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Medium Effect Size (medium + effect_size)
Selected AbstractsHypofrontality in schizophrenia: a meta-analysis of functional imaging studiesACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2004K. Hill Objective:, Hypofrontality is not a well-replicated finding in schizophrenia either at rest or under conditions of task activation. Method:, Studies comparing whole brain and frontal blood flow/metabolism in schizophrenic patients and normal controls were pooled. Voxel-based studies were also combined to examine the pattern of prefrontal activation in schizophrenia. Results:, Whole brain flow/metabolism was reduced in schizophrenia to only a small extent. Resting and activation frontal flow/metabolism were both reduced with a medium effect size. Duration of illness significantly moderated resting hypofrontality, but the moderating effects of neuroleptic treatment were consistent with an influence on global flow/metabolism only. Pooling of voxel-based studies did not suggest an abnormal pattern of activation in schizophrenia. Conclusion:, Meta-analysis supports resting hypofrontality in schizophrenia. Task-activated hypofrontality is also supported, but there is little from voxel-based studies to suggest that this is associated with an altered pattern of regional functional architecture. [source] What changes in health-related quality of life matter to multiple myeloma patients?EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2010A prospective study Abstract Objective: To determine the clinical significance of changes in quality-of-life scores in patients with multiple myeloma (MM), we have estimated the minimal important difference (MID) for the health-related quality-of-life instrument, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. The MID is the smallest change in a quality-of-life score considered important to patients. Methods: Between 2006 and 2008, 239 patients with MM completed the EORTC QLQ-C30 at inclusion (T1) and after 3 months (T2). At T2, a structured quality-of-life interview was also performed. MIDs were calculated by using mean score changes (T2,T1) for patients who in the interview stated they had improved, deteriorated or were unchanged. MIDs were also estimated by the receiver-operating characteristic (ROC) curve method as well as by calculation effect sizes using standard deviations of baseline scores. Results: MIDs varied slightly depending on the method used. Patients stating in the interview that they had ,improved' or ,deteriorated' had a corresponding change in EORTC QLQ-C30 score ranging from 6 to15 (improvement) and from 9 to17 (deterioration) (scale range 0,100). The ROC analysis indicated that changes in score from 7 to17 represent clinically important changes to patients. The effect size method suggested 5,6 to be a small and 11,15 to be a medium change. Conclusion: Calculation of MIDs as mean score changes or by ROC analysis suggested that a change in the EORTC QLQ-C30 score in the range of approximately 6,17 is considered important by patients with MM. These MIDs are closer to a medium effect size than to a small effect size. Our findings imply that mean score changes smaller than 6 are unlikely to be important to the patients, even if these changes are statistically significant. [source] Measuring physiotherapists' guideline adherence by means of clinical vignettes: a validation studyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 5 2006Geert M.J. Rutten MPH Abstract Rationale, aims and objectives, To assess the criterion validity of paper-and-pencil vignettes to assess guideline adherence by physiotherapists in the Netherlands. The evidence-based physiotherapy practice guideline for low back pain was used as an example. Methods, Four vignettes were constructed and pre-tested. Three vignettes were found to represent an adequate case-mix. They described one patient with specific low back pain, one with non-specific low back pain and a normal recovery process and one with non-specific low back pain and a delay in the recovery process. Invited to participate were 113 primary care physiotherapists who had joined an randomized controlled trial study 8 months before, in which guideline adherence had been measured by means of semi-structured treatment recording forms. The criterion validity was determined with Spearman's rs, using Cohen's classification for the behavioural sciences to categorize its effect size. Results, Of the 72 physiotherapists who agreed to participate, 39 completed the questions on the vignettes. In the end, both adherence measures were available for 34 participants, providing 102 vignettes and 268 recording forms. Mean guideline adherence scores were 57% (SD = 17) when measured by vignettes and 74% (SD = 15) when measured by recording forms. Spearman's rs was 0.31 (P = 0.036), which, according to Cohen's classification, is a medium effect size. Conclusion, Vignettes are of acceptable validity, and are an inexpensive and manageable instrument to measure guideline adherence among large groups of physiotherapists. Further validation studies could benefit from the use of standardized patients as a gold standard, a more diverse case mix to better reflect real physiotherapy practice, and