Adapting the multilevel model for estimation of the reliable change index (RCI) with multiple timepoints and multiple sources of error

Autor: Antonio Alexander Morgan‐Lopez, Lissette Maria Saavedra, Derek D. Ramirez, Luke M. Smith, Anna Catherine Yaros
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: International Journal of Methods in Psychiatric Research, Vol 31, Iss 2, Pp n/a-n/a (2022)
Druh dokumentu: article
ISSN: 1557-0657
1049-8931
DOI: 10.1002/mpr.1906
Popis: Abstract Objective One of the primary tools in the assessment of individual‐level patient outcomes is Jacobson and Truax, (1991’s) Reliable Change Index (RCI). Recent efforts to optimize the RCI have revolved around three issues: (a) extending the RCI beyond two timepoints, (b) estimating the RCI using scale scores from item response theory or factor analysis and (c) estimation of person‐ and time‐specific standard errors of measurement. Method We present an adaptation of a two‐stage procedure, a measurement error‐corrected multilevel model, as a tool for RCI estimation (with accompanying Statistical Analysis System syntax). Using DASS‐21 data from a community‐based mental health center (N = 379), we illustrate the potential for the model as unifying framework for simultaneously addressing all three limitations in modeling individual‐level RCI estimates. Results Compared to the optimal‐fitting RCI model (moderated nonlinear factor analysis scoring with measurement error correction), an RCI model that uses DASS‐21 total scores produced errors in RCI inferences in 50.8% of patients; this was largely driven by overestimation of the proportion of patients with statistically significant improvement. Conclusion Estimation of the RCI can now be enhanced by the use of latent variables, person‐ and time‐specific measurement errors, and multiple timepoints.
Databáze: Directory of Open Access Journals
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