on initial depression severity, and statistical modelling indicated that MCID is best measured on a ratio scale as a percentage reduction of score. We estimated a MCID of a 17.5% reduction in scores from baseline from ROC analyses. The corresponding estimate for individuals with longer duration depression who had not responded to antidepressants was higher at 32%. Conclusions MCID on the BDI-II is dependent on baseline severity, is best measured on a ratio scale, and the MCID for treatment-resistant depression is larger than that for more typical depression. This has important implications for clinical trials and practice.
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