Kitty S Chan1, Lisa Aronson Friedman2, O Joseph Bienvenu3, Victor D Dinglas2, Brian H Cuthbertson4, Richard Porter5, Christina Jones6, Ramona O Hopkins7, Dale M Needham8. 1. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: kchan10@jhu.edu. 2. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins University Bloomberg, School of Public Health, Baltimore, MD. 4. Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Anesthesia, University of Toronto, Toronto, ON, Canada. 5. Glenfield Hospital, Leicester, UK. 6. University of Liverpool, Liverpool, UK. 7. Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, UT, USA; Center for Humanizing Critical Care, Intermountain Health Care, Murray, UT, USA; Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT, USA. 8. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
OBJECTIVE: This study will estimate distribution-based minimal important difference (MID) for the Hospital Anxiety and Depression Scale anxiety (HADS-A) and depression (HADS-D) subscales, and the Impact of Event Scale-Revised (IES-R) in survivors of acute respiratory failure (ARF). METHODS: Secondary analyses of data from two US and three UK studies of ARF survivors (total N=1223). HADS-D and HADS-A were used to assess depression and anxiety symptoms. IES-R assessed post-traumatic stress disorder symptoms. Standard error of measurement, minimal detectable change90, 0.5 standard deviation (S.D.), and 0.2 S.D. were used to estimate MID for the combined sample, by studies, 6- and 12-month follow-ups, country and mental health condition. RESULTS: Overall, MID estimates converged to 2.0-2.5 for the HADS-A, 1.9-2.3 for the HADS-D and 0.17-0.18 for the IES-R. MID estimates were comparable across studies, follow-up, country and mental health condition. CONCLUSION: Among ARF survivors, 2.0-2.5 is a reasonable range for the MID for both HADS subscales, and 0.2 is reasonable for IES-R. Until anchor-based MIDs for these instruments are available, these distribution-based estimates can help researchers plan future studies and interpret the clinical importance of findings in ARF patient populations.
OBJECTIVE: This study will estimate distribution-based minimal important difference (MID) for the Hospital Anxiety and Depression Scale anxiety (HADS-A) and depression (HADS-D) subscales, and the Impact of Event Scale-Revised (IES-R) in survivors of acute respiratory failure (ARF). METHODS: Secondary analyses of data from two US and three UK studies of ARF survivors (total N=1223). HADS-D and HADS-A were used to assess depression and anxiety symptoms. IES-R assessed post-traumatic stress disorder symptoms. Standard error of measurement, minimal detectable change90, 0.5 standard deviation (S.D.), and 0.2 S.D. were used to estimate MID for the combined sample, by studies, 6- and 12-month follow-ups, country and mental health condition. RESULTS: Overall, MID estimates converged to 2.0-2.5 for the HADS-A, 1.9-2.3 for the HADS-D and 0.17-0.18 for the IES-R. MID estimates were comparable across studies, follow-up, country and mental health condition. CONCLUSION: Among ARF survivors, 2.0-2.5 is a reasonable range for the MID for both HADS subscales, and 0.2 is reasonable for IES-R. Until anchor-based MIDs for these instruments are available, these distribution-based estimates can help researchers plan future studies and interpret the clinical importance of findings in ARFpatient populations.
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