the inclusion of longitudinal vignettes that cover the patients' course of treatment. [source] Cognitive training in Alzheimer's disease: a meta-analysis of the literatureACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2006D. I. Sitzer Objective:, To systematically review the literature and summarize the effect of cognitive training (CT) for Alzheimer's disease (AD) patients on multiple functional domains. Method:, Effect sizes (Cohen's d) were calculated for 17 controlled studies identified through a comprehensive literature review. Results:, An overall effect size of 0.47 was observed for all CT strategies across all measured outcomes. Mean effect sizes were higher for restorative (0.54) than for compensatory (0.36) strategies. Domain-specific effect sizes ranged from 2.16 (verbal and visual learning) to ,0.38 (visuospatial functioning). Data are also presented on the relative impact of restorative and compensatory strategies for each domain of functioning. Conclusion:, CT evidenced promise in the treatment of AD, with primarily medium effect sizes for learning, memory, executive functioning, activities of daily living, general cognitive problems, depression, and self-rated general functioning. Restorative strategies demonstrated the greatest overall effect on functioning. Several limitations of the published literature are discussed. [source] Psychometric Correlates of FIRO-B Scores: Locating the FIRO-B scores in personality factor spaceINTERNATIONAL JOURNAL OF SELECTION AND ASSESSMENT, Issue 1 2008Adrian Furnham This paper investigated the relationship between the six Fundamental Interpersonal Relations Orientation (FIRO)-B scales, the Big Five Personality traits assessed by the NEO PI-R, the Hogan Development Survey (HDS) and two measures of cognitive ability (Watson Glaser; Graduate and Managerial Assessment). It examined the concurrent and construct validity of the measure in various adult groups attending assessment centres in order to locate the FIRO-B dimensions in established personality factor space. The FIRO-B was consistently correlated with Extraversion, though analysis at the primary factor (facet) level showed many traits from all five factors were strongly correlated with the six FIRO-B scores. Regressing the six FIRO-B facets onto each of the Big Five in turn showed all were significant particularly for Expressed Inclusion and Wanted Control. The second study also showed considerable and logical overlap between the six FIRO-B scales and the 11 dysfunctional personality strategies as measured by the HDS. There were also strong correlational patterns for the Cautious, Reserved, Colourful and Dutiful type disorders. The third study showed the FIRO-B was statistically associated with both cognitive ability tests though it only accounted for small percentages of the explained variance. Expressed Control was the most consistently correlated of the intelligence test scores. Despite the fact that many explicable associations were found between the FIRO-B and other measure the effect sizes were not large. Thus only 4% of the trait facet scores and 4.5% of the HDS showed medium effect sizes. Results are discussed in terms of the usefulness and possible discriminant validity of the instrument for use in selection and assessment. [source] Medication adherence skills training for middle-aged and elderly adults with bipolar disorder: development and pilot studyBIPOLAR DISORDERS, Issue 6 2007Colin A Depp Objectives:, To present the rationale, development, and pilot study of a medication adherence skills training (MAST-BD) intervention for older adults with bipolar disorder (BPD). We developed a 12-week manualized group intervention that combined educational, motivational, medication management skills and symptom management training adapted for older adults. Methods:, Among 21 older outpatients with BPD (mean age = 60 years; SD = 6), the feasibility and acceptability of MAST-BD were assessed in a quasi-experimental clinical trial. We also obtained preliminary effect sizes associated with pre,post change on measures of self-reported adherence to psychiatric medications, performance-based medication management ability, attitudes toward medication, depressive and manic symptoms, and health-related quality of life. Results:, At baseline, 55% of participants reported recent non-adherence to psychiatric medications and were, on average, suffering from moderately severe depressive symptoms and minimal symptoms of mania. A total of 76% of participants completed the intervention, and 86% of sessions were attended by completers. Participants reported high levels of satisfaction with the intervention and manual. Pre,post improvement by small to medium effect sizes (Cohen's d = 0.30,0.57) was seen in medication adherence, medication management ability, depressive symptoms, and selected indices of health-related quality of life. Conclusions:, Notwithstanding the limitations of this small preliminary study, the results are encouraging in that the MAST-BD intervention was feasible, acceptable to patients, and associated with improvement in key outcomes. Suggestions for further development of medication adherence interventions for this neglected group of patients are discussed. [source] | ||||||||||