scholarly journals Effect of varying the time frame for COOP-WONCA functional health status charts: a nested randomised controlled trial in Bristol, UK

1998 ◽  
Vol 52 (1) ◽  
pp. 59-64 ◽  
Author(s):  
T. J. Peters ◽  
J. Coast ◽  
S. H. Richards ◽  
D. J. Gunnell
Keyword(s):  
Health Status ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Time Frame ◽  
Functional Health ◽  
Functional Health Status ◽  
Randomised Controlled

scholarly journals Very brief dynamic psychotherapy

2001 ◽  
Vol 7 (5) ◽  
pp. 373-380 ◽  
Author(s):  
Mark Aveline
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Time Frame ◽  
Limited Time ◽  
Brief Psychotherapy ◽  
Single Session ◽  
Dynamic Psychotherapy ◽  
Maximum Benefit ◽  
Randomised Controlled ◽  
Therapeutic Task

The practice of brief psychotherapy is a distillate of the active ingredients in longer-term work but with the addition of two special elements: limited time and therapist activity in formulating a focus and focusing on it. Typically, patient and therapist work together over 10 to 25 sessions in weekly meetings. In very brief dynamic psychotherapy (VBDT), the time frame is shrunk to fewer than 10 sessions, sometimes just a single session; the constraint means that there is less room for corrective manoeuvre in order to achieve the therapeutic task of maximum benefit and minimum harm in the time available. To do this well requires knowledge, skill and sensitivity. In this paper, special attention is paid to a ‘three-plusone’ intervention (brief intervention and followup (BRF)) that has been tested in a randomised controlled trial (RCT).

scholarly journals Thresholds for clinically important deterioration versus improvement in COPD health status: results from a randomised controlled trial in pulmonary rehabilitation and an observational study during routine clinical practice

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025776 ◽  
Author(s):  
Harma Johanna Alma ◽  
Corina de Jong ◽  
Danijel Jelusic ◽  
Michael Wittmann ◽  
Michael Schuler ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Status ◽  
Randomised Controlled Trial ◽  
Pulmonary Rehabilitation ◽  
Controlled Trial ◽  
Routine Clinical Practice ◽  
Observational Research ◽  
Chronic Obstructive ◽  
Global Rating ◽  
Randomised Controlled

ObjectivesChronic Obstructive Pulmonary Disease (COPD) is a progressive disease. Preventing deterioration of health status is therefore an important therapy goal. (Minimal) Clinically Important Differences ((M)CIDs) are used to interpret changes observed. It remains unclear whether (M)CIDs are similar for both deterioration and improvement in health status. This study investigates and compares these clinical thresholds for three widely-used questionnaires.Design and settingData were retrospectively analysed from an inhouse 3-week pulmonary rehabilitation (PR) randomised controlled trial in the German Klinik Bad Reichenhall (study 1), and observational research in Dutch primary and secondary routine clinical practice (RCP) (study 2).ParticipantsPatients with COPD aged ≥18 years (study 1) and aged ≥40 years (study 2) without respiratory comorbidities were included for analysis.Primary outcomesThe COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ) and St George’s Respiratory Questionnaire (SGRQ) were completed at baseline and at 3, 6 and 12 months. A Global Rating of Change scale was added at follow-up. Anchor-based and distribution-based methods were used to determine clinically relevant thresholds.ResultsIn total, 451 patients were included from PR and 207 from RCP. MCIDs for deterioration ranged from 1.30 to 4.21 (CAT), from 0.19 to 0.66 (CCQ), and from 2.75 to 7.53 (SGRQ). MCIDs for improvement ranged from −3.78 to −1.53 (CAT), from −0.50 to −0.19 (CCQ), and from −9.20 to −2.76 (SGRQ). Thresholds for moderate improvement versus deterioration ranged from −5.02 to −3.29 vs 3.89 to 8.14 (CAT), from −0.90 to −0.72 vs 0.42 to 1.23 (CCQ), and from −15.85 to −13.63 vs 7.46 to 9.30 (SGRQ).ConclusionsMCID ranges for improvement and deterioration on the CAT, CCQ and SGRQ were somewhat similar. However, estimates for moderate and large change varied and were inconsistent. Thresholds differed between study settings.Trial registration numberRoutine Inspiratory Muscle Training within COPD Rehabilitation trial: #DRKS00004609; MCID study: #UMCG201500447.

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