The minimally important difference of the Gastrointestinal Quality of Life Index for symptomatic gallstone surgery

An examination of rectal prolapse surgery patients' quality of life and symptoms using patient-reported outcome instruments: A prospective cohort study

BACKGROUND

We measured changes in self-reported health and symptoms attributable to rectal prolapse surgery using patient-reported outcome (PRO) measures.

METHODS

A prospectively recruited cohort of patients scheduled for rectal prolapse repair in Vancouver, Canada between 2013 and 2021 were surveyed before and 6-months after surgery using seven PROs: the EuroQol Five-Dimension Instrument (EQ-5D-5L), Generalized Anxiety Disorder Scale (GAD-7), Pain Intensity, Interference with Enjoyment of Life and General Activity (PEG), Patient Health Questionnaire (PHQ-9), Fecal Incontinence Severity Index (FISI), Gastrointestinal Quality of Life Index (GIQLI), and the Fecal Incontinence Quality of Life Scale (FIQL).

RESULTS

We included 46 participants who reported improvements in health status (EQ-5D-5L; p ​< ​0.01), pain interference (PEG; p ​< ​0.01), depressive symptoms (PHQ-9; p ​= ​0.01), fecal incontinence severity (FISI; p ​< ​0.01), gastrointestinal quality of life (GIQLI; p ​< ​0.01), and fecal incontinence quality of life (FIQL) related to lifestyle (p ​= ​0.02), coping and behaviour (p ​= ​0.02) and depression and self-perception (p ​= ​0.01).

CONCLUSION

Surgical repair of rectal prolapse improved patients' quality of life with meaningful improvements in fecal incontinence severity and pain, and symptom interference with daily activities.

Health-related quality of life among patients with gallstone disease: a systematic review and meta-analysis of EQ-5D utility scores

PURPOSE

Gallstone disease or cholelithiasis is a chronic illness that usually presents with pain in the abdomen, vomiting and indigestion leading to impaired quality of life. EQ-5D utility score is a validated measure of health-related quality of life (HRQoL). We systematically reviewed the literature and synthesised EQ-5D utility scores among patients with gallstone disease and its improvement on treatment.

METHODS

We have systematically searched observational studies reporting EQ-5D utility scores of gallstone disease in PubMed, Scopus, and Embase databases, from inception until February 2021. We selected the studies adhering to the PRISMA guidelines. The selected studies were reviewed, and the EQ-5D utility values of pre and post cholecystectomy were pooled using the random-effects model.

RESULT

From identified 4,817 records of database search, eleven studies predominantly from western countries with 2,189 participants were included for systematic review and meta-analysis. The pooled EQ-5D and visual analogue scores were 0.87 (0.82 to 0.91, I² = 93.73%) and 83.30 (60.59 to 106.12, I² = 99.30%) respectively with high heterogeneity. The pooled EQ-5D and EQ-5D visual analogue scores post cholecystectomy treatment were 0.93 (0.91 to 0.95, I² = 90.17%) and 91.7 (85.99 to 96.35, I² = 97.93%) respectively. The mean difference between the baseline and post intervention were 0.05 (0.01 to 0.10, I² = 93.50%) and 10.58 (-8.63 to 29.79, I² = 98.32%) for EQ-5D and visual analogue scores respectively with high heterogeneity between the studies.

CONCLUSION

The pooled mean difference indicates improvement in HRQoL after cholecystectomy but with high heterogeneity. Further high-quality studies from Asian countries are required for globally representative quantification and precise estimates of HRQoL among gallstone diseases.

PROSPERO REGISTRATION ID

CRD42021234467.