![]() ![]() All papers calculated effect size and used Cohen’s criteria to determine their MID. One of the papers used both anchor- and distribution-based methods with the intention of comparing and confirming results. The two approaches used for determining MIDs are anchor-based and distribution-based approaches. We reviewed 210 papers reporting clinically important differences in HADS scores and found 7 papers that calculated MIDs for the HADS. For example, an improvement in mood such that a patient is ‘no longer having suicidal thoughts’, may not register a post-treatment HADS score below the clinical cut-off but would be considered a clinically important change. Only a few papers have determined a MID that would indicate a clinically significant change independent of cut-off scores, however calculating and reporting the MID in clinical trials could provide valuable information. A clinically significant change in HADS has been defined as scoring below the clinical cut-off post-treatment 5, and various HADS clinical cut-off scores have been determined for different cancer treatment studies (see Ziegler 2011 for a summary) 13. The scale can also be used as a valid measure of severity of mood disorder 14, and therefore is suitable for repeated administration to assess change in patients over time. Therefore, the HADS is typically used in clinical trials to compare prevalence rates across groups or over time. ![]() The Hospital Anxiety and Depression Scale (HADS) was developed for screening purposes to identify patients with clinically significant anxiety and depression. For more information about MIDs in general, please read the QOL Office Frequently Asked Question “ what is a minimally important difference or MID? ” ![]() King (2011) 6 summarises the definitions, terms and methods for calculating MIDs. The Minimally important difference (MID) can be defined as “the smallest difference in score in the domain of interest that patients perceive as important, either beneficial or harmful, and which would lead the clinician to consider a change in the patient’s management” 4 What is the Current evidence about MIDs for HADS? ![]()
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