Measuring clinically significant outcomes - LDQ, CORE-10 and SSQ as dimension measures of addiction.
TL;DR: Values for reliable change and clinically significant change for the Leeds Dependence Questionnaire and Social Satisfaction Questionnaire are determined and add to the evidence for the performance of the LDQ, CORE-10 and SSQ as dimension measures of addiction.
Abstract: Aims and method To determine values for reliable change and clinically significant change for the Leeds Dependence Questionnaire (LDQ) and Social Satisfaction Questionnaire (SSQ). The performance of these two measures with the Clinical Outcomes in Routine Evaluation (CORE-10) as three dimension measures of addiction was then explored. Results The reliable change statistic for both LDQ and SSQ was ⩾4; the cut-offs for clinically significant change were LDQ ⩽10 males, ⩽5 females, and SSQ ⩾16. There was no overlap of 95% CIs for means by gender between 'well-functioning' and pre- and post-treatment populations. Clinical implications These data enable the measurement of clinically significant change using the LDQ and SSQ and add to the evidence for the performance of the LDQ, CORE-10 and SSQ as dimension measures of addiction. The CORE-10 and SSQ can be used as treatment outcome measures for mental health problems other than addiction.
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TL;DR: The ICECAP-A and EuroQol five-dimensional questionnaire (EQ-5D-5L) have been used for the economic evaluation of treatments for substance use disorders.
35 citations
TL;DR: Investigation of the views of service users, family and friends on what constitutes a good outcome for the treatment of substance misuse problems found significant weight was placed, by both SUs and their family andFriends, on abstinence and ways of maintaining abstinence.
Abstract: Aims: The aim of this study was to investigate the views of service users (SUs), family and friends on what constitutes a good outcome for the treatment of substance misuse problems.Methods: Six focus groups were arranged to explore and identify important elements of good outcome. Transcripts of the focus groups were analysed using thematic analysis. The content of the main theme, good outcome, was cross checked with SUs and the four authors. The main theme was analysed further into sub-themes.Findings: Participants were 24 SUs and 12 family and friend members recruited from specialist drug and alcohol services. The participants represented a broad range of treatment journey experiences in a variety of treatment modalities. A total of 20 outcome elements were elicited and categorised into seven sub-themes: abstinence, health, activities, relationships, social circumstances, self-awareness and wellbeing of family and friends.Conclusions: The focus of this study was on the ideal outcome rather than intermed...
16 citations
Cites background from "Measuring clinically significant ou..."
...These approaches all have in common the idea that an individual’s wellbeing is defined by a number of constructs and outcome is, therefore, a compilation of related but independent measures (Raistrick et al., 2014)....
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TL;DR: Factor analysis of treatment outcomes from a UK specialist addiction service: Relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation found social satisfaction appears to be a unique construct of addiction.
Abstract: Introduction and Aims
To examine the relationship between three outcome measures used by a specialist addiction service (UK): the Leeds Dependence Questionnaire (LDQ), the Social Satisfaction Questionnaire (SSQ) and the 10-item Clinical Outcomes in Routine Evaluation (CORE-10).
Design and Method
A clinical sample of 715 service user records was extracted from a specialist addiction service (2011) database. The LDQ (dependence), SSQ (social satisfaction) and CORE-10 (psychological distress) were routinely administered at the start of treatment and again between 3 and 12 months post-treatment. A mixed pre/post-treatment dataset of 526 service users was subjected to exploratory factor analysis. Parallel Analysis and the Hull method were used to suggest the most parsimonious factor solution.
Results
Exploratory factor analysis with three factors accounted for 66.2% of the total variance but Parallel Analysis supported two factors as sufficient to account for observed correlations among items. In the two-factor solution, LDQ items and nine of the 10 CORE-10 items loaded on the first factor >0.41, and the SSQ items on factor 2 with loadings >0.63. A two dimensional summary appears sufficient and clinically meaningful.
Discussion and Conclusions
Among specialist addiction service users, social satisfaction appears to be a unique construct of addiction and is not the same as variation due to psychological distress or dependence. Our interpretation of the findings is that dependence is best thought of as a specific psychological condition subsumed under the construct psychological distress. [Fairhurst C, Bohnke JR, Gabe R, Croudace TJ, Tober G, Raistrick D. Factor analysis of treatment outcomes from a UK specialist addiction service: Relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation. Drug Alcohol Rev 2014;33:643–650]
9 citations
Cites background or methods from "Measuring clinically significant ou..."
...The scales described here are brief enough for routine use, can be embedded with other measures and they produce clinically meaningful data [17]....
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...The development of the scales as a package [16] and the measurement of outcomes in a large clinical sample [17] have been described elsewhere....
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TL;DR: This feasibility RCT aimed to test recruitment, randomisation, retention, and data collection methods, but recruited only 19 participants, illustrating the importance of undertaking feasibility studies prior to fully powered RCTs.
Abstract: The harmful use of alcohol is a causal factor in more than 200 disease and injury conditions and leads to over 3 million deaths every year worldwide. Relatively few problem alcohol users access treatment due to stigma and lack of services. Alcohol-specific digital health interventions (DHI) may help them, but trial data comparing DHI with face-to-face treatment are lacking. We conducted a feasibility RCT of an alcohol DHI, testing recruitment, online data-collection and randomisation processes, with an embedded process evaluation. Recruitment ran from October 2015 for 12 months. Participants were adults, drinking at hazardous and harmful levels, recruited from hospital emergency departments (ED) in London or recruited online. Participants were randomised to HeLP-Alcohol, a six module DHI with weekly reminder prompts (phone, email or text message), or to face-to-face treatment as usual (TAU). Participants were invited to take part in qualitative interviews after the trial. The trial website was accessed 1074 times: 420 people completed online eligibility questionnaires; 350 did not meet eligibility criteria, 51 declined to participate, and 19 were recruited and randomised. Follow-up data were collected from three participants (retention 3/19), and four agreed to be interviewed for the process evaluation. The main themes of the interviews were:
This feasibility RCT aimed to test recruitment, randomisation, retention, and data collection methods, but recruited only 19 participants. This illustrates the importance of undertaking feasibility studies prior to fully powered RCTs. From the qualitative interviews we found that potential recruits were not at equipoise for recruitment. An alternative methodology, for example a preference RCT recruiting from multiple locations, needs to be explored in future trials. International Standard Randomized Controlled Trial Number: ISRCTN31789096
5 citations
References
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TL;DR: In this paper, the authors defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the ranges of the functional population, and proposed a reliable change index (RC) to determine whether the magnitude of change for a given client is statistically reliable.
Abstract: In 1984, Jacobson, Follette, and Revenstorf defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the range of the functional population. In the present article, ways of operationalizing this definition are described, and examples are used to show how clients can be categorized on the basis of this definition. A reliable change index (RC) is also proposed to determine whether the magnitude of change for a given client is statistically reliable. The inclusion of the RC leads to a twofold criterion for clinically significant change.
7,653 citations
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