Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials

Abstract Background The Recap of atopic eczema (RECAP) is a patient‐reported instrument designed to assess eczema control. There is a lack of evidence on the interpretability of change scores in clinical trials. Objectives To calculate the smallest detectable change (SDC) in RECAP and estimate the m...

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Main Authors: Arabella Baker, Beth Stuart, Laura Howells, Eleanor J. Mitchell, Kim S. Thomas
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Skin Health and Disease
Online Access:https://doi.org/10.1002/ski2.470
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author Arabella Baker
Beth Stuart
Laura Howells
Eleanor J. Mitchell
Kim S. Thomas
author_facet Arabella Baker
Beth Stuart
Laura Howells
Eleanor J. Mitchell
Kim S. Thomas
author_sort Arabella Baker
collection DOAJ
description Abstract Background The Recap of atopic eczema (RECAP) is a patient‐reported instrument designed to assess eczema control. There is a lack of evidence on the interpretability of change scores in clinical trials. Objectives To calculate the smallest detectable change (SDC) in RECAP and estimate the minimal important change (MIC) for RECAP using various calculation methods in three eczema clinical trial datasets. Methods In this study, four anchor‐based methods (within‐person score change, between‐patient score change, predictive modelling, receiver operating characteristic curve) and a distribution‐based method (effect size) was used to determine the MIC of RECAP. The trial datasets involved children (0–12 years), young people (13–25 years) and adults (>25 years) with all eczema severities. Results A total of 698 participants were included in this study. The SDC was between 1.74 and 1.80. For the anchor‐based methods, the patient global assessment anchor provided MIC values ranging from 2.35 to 3.94 and the patient oriented eczema measure anchor yielded values between 1.11 and 3.62. The MIC for the distribution‐based method ranged from 2.66 to 3.06, respectively. Conclusions The interpretability of RECAP was improved by establishing MIC values and the following thresholds are suggested for interpreting changes in RECAP scores: <2.0 points is possibly a measurement error; 2.0–2.9 points denotes a small improvement that may be clinically relevant; 3.0–3.9 points indicates an improvement that is likely to be clinically important and ≥4.0 points is highly likely to represent a clinically important change.
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spelling doaj-art-a5ecbe07278a45418a464323f6f0529a2024-12-02T04:03:51ZengWileySkin Health and Disease2690-442X2024-12-0146n/an/a10.1002/ski2.470Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trialsArabella Baker0Beth Stuart1Laura Howells2Eleanor J. Mitchell3Kim S. Thomas4Centre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UKPragmatic Clinical Trials Unit Queen Mary University of London London UKCentre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UKNottingham Clinical Trials Unit University of Nottingham Nottingham UKCentre of Evidence Based Dermatology School of Medicine University of Nottingham Nottingham UKAbstract Background The Recap of atopic eczema (RECAP) is a patient‐reported instrument designed to assess eczema control. There is a lack of evidence on the interpretability of change scores in clinical trials. Objectives To calculate the smallest detectable change (SDC) in RECAP and estimate the minimal important change (MIC) for RECAP using various calculation methods in three eczema clinical trial datasets. Methods In this study, four anchor‐based methods (within‐person score change, between‐patient score change, predictive modelling, receiver operating characteristic curve) and a distribution‐based method (effect size) was used to determine the MIC of RECAP. The trial datasets involved children (0–12 years), young people (13–25 years) and adults (>25 years) with all eczema severities. Results A total of 698 participants were included in this study. The SDC was between 1.74 and 1.80. For the anchor‐based methods, the patient global assessment anchor provided MIC values ranging from 2.35 to 3.94 and the patient oriented eczema measure anchor yielded values between 1.11 and 3.62. The MIC for the distribution‐based method ranged from 2.66 to 3.06, respectively. Conclusions The interpretability of RECAP was improved by establishing MIC values and the following thresholds are suggested for interpreting changes in RECAP scores: <2.0 points is possibly a measurement error; 2.0–2.9 points denotes a small improvement that may be clinically relevant; 3.0–3.9 points indicates an improvement that is likely to be clinically important and ≥4.0 points is highly likely to represent a clinically important change.https://doi.org/10.1002/ski2.470
spellingShingle Arabella Baker
Beth Stuart
Laura Howells
Eleanor J. Mitchell
Kim S. Thomas
Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials
Skin Health and Disease
title Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials
title_full Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials
title_fullStr Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials
title_full_unstemmed Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials
title_short Determining the minimal important change of the recap of atopic eczema (RECAP) instrument in clinical trials
title_sort determining the minimal important change of the recap of atopic eczema recap instrument in clinical trials
url https://doi.org/10.1002/ski2.470
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