Lam Employment Absence and Productivity Scale (LEAPS): Analysis of the minimal clinically important difference (MCID) in patients with major depressive disorder using data from the CAN-BIND-1 study

OBJECTIVES: Major depressive disorder (MDD) is associated with significant impairment in occupational functioning. The Lam Employment Absence and Productivity Scale (LEAPS) is a self-report questionnaire validated for the assessment of work productivity and absenteeism in patients with MDD. Our study objective was to establish a minimal clinically important difference (MCID) for the LEAPS. METHODS: Data from the Canadian Biomarker Integration Network in Depression (CAN-BIND)-1 study was used. CAN-BIND-1 involved participants with MDD treated with escitalopram for 8 weeks (n = 138). Assessments included the LEAPS, Sheehan Disability Scale (SDS), and Quick Inventory of Depressive Symptomatology-Self-Rated (QIDS-SR). The MCID for the LEAPS was calculated using both distribution (value equivalent to half the standard deviation for LEAPS baseline scores) and anchor-based (comparing to the SDS work item) methods. RESULTS: The LEAPS total score was significantly correlated (p < 0.01) with other measures including SDS work item (r = 0.598), SDS total score (r = 0.609), and QIDS-SR (r = 0.678). Using the distribution-based method, the MCID value for LEAPS total score was 3.0 and MCID for LEAPS productivity subscale score was 1.5. Using the anchor-based method, the MCID value for the LEAPS total score was shown to lie between 2.7 and 3.5 and for the LEAPS productivity subscale score between 0.9 and 1.4. CONCLUSIONS: Establishing an MCID is important for determining clinically relevant change in the LEAPS, both for treatment studies and for individual patients in clinical care. For clinical use, the proposed MCID is 3 points for the LEAPS total score and 2 points for the LEAPS productivity subscale score.