Biobehavioral measures as outcomes: A cautionary Tale
Open accessAbstract
This article discusses the use of biobehavioral measures as outcomes for health care intervention studies. Effect size (ES) values for salivary cortisol and observation-based measures of pain and agitation were examined. Effects pre to post treatment were assessed separately for nursing home residents with and without acute psychotic symptoms. This study revealed large positive effects on both pain and agitation measures in the group with acute psychotic symptoms and small-to-medium positive effects on these same measures in the group without acute psychotic symptoms. In both of these groups, the ES values were not consistently positive on the cortisol measures. Prior to determining whether a measure can be used to estimate minimum clinically important differences, it is essential to consider if the biomarker will be responsive to therapy in the populations and contexts being studied. [[Res Gerontol Nurs. 2014; 7(2):56–65.]
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Concerns have been raised about the salivary cortisol biomarker's long-term stability over spans exceeding one month and its short-term reliability in the context of day-to-day state effects, non-compliance, and other factors.
“Moreover, concerns have been raised about the biomarker’s long-term stability over spans exceeding one month and its short-term reliability in the context of day-to-day state effects, non-compliance, and other factors [33,34,35,36].”
From The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders (2023) · cites this paper as [36]
Methods > Measures and Procedures (page unavailable) identifies acute stress, incorrect sampling time, and improper sample handling as factors that can add variability to salivary cortisol measurements. The copy does not establish concerns about the biomarker’s stability over periods exceeding one month or specifically discuss day-to-day reliability or non-compliance; a background passage concerns sample storage for up to two weeks, not long-term biomarker stability. (LLM, conf=0.84)
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The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders
Knezevic, E., Nenic, K., Milanovic, V., & Knezevic, N. N. (2023) · Cells · doi:10.3390/cells12232726 · Cited by 564 · see citing works
“Moreover, concerns have been raised about the biomarker’s long-term stability over spans exceeding one month and its short-term reliability in the context of day-to-day state effects, non-compliance, and other factors [33–36].”
Background
- Authors
- Kovach, C. R., Woods, D. L., Devine, E. C., Logan, B. R., & Raff, H.
- Affiliations
- Medical College of Wisconsin (US)
- Venue
- Research in Gerontological Nursing
- Publisher
- SLACK, Inc.
- Published
- 2014-03
- Volume
- 7
- Issue
- 2
- Pages
- 56-65
- ISSN
- 1938-2464 (ISSN-L)
- 1940-4921
- PMC
- PMC3965632
- OpenAlex
- W2058546066
- Semantic Scholar
- 72aa051403e1a4ba45691e17899a968692ab7276
- Cited by
- 4
- References
- 69
- Citations by year
- 2023: 1 · 2022: 1 · 2016: 2
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Research in Gerontological Nursing (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health
- National Institute of Nursing Research (5R01NR07765, R01NR007765, P20NR010674)
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- outcome measures, salivary cortisol, pain, agitation, nursing home residents, effect size, minimal clinically important difference
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Female, Humans, Hydrocortisone, Nursing Homes, Pain Measurement, Psychomotor Agitation, Biomarkers, Outcome Assessment, Health Care, Observation, Pain Management
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