Minimal Clinically Important Difference Estimates Are Biased by Adjusting for Baseline Severity, Not by Regression to the Mean
article
Minimal clinically important difference (MCID) estimates are often used to interpret change scores from measurement instruments. Researchers debate how MCID values should be estimated. In a recent paper, Tenan et al1 recommended adjusting for baseline severity in the analysis to avoid biased MCID estimates due to regression to the mean (RTM). They stated that anchored MCID estimation can be biased by RTM due to repeated measurements. They also stated that including baseline severity as a covariate in the analysis (the authors used baseline covariate-adjusted receiver operating characteristic [ROC] analysis) averts this bias. No proof or justification was offered to support these statements. In this letter, we argue that adjusting for baseline severity is bound to introduce bias, instead of warding it off.
Topics
TNO Identifier
982016
ISSN
10626050
Source
Journal of Athletic Training, 57(11-12), pp. 1122-1123.
Pages
1122-1123