Ascertainment of Minimal Clinically Important Differences in the Diabetes Distress Scale–17: A Secondary Analysis of a Randomized Clinical Trial
Authors' conclusion
In this secondary analysis of data from a randomized clinical trial, an MCID improvement or worsening of more than 0.25 on the DDS-17 was quantitatively significant and patients in the EPICC group were more likely to experience improvement than those in the EUC group.
Study context
- Population
- Adults with uncontrolled T2D (HbA1c >8.0%) receiving primary care in Department of Veterans Affairs clinics in Illinois, Indiana and Texas; mean (SD) age 67.4 (8.3) years, 94.76% mencomplete DDS-17 data
- Participants
- 248 adults
- Comparison
- Empowering Patients in Chronic Care (EPICC) vs enhanced usual care
- EPICCn = 123
- EUCn = 125reference
- Primary endpoint
- Distribution-based MCID values for total DDS-17 and its 4 subscales, calculated using the standard error of measurement
Methodological detailshybrid implementation-effectiveness trial, multicentre, Data collection completed November 2018; analysis completed June 2023
- Hybrid implementation-effectiveness trial
- Multicentre
- Data collection completed November 2018; analysis completed June 2023
Primary result
As reported in the abstract
Minimal clinically important difference (MCID), total DDS-17
0.25
MCID, emotional and interpersonal distress subscales
0.38
MCID, physician and regimen distress subscales
0.39
Further findings
DDS-17 MCID improvement category · baseline to postintervention · more EPICC participants improved
P = 0.003
DDS-17 MCID worsened category · baseline to postintervention · fewer EPICC participants worsened
P = 0.008
Association of DDS-17 MCID category with HbA1c, all participants
- MCID improvement vs HbA1c: β =
- −0.25 (95% CI, −0.59 to 0.10; P = .17)
- MCID worsening vs HbA1c: β =
- 0.18 (95% CI, −0.22 to 0.59; P = .38)
- No direct association
Original publication
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