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Clinical significance in dementia research: a review of the literature - PubMed

Review

Clinical significance in dementia research: a review of the literature

Syed H Shabbir et al. Am J Alzheimers Dis Other Demen. 2014 Sep.

Abstract

Clinical research traditionally relies on measures of statistical significance to assess the strength of evidence while less attention is paid to the practical import of the results. The objective of this study was to provide a critical overview of the current approaches to measuring clinical significance in dementia research and to provide suggestions for future research. A systematic search was conducted of Medline and Embase for original, English-language, peer-reviewed articles published before July 2012. A total of 18 articles met the inclusion criteria, of which 13 used multiple approaches to measure clinical significance. In all, 5 articles used expert opinion as anchors; 4 also used distribution-based approaches. In all, 8 articles used Goal Attainment Scaling; 7 of these also relied on clinician-based impressions of change. Another 3 articles used only clinical global impressions of change, 1 article used changes in symptomatology, and another used the value from literature.

Keywords: Alzheimer’s; clinical significance; cognitive impairment; dementia; minimal clinically significant difference; systematic review.

© The Author(s) 2014.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Mr Shabbir has nothing to disclose. Dr Sanders receives loan repayment support from LRP/NIA; has received pilot funds from the Resnick Gerontology Center; funding for travel from the American Academy of Neurology, and the Albert Einstein College of Medicine; has reviewed for the NIH/NIA, the Center for Medicare and Medicaid Innovation (CMMI), the Patient-Centered Outcomes Research Institute (PCORI), and the Alzheimer’s Association; has received honoraria for serving on peer-review panels from the CMMI and PCORI, and is a member of a federal advisory committee (MEDCAC).

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Figure 1.

Study selection process.

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