Sommerlad, Andrew; Livingston, Gillian; (2022) Minimum clinically important difference of the Social Functioning in Dementia Scale (SF-DEM). BMJ Open , 12 (3) , Article e058252. 10.1136/bmjopen-2021-058252.

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Abstract

Objectives: Good social functioning is important for people living with dementia and their families. The Social Functioning in Dementia Scale (SF-DEM) is a valid and reliable instrument measuring social functioning in dementia. However the minimum clinically important difference (MCID) has not yet been derived for SF-DEM. This study aims to define the MCID for the SF-DEM. // Design: We used triangulation, incorporating data from a cross-sectional study to calculate the MCID using distribution-based and anchor-based methods, and a Delphi survey. // Setting and participants: The cross-sectional survey comprised 299 family carers of people with dementia. Twenty dementia experts (researchers, clinicians, family carers) rated whether changes on clinical vignettes represented a meaningful change in the Delphi survey. // Primary outcome measures: We calculated the distribution-based MCID as 0.5 of an SD for each of the three SF-DEM domains (1—spending time with others, 2—communicating with others, 3—sensitivity to others). We used the carers’ rating of social functioning to calculate the anchor-based MCID. For the Delphi survey, we defined consensus as ≥75% agreement. Where there was lack of consensus, experts were asked to complete a further survey round. // Results: We found that 0.5 SD of SF-DEM was 1.9 points, 2.2 and 1.4 points in domains 1, 2 and 3, respectively. Using the anchoring analysis, the MCIDs were 1.7 points, 1.7 points, and 0.9 points in domains 1, 2 and 3, respectively. The Delphi method required two rounds. In the second round, a consensus was reached that a 2-point change was considered significant in all three domains, but no consensus was reached on a 1-point change. // Conclusions: By triangulating all three methods, the SF-DEM’s MCIDs were 1.9, 2.0 and 1.4 points for domains 1, 2 and 3, respectively. For individuals, these values should be rounded to a 2-point change for each domain.

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