Challenging the understanding of significant improvement and outcome in XXXX - the concept of reliable and clinically significant change methods.

@entity1 @entity161
UNASSIGNED: Significant changes of @entity161 @entity1 during inpatient treatment were evalutaed and compared to established outcome criteria. The concept of reliable and clinically significant change methods was applied to three hundred and ninety-six @entity1 suffering from a @entity161 spectrum disorder. First, information on whether or not the change of the @entity1 's condition is sufficient in order to declare that it is beyond a measurement error or random effect (= reliable change) was evaluated and in a second step it was observed if the reliable change was clinically meaningful (= clinically significant change). Different Positive and Negative Syndrome Scale for @entity161 (PANSS) thresholds were applied to define the clinically significant change (40, 45 and 50 points). These changes were then compared to established outcome criteria such as response and remission. Seventy-nine of the 396 @entity1 (20%) showed a reliable improvement of symptoms, whereas 70% improved without achieving a reliable change of their condition. Of the 79 @entity1 achieving a reliable change during treatment 8-15% concurrently showed a clinically significant change depending on the respective PANSS threshold. In contrast, 56% of the @entity1 achieved response and 60% were in remission at discharge when applying established outcome criteria. Our results showed that a rather small number of @entity161 @entity1 were found to reliably change during inpatient treatment, with even less @entity1 achieving a clinically significant change. The concept of reliable and clinically significant changes revealed to be a lot more stringent than today's established outcome criteria and should be critically evaluated regarding its use in @entity161 @entity1 . Copyright    2015 John Wiley _ Sons, Ltd.
