PMID- 30383220
OWN - NLM
STAT- MEDLINE
DCOM- 20191115
LR  - 20200225
IS  - 1558-9102 (Electronic)
IS  - 1092-4388 (Print)
IS  - 1092-4388 (Linking)
VI  - 61
IP  - 11
DP  - 2018 Nov 8
TI  - Minimally Detectable Change and Minimal Clinically Important Difference of a 
      Decline in Sentence Intelligibility and Speaking Rate for Individuals With 
      Amyotrophic Lateral Sclerosis.
PG  - 2757-2771
LID - 10.1044/2018_JSLHR-S-17-0366 [doi]
AB  - PURPOSE: The purpose of this study was to determine the minimally detectable 
      change (MDC) and minimal clinically important difference (MCID) of a decline in 
      speech sentence intelligibility and speaking rate for individuals with 
      amyotrophic lateral sclerosis (ALS). We also examined how the MDC and MCID vary 
      across severities of dysarthria. METHOD: One-hundred forty-seven patients with 
      ALS and 49 healthy control subjects were selected from a larger, longitudinal 
      study of bulbar decline in ALS, resulting in a total of 650 observations. 
      Intelligibility and speaking rate in words per minute (WPM) were calculated using 
      the Sentence Intelligibility Test (Yorkston, Beukelman, & Hakel, 2007), and the 
      ALS Functional Rating Scale-Revised (Cedarbaum et al., 1999) was administered to 
      capture patient perception of motor impairment. The MDC at the 95% confidence 
      level was estimated using the following formula: MDC95 = 1.96 x  radical2 x SEM. For 
      estimation of the MCID, receiver operating characteristic curves were generated, 
      and area under the curve and optimal thresholds to maximize sensitivity and 
      specificity were calculated. RESULTS: The MDC for sentence intelligibility was 
      12.07%, and the MCID was 1.43%. The MDC for speaking rate was 36.57 WPM, and the 
      MCID was 8.80 WPM. Both MDC and MCID estimates varied with severity of 
      dysarthria. CONCLUSIONS: The findings suggest that declines greater than 12% 
      sentence intelligibility and 37 WPM are required to be outside measurement error 
      and that these estimates vary widely across dysarthria severities. The MDC and 
      MCID metrics used in this study to detect real and clinically relevant change 
      should be estimated for other measures of speech outcomes in intervention 
      research.
FAU - Stipancic, Kaila L
AU  - Stipancic KL
AD  - Department of Communication Sciences and Disorders, MGH Institute of Health 
      Professions, Boston, MA.
FAU - Yunusova, Yana
AU  - Yunusova Y
AD  - Department of Speech-Language Pathology, University of Toronto, Ontario, Canada.
FAU - Berry, James D
AU  - Berry JD
AD  - MDA ALS Clinic, Massachusetts General Hospital, Boston.
FAU - Green, Jordan R
AU  - Green JR
AD  - Department of Communication Sciences and Disorders, MGH Institute of Health 
      Professions, Boston, MA.
LA  - eng
GR  - K24 DC016312/DC/NIDCD NIH HHS/United States
GR  - R01 DC009890/DC/NIDCD NIH HHS/United States
GR  - R01 DC013547/DC/NIDCD NIH HHS/United States
GR  - R01 DC017291/DC/NIDCD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Speech Lang Hear Res
JT  - Journal of speech, language, and hearing research : JSLHR
JID - 9705610
SB  - IM
MH  - Adult
MH  - Amyotrophic Lateral Sclerosis/*physiopathology
MH  - Case-Control Studies
MH  - Child
MH  - Humans
MH  - *Minimal Clinically Important Difference
MH  - ROC Curve
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Speech
MH  - *Speech Intelligibility/classification
MH  - Speech Production Measurement
MH  - *Speech Therapy
PMC - PMC6693567
EDAT- 2018/11/02 06:00
MHDA- 2019/11/16 06:00
PMCR- 2019/05/01
CRDT- 2018/11/02 06:00
PHST- 2017/09/26 00:00 [received]
PHST- 2018/06/28 00:00 [accepted]
PHST- 2018/11/02 06:00 [pubmed]
PHST- 2019/11/16 06:00 [medline]
PHST- 2018/11/02 06:00 [entrez]
PHST- 2019/05/01 00:00 [pmc-release]
AID - 2712908 [pii]
AID - 10924388006100112757 [pii]
AID - 10.1044/2018_JSLHR-S-17-0366 [doi]
PST - ppublish
SO  - J Speech Lang Hear Res. 2018 Nov 8;61(11):2757-2771. doi: 
      10.1044/2018_JSLHR-S-17-0366.