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Biomedical subjects

W J Hageman

Publications and source records attributed to W J Hageman.

3 recordsLinked to original sources

Establishing clinically significant change: increment of precision and the distinction between individual and group level of analysis.

Some essential adaptations to the method for determining clinically significant change originally introduced by Jacobson, Follette and Revenstorf [Jacobson, N. S., Follette, W. C. & Revenstorf, D. (1984a). Psychotherapy outcome research: methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15, 336-352.] are presented. One adaptation deals with the failure in the original method to distinguish between analysis at the individual versus analysis at the group level. A second adaptation entails the provision of a closer approximation of the underlying true scores. This refinement represents an enhancement in precision. Specific aspects of this refinement may be understood in terms of a correction for error-based regression to the mean. Taking into account these adaptations, new procedures are described for determining (clinically significant) change. Some guidelines for the publication of outcome findings are also presented.

Data Interpretation, Statistical↗

Clinically significant and practical! Enhancing precision does make a difference. Reply to McGlinchey and Jacobson, Hsu, and Speer.

UNLABELLED: Based on a secondary analysis of the Jacobson and Truax [Jacobson, N.S. & Truax, P. (1991). CLINICAL SIGNIFICANCE: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.] data using both their own traditional approach and the refined method advanced by Hageman and Arrindell [Hageman, W.J.J.M., & Arrindell, W.A. (1999). Establishing clinically significant change: increment of precision and the distinction between individual and group level of analysis. Behaviour Research and Therapy, 37, 1169-1193], McGlinchey and Jacobson [McGlinchey, J. B., & Jacobson, N. S. (1999). Clinically significant but impractical? A response to Hageman and Arrindell. Behaviour Research and Therapy, 37, 1211-1217.] reported practically identical findings on reliable and clinically significant change across the two approaches. This led McGlinchey and Jacobson to conclude that there is little practical gain in utilizing the refined method over the traditional approach. Close inspection of the data used by McGlinchey and Jacobson however revealed a serious mistake with respect to the value of the standard error of measurement that was employed in their calculations. When the proper index value was utilised, further re-analysis by the present authors disclosed clear differences (i.e. different classifications of S's) across the two approaches. Importantly, these differences followed exactly the same pattern as depicted in Table 2 in Hageman and Arrindell (1999). The theoretical advantages of the refined method, i.e. enhanced precision, appropriate distinction between analysis at the individual and group levels, and maximal comparability of findings across studies, exceed those of the traditional method. Application of the refined method may be carried out within approximately half an hour, which not only supports its practical manageability, but also challenges the suggestion of McGlinchey and Jacobson (1999) that the relevant method would be too complex (impractical) for the average scientist. The reader is offered the opportunity of obtaining an SPSS setup in the form of an ASCII text file by means of which the relevant calculations can be carried out. The ways in which the valuable commentaries by Hsu [Hsu, L. M. (1999). A comparison of three methods of identifying reliable and clinically significant client changes: commentary on Hageman and Arrindell. Behaviour Research and Therapy, 37, 1195-1202.] and Speer [Speer, D. C. (1999). What is the role of two-wave designs in clinical research? Comment on Hageman and Arrindell. Behaviour Research and Therapy, 37, 1203-1210.) contribute to a better understanding of the technical/statistical backgrounds of the traditional and refined methods were also discussed.

Humans↗

A further refinement of the reliable change (RC) index by improving the pre-post difference score: introducing RCID.

The development of methods for demonstrating clinical (in addition to statistical) significance has been referred to as one of the major advances in outcome research. In a recent article, Speer (1992; Journal of Consulting and Clinical Psychology, 60, 402-408) suggested that the Reliable Change (RC) Index neglects possible confounding of improvement rate estimates by regression to the mean, to which latter's existence he concludes when a negative correlation between initial score and amount of change is observed. Speer (1992) proposed an alternative method that incorporates an adjustment which minimizes this confound when statistical regression has been empirically shown to be present. In the present paper, it is argued that both the rationale for arriving at this alternative method and the method itself are erroneous. Introducing RCID, the present authors provide a modification and refinement of the RC Index by improving the pre-post difference score, taking into account regression to the mean due to measurement unreliability. Further advantages of the RCID Index are briefly discussed.

Behavior Therapy↗