title: Minimally important differences were estimated for the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) instrument using a combination of distribution- and anchor-based approaches.
abstract: OBJECTIVE
  To estimate minimally important differences (MIDs) on the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) instrument using anchor- and distribution-based methods.
  
  
  METHODS
  Preliminary MIDs were generated for FACT-C scores based on published results for two samples (n = 60 and n = 63) from the FACT-C validation study. Preliminary MIDs were confirmed using data from a Phase II randomized controlled clinical trial (n = 104) and a population-based observational study (n = 568). MIDs were estimated for the colorectal cancer subscale (CCS); the FACT-C Trial Outcome Index (TOI-C), which is the sum of the CCS, physical well-being, and functional well-being subscales; and the FACT-C total score. Both cross-sectional and longitudinal analyses were used.
  
  
  RESULTS
  MIDs were stable across the different patient samples. The recommended MIDs ranged from 2 to 3 points for the CCS, 4 to 6 points for the TOI-C, and 5 to 8 points for the FACT-C total score.
  
  
  CONCLUSIONS
  MIDs can enhance the interpretability of FACT-C scores, and they can be used to provide a basis for sample size estimation and to determine clinical benefit in combination with other measures of efficacy. General guidelines for estimating MIDs for other FACT instruments are suggested.
authors.affiliation: Center on Outcomes, Research and Education, Evanston Northwestern Healthcare Research Institute, IL 60201, USA. kyost@enh.org
authors.forename: K J
authors.initials: KJ
authors.lastname: Yost
authors.forename: D
authors.initials: D
authors.lastname: Cella
authors.forename: A
authors.initials: A
authors.lastname: Chawla
authors.forename: E
authors.initials: E
authors.lastname: Holmgren
authors.forename: D T
authors.initials: DT
authors.lastname: Eton
authors.forename: J Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: D W
authors.initials: DW
authors.lastname: West
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000628:therapy*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab