Clinical significance in dementia research: a review of the literature

Am J Alzheimers Dis Other Demen. 2014 Sep;29(6):492-7. doi: 10.1177/1533317514522539. Epub 2014 Feb 13.


Clinical research traditionally relies on measures of statistical significance to assess the strength of evidence while less attention is paid to the practical import of the results. The objective of this study was to provide a critical overview of the current approaches to measuring clinical significance in dementia research and to provide suggestions for future research. A systematic search was conducted of Medline and Embase for original, English-language, peer-reviewed articles published before July 2012. A total of 18 articles met the inclusion criteria, of which 13 used multiple approaches to measure clinical significance. In all, 5 articles used expert opinion as anchors; 4 also used distribution-based approaches. In all, 8 articles used Goal Attainment Scaling; 7 of these also relied on clinician-based impressions of change. Another 3 articles used only clinical global impressions of change, 1 article used changes in symptomatology, and another used the value from literature.

Keywords: Alzheimer’s; clinical significance; cognitive impairment; dementia; minimal clinically significant difference; systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Biomedical Research
  • Cognition Disorders / therapy*
  • Dementia / therapy*
  • Humans
  • Knowledge Discovery
  • Sample Size
  • Treatment Outcome