Earticle

초록

영어

The valid confirmation of a positive change (improvement) in a patient’s health status due to intervention has been at the core of medicine and rehabilitation since their very inception as clinicians always aspired to ensure that treating their patients had led to successful outcomes both in acute and chronic conditions. However what is change: either im-provement or worsening (aggravation), is a complicated issue which involves clinical as well as statistical considerations. Change invariably relates to a difference in some measurable entity and almost always it relates to a time span. The confirmation of clinical change is important both for varying the treatment course (if necessary) and for the termina-tion of treatment when the latter has reached wither its prescribed ob-jective or a plateau. Since in the context of rehabilitation, the outcome measures (OM) are strongly linked to performance, determination of change in the latter is confounded by many factors, collectively known as the error of measurement, which render a decision regarding clini-cally meaningful change, highly involved. This is further complicated by the stability of the observed OM, the so-called reproducibility of the OM, and the accuracy of the measurement instrument. The higher the re-producibility the lower is the error. Moreover, in order to proclaim change, in most cases a positive one, it is necessary for the difference in outcome scores (i.e. the change) to surpass the error of measure-ment, in varying degree of rigor. This paper describes selected methods associated with determination of change and focuses predominantly on the difference between a simple difference in scores (‘simple change’), a significant difference in scores and the so-called clinically meaningful change in scores which is considered today as the bench-mark for confirmation of a real change.

목차

Abstract
 INTRODUCTION
 WHAT IS CHANGE?
 ACCURACY, REPRODUCIBILITY, AND RESOLUTION
 HOW DO THESE CONCEPTS COME INTO THE DOMAIN OF CHANGE?
 NUMERIC PAIN RATING SCALE
 CONCLUSIONS
 CONFLICT OF INTEREST
 REFERENCES

키워드

저자

• Zeevi Dvir [ Department of Physical Therapy, Sackler Faculty of Medicine. Tel Aviv University, Israel ]

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  JER [Journal of Exercise Rehabilitation]

• 간기

  격월간

• pISSN

  2288-176X

• eISSN

  2288-1778

• 수록기간

  2013~2026

• 등재여부

  SCOPUS,KCI 등재

• 십진분류

  KDC 517 DDC 613