Practical Guidelines for Assessing the Clinical Significance of Health-Related Quality of Life Changes within Clinical Trials

Jeff A. Sloan, Tara Symonds, Delfino Vargas-Chanes, Brooke Fridley

Research output: Contribution to journalReview article

168 Scopus citations


Health related quality of life (HRQOL) assessment is becoming common practice in many clinical trials. There is much debate over how to determine the clinical significance of changes in HRQOL scores. A number of techniques have been used to address this issue. This paper reviews the most popular of these approaches for use in a clinical trial setting. More specifically, the anchor-based "minimal clinically important difference" technique is described and critiqued, as is the more traditional distribution-based effect size techniqne. A novel application of effect size, which applies a common statistical premise known as the empirical rule, is also presented. The review of these techniques indicates that there is no single, optimal solution to determining clinical sigificance of changes in HRQOL scores. However, it is encouraging to note that they all suggest a similar criterion of a half-standard deviation for whether or not a change in HRQOL score is clinically significant. Recommendations are given for reporting the clinical significance of HRQOL assessments in clinical trials.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalDrug Information Journal
Issue number1
StatePublished - Jan 1 2003



  • Clinical significance
  • Effect size
  • Minimal clinically important difference
  • Psychometrics

ASJC Scopus subject areas

  • Pharmacology (nursing)
  • Drug guides
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)

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