Is evidence‐based treatment helping my patient? Utilizing modified Brinley plots to measure clinical change.

Abstract

Using both group (nomothetic) and individual (idiographic) approaches to measuring clinical change may provide more information about the effectiveness of an intervention than either approach alone. The current study re-examined previously published data from two randomized clinical trials of omega-3 fatty acids and Individual-Family Psychoeducational Psychotherapy as treatment for mood disorders in youth, using modified Brinley plots, a method of illustrating individuals' treatment response in the context of group information. Although the original nomothetic approach provided information about the average effect of treatment, modified Brinley plots gave more information about individual children's outcomes. Practicing clinicians in particular could use modified Brinley plots to track treatment trajectories and outcomes for specific clients and subsequently use these data to inform treatment planning. K E Y W O R D S children and adolescents, modified Brinley plots, mood disorders, reliable change index, treatment outcomes 2 of 17 | BLACK et AL.

Where do Brinley plots fit in the toolkit for clinical data visualization?

“…Scatterplots also can map additional variables by changing the size, fill (solid, empty; or different shades or hues), or shape of the point, as Black, Blampied, Arnold, and Fristad (2019) illustrate in their figure 5, denoting which cases had a maternal history of depression. Scatterplots are among the most effective visualizations-they can show all data points, and they provide a visual sense of central tendency and association and indicate potential nonlinear trends and outliers.…”

“…The Brinley plot forces the X and Y axes to use the same scale range (worth noting, because treatment may reduce score ranges, and many software programs will adjust the axis by default to fit the observed data range). Black et al (2019) used accepted conventions as the definitions of moderate mood severity and remission. Dots above the diagonal indicate worsening, and dots below the diagonal connote improvement.…”

“…Dots above the diagonal indicate worsening, and dots below the diagonal connote improvement. If these benchmarks were available, then it would be easy to use them in Black et al's (2019) modified plot: there would be three horizontal lines instead of one. Black et al (2019) modify the original Brinley plot by adding three nomothetic pieces of information.…”

Modified Brinley plots: Advantages and disadvantages.

“…The authors present several modified Brinley plots depicting data from two previously published clinical trials (Black et al, 2019). Most of these plots offer an innovative method of visualizing pre-/post-treatment data.…”

“…The authors explain that time-series visualization is possible with modified Brinley plots (figure 11; Black et al, 2019), but involves plotting change from baseline to each session as separate points on a vertical axis for each participant. This is primarily because more traditional idiographic approaches employ time-series analyses and obtain a great deal of value from visualizing clinical data along a temporal x-axis.…”