PMID- 26360003
OWN - NLM
STAT- MEDLINE
DCOM- 20180305
LR  - 20181202
IS  - 1550-509X (Electronic)
IS  - 0885-9701 (Linking)
VI  - 31
IP  - 4
DP  - 2016 Jul-Aug
TI  - Responsiveness, Minimal Detectable Change, and Minimally Clinically Important 
      Differences for the Disorders of Consciousness Scale.
PG  - E43-51
LID - 10.1097/HTR.0000000000000184 [doi]
AB  - OBJECTIVES: To determine the responsiveness, minimal detectable change (MDC95), 
      and minimally clinically important difference (MCID) of the Disorders of 
      Consciousness Scale (DOCS-25) in patients with severe traumatic brain injury 
      (TBI) and to report the percentages of patients' change scores exceeding MDC and 
      MCID after 3 weeks of inpatient rehabilitation. SETTING: Post-acute 
      rehabilitation hospitals. PARTICIPANTS: One hundred seventy-two patients with 
      severe TBI. Ninety-two were included in the DOCS-25 3-week analysis. DESIGN: 
      Retrospective cohort study. MAIN MEASURE(S): Disorders of Consciousness Scale, 
      Glasgow Coma Scale. RESULTS: The effect size and standardized response mean of 
      the DOCS-25 for those who improved were 0.45 and 1.3, respectively-moderate to 
      large by Cohen criteria. The MDC95 (95% confidence interval) was 5.6. 
      Distribution-based MCIDs for small (0.20 SD), moderate (0.33 SD), and large (0.50 
      SD) differences were 2.6 units, 4.4 units, and 6.6 units, respectively. The 
      anchor-based MCID was 8.6 units. On average, patients who improved (n = 57) 
      gained 14.5 units by week 3, exceeding the anchor-based MCID. On average, 
      patients who did not improve (n = 35) declined by 7.2 units, which exceeds both 
      the MDC95 and the largest distribution-based MCID. CONCLUSION(S): The DOCS-25 is 
      a responsive, clinician-observed assessment tool for capturing change in 
      neurobehavioral function in adults recovering from severe TBI. This is the first 
      study to provide evidence for the size of neurobehavioral function change that 
      might indicate meaningful recovery in patients with severe TBI. Results from this 
      study may support future research by better informing sample size calculations 
      for clinical trials and also assist clinicians in identifying when variation in 
      level of consciousness is consequential enough to warrant changes in 
      intervention.
FAU - Mallinson, Trudy
AU  - Mallinson T
AD  - The School of Medicine & Health Sciences, The George Washington University, 
      Washington, District of Columbia (Dr Mallinson); The Department of Veterans 
      Affairs Hines VA Hospital, Research Service and the Center for Innovation in 
      Complex Chronic Healthcare & Research Service, Hines, Illinois (Dr Pape and Ms 
      Guernon); Department of Physical Medicine and Rehabilitation, Northwestern 
      University Feinberg School of Medicine, Chicago, Illinois (Dr Pape); and 
      Marianjoy Rehabilitation Hospital, Research Department, Wheaton, Illinois (Ms 
      Guernon).
FAU - Pape, Theresa Louise-Bender
AU  - Pape TL
FAU - Guernon, Ann
AU  - Guernon A
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - J Head Trauma Rehabil
JT  - The Journal of head trauma rehabilitation
JID - 8702552
SB  - IM
MH  - Adult
MH  - Brain Injuries, Traumatic/diagnosis/*physiopathology
MH  - Consciousness Disorders/*diagnosis
MH  - Female
MH  - Glasgow Coma Scale
MH  - Humans
MH  - Inpatients
MH  - Male
MH  - Middle Aged
MH  - *Neuropsychological Tests
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2015/09/12 06:00
MHDA- 2018/03/06 06:00
CRDT- 2015/09/12 06:00
PHST- 2015/09/12 06:00 [entrez]
PHST- 2015/09/12 06:00 [pubmed]
PHST- 2018/03/06 06:00 [medline]
AID - 10.1097/HTR.0000000000000184 [doi]
PST - ppublish
SO  - J Head Trauma Rehabil. 2016 Jul-Aug;31(4):E43-51. doi: 
      10.1097/HTR.0000000000000184.