Regular Article

The Journal of Behavioral Health Services & Research

, Volume 34, Issue 3, pp 272-289

First online:

Measuring Clinically Meaningful Change Following Mental Health Treatment

  • Susan V. EisenAffiliated withCenter for Health Quality, Outcomes and Economic Research (CHQOER), Edith Nourse Rogers Memorial Veterans HospitalDepartment of Health Policy and Management, Boston University School of Public Health Email author 
  • , Gayatri RanganathanAffiliated withMetaWorks Inc.
  • , Pradipta SealAffiliated withCenter for Health Quality, Outcomes and Economic Research (CHQOER), Edith Nourse Rogers Memorial Veterans Hospital
  • , Avron SpiroIIIAffiliated withMassachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare SystemDepartment of Epidemiology, Boston University School of Public Health

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Abstract

Assessment of clinically meaningful change is useful for treatment planning, monitoring progress, and evaluating treatment response. Outcome studies often assess statistically significant change, which may not be clinically meaningful. Study objectives are to: (1) evaluate responsiveness of the BASIS-24© using three methods for determining clinically meaningful change: reliable change index (RCI), effect size (ES), and standard error of measurement (SEM); and (2) determine which method provides an estimate of clinically meaningful change most concordant with other change measures. BASIS-24© assessments were obtained at two time points for 1,397 inpatients and 850 outpatients. The proportion showing clinically meaningful change using each method was compared to the proportion showing change in global mental health, retrospectively reported change, and clinician-assessed change. BASIS-24© demonstrated responsiveness at both aggregate and individual levels. Regarding clinically meaningful improvement and decline, SEM was most concordant with all three outcome measures; regarding no change, RCI was most concordant with all three measures.

Keywords

clinically meaningful change outcome assessment