Specific HRQL instruments and symptom scores were more responsive than preference-based generic instruments in patients with GERD

Patient-reported outcome measures for primary hyperparathyroidism: a systematic review of measurement properties

BACKGROUND

The quality of patient-reported outcome measures (PROMs) used to assess the outcomes of primary hyperparathyroidism (PHPT), a common endocrine disorder that can negatively affect patients' health-related quality of life due to chronic symptoms, has not been rigorously examined. This systematic review aimed to summarize and evaluate evidence on the measurement properties of PROMs used in adult patients with PHPT, and to provide recommendations for appropriate measure selection.

METHODS

After PROSPERO registration (CRD42023438287), Medline, EMBASE, CINAHL Complete, Web of Science, PsycINFO, and Cochrane Trials were searched for full-text articles in English investigating PROM development, pilot studies, or evaluation of at least one PROM measurement property in adult patients with any clinical form of PHPT. Two reviewers independently identified studies for inclusion and conducted the review following the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) Methodology to assess risk of bias, evaluate the quality of measurement properties, and grade the certainty of evidence.

RESULTS

From 4989 records, nine PROM development or validation studies were identified for three PROMs: the SF-36, PAS, and PHPQoL. Though the PAS demonstrated sufficient test-retest reliability and convergent validity, and the PHPQoL sufficient test-retest reliability, convergent validity, and responsiveness, the certainty of evidence was low-to-very low due to risk of bias. All three PROMs lacked sufficient evidence for content validity in patients with PHPT.

CONCLUSIONS

Based upon the available evidence, the SF-36, PAS, and PHPQoL cannot currently be recommended for use in research or clinical care, raising important questions about the conclusions of studies using these PROMs. Further validation studies or the development of more relevant PROMs with strong measurement properties for this patient population are needed.

Estimating productivity costs in health economic evaluations: a review of instruments and psychometric evidence

Health economic evaluations (i.e. cost-effectiveness appraisal of an intervention) are useful aids for decision makers responsible for the allocation of scarce healthcare resources. The relevance of including health-related productivity costs (or benefits) in these evaluations is increasingly recognized and, as such, reliable and valid instruments to quantify productivity costs are needed. Over the years, a number of work productivity instruments have emerged in the literature, along with a growing body of psychometric evidence. The overall aim of this paper is to provide a review of available instruments with potential for estimating health-related productivity costs. This included the Health and Labor Questionnaire, Health and Work Performance Questionnaire, Health-Related Productivity Questionnaire Diary, Productivity and Disease Questionnaire, Quantity and Quality method, Stanford Presenteeism Scale 13, Valuation of Lost Productivity, Work and Health Interview, Work Limitations Questionnaire, Work Productivity and Activity Impairment Questionnaire, and Work Productivity Short Inventory. Critical discussions on the instruments' overall strengths and limitations, applicability for health economic evaluations, as well as the methodological quality of existing psychometric evidence were provided. Lastly, a set of reflective questions were proposed for users to consider when selecting an instrument for health economic evaluations.

Comparison of the reliability, responsiveness, and construct validity of 4 different questionnaires for evaluating outcomes after total knee arthroplasty

The study aimed to compare the reliability, responsiveness and construct convergent validity of four questionnaires (Western Ontario and McMaster Universities Osteoarthritis Index, Activities of Daily Living of the Knee Outcome Survey, Oxford Knee Score, and the 12-item Short Form Health Survey) in total knee arthroplasty patients. Seventy-nine patients completed the questionnaires before surgery and 6 months later. The reliability was high for all instruments with intraclass correlation coefficients from 0.81 to 0.96 and SEMs from 6.6% to 28.3% of mean scores. The score changes after surgery were three- to five-fold the instruments' measurement error. The responsiveness was large for all instruments. In conclusion most of the selected instruments were reliable and responsive. It was not possible to clearly identify a "best" or "better" tool and hence all can be considered useful, with the reported psychometric properties serving to guide the choice of instrument for a given purpose.

[Health-related quality of life issues in gastroesophageal reflux disease]

Several studies have reported significant Health-Related Quality of life (HRQOL) impairment in gastroesophageal reflux disease (GERD) patients compared with the general population. The evaluation of quality of life is important as a parameter for the treatment. Because GERD has diverse symptoms such as esophageal and extraesophageal syndromes, HRQOL of GERD should be determined by both disease and non-disease related factors. The purpose is to overview the HRQOL instruments used in the evaluation of GERD, published reports regarding HRQOL in GERD, and the effects of medical treatments on GERD.

Assessment of differences between the modified Cincinnati and International Knee Documentation Committee patient outcome scores: a prospective study

BACKGROUND

Functional outcome questionnaires have become a common part of patient follow-up in the orthopaedic community. The modified Cincinnati Knee Rating System and the International Knee Documentation Committee (IKDC) subjective scale were designed to provide clinicians with information regarding a patient's functional and clinical status after knee surgery.

HYPOTHESIS

The functional outcome data reported on the modified Cincinnati Knee Rating System and the IKDC subjective questionnaire are equivalent.

STUDY DESIGN

Cohort study (diagnosis); Level of evidence, 2.

METHODS

Between 2000 and 2007, all patients with complex knee disorders seen in our orthopaedic clinic were prospectively followed and given simultaneously the modified Cincinnati Knee Rating System and the IKDC subjective questionnaires to report their functional outcomes. The total scores of each instrument were compared at each time of evaluation. As a measure of responsiveness, the standardized response means were calculated. A second within-patient analysis was also performed to determine if the results would be different when looked at by the patient.

RESULTS

There were a total of 130 patients with a total of 444 modified Cincinnati Knee Rating System questionnaires and 462 IKDC subjective complete questionnaires included in the study. Overall total scores on both the modified Cincinnati Knee Rating System and the IKDC subjective questionnaires were equivalent in a population analysis. Overall total scores showed improvement in function over time from preoperative measurement through the 2-year follow-up. The individual patient analysis demonstrated that, for a specific patient, it was possible that up to 34% of the population would report a total score of more than 10 points difference, depending on the scale selected.

CONCLUSION

The modified Cincinnati Knee Rating System and the IKDC subjective rating questionnaires reported by patient population provide similar results. The practitioner who is not performing a population-based study but following individual patients for recovery will find that the individual questionnaires may offer different functional limitations. Individual differences were lost in the population means, with the approximate balance of positive and negative score differences masking the individual patient differences.