The Notion of Clinically Significant Change Determining if treatment results in a significant change in a client’s communication ability can be a difficult task for clinicians. We addressed this issue by proposing a definition of clinically significant change that contains three dimensions. A clinically significant change is a change in client performance that (a) can be ... Clinical Forum
Clinical Forum  |   October 01, 1991
The Notion of Clinically Significant Change
 
Author Affiliations & Notes
  • Barbara A. Bain, Ph.D.
    Idaho State University, Pocatello
  • Christine A. Dollaghan
    University of Pittsburgh
  • Requests for reprints may be sent to Barbara A. Bain, Idaho State University, Department of Speech Pathology & Audiology, P.O. Box 8116, Pocatello, Idaho 83209-8116.
Article Information
Research Issues, Methods & Evidence-Based Practice / Professional Issues & Training / Clinical Forum: Treatment Efficacy
Clinical Forum   |   October 01, 1991
The Notion of Clinically Significant Change
Language, Speech, and Hearing Services in Schools, October 1991, Vol. 22, 264-270. doi:10.1044/0161-1461.2204.264
History: Received July 9, 1990 , Accepted November 26, 1990
 
Language, Speech, and Hearing Services in Schools, October 1991, Vol. 22, 264-270. doi:10.1044/0161-1461.2204.264
History: Received July 9, 1990; Accepted November 26, 1990

Determining if treatment results in a significant change in a client’s communication ability can be a difficult task for clinicians. We addressed this issue by proposing a definition of clinically significant change that contains three dimensions. A clinically significant change is a change in client performance that (a) can be shown to result from treatment rather than from maturation or other uncontrolled factors, (b) can be shown to be real rather than random, and (c) can be shown to be important rather than trivial. Additionally, some methods are described for evaluating the clinical significance of improvements in client performance during treatment.

ACKNOWLEDGMENTS
The authors appreciate the valuable editorial suggestions and constructive comments provided by Marc Fey and Alan Kamhi on an earlier version of this manuscript. Thanks are extended to Lesley Olswang and Tom Campbell for their insightful conversations as we all pondered treatment efficacy.
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