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McLaughlin C, Moorman SEH, Yin C, Shankar PR, Davenport MS, Neal CH, Pinsky RW, Pujara AC. Continuity of Radiologists Between Diagnostic Breast Imaging and Image-Guided Breast Biopsy: Impact on Patient-Reported Biopsy Morbidity Experiences. JOURNAL OF BREAST IMAGING 2024; 6:141-148. [PMID: 38170567 DOI: 10.1093/jbi/wbad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To determine whether continuity of care between diagnostic breast imaging and subsequent image-guided breast biopsy could reduce patient-reported biopsy-related morbidity. METHODS This was a prospective, pragmatically randomized, 2-arm health utilities analysis of 200 women undergoing diagnostic breast imaging followed by US- or stereotactic-guided breast biopsy at a single quaternary care center from September 3, 2019, to April 10, 2023. Breast biopsy-naive women with a BI-RADS 4 or 5 finding at diagnostic imaging were randomly scheduled for the typically first available biopsy appointment. One day after biopsy, enrolled patients were administered the Testing Morbidities Index (TMI). The primary outcome was the difference in TMI summary utility scores in patients who did vs did not have the same radiologist perform diagnostic imaging and biopsy. RESULTS Response rates were 63% (100/159) for the different radiologist cohort and 71% (100/140) for the same radiologist cohort; all respondents answered all questions in both arms. Mean time to biopsy was 7 ± 6 days and 10 ± 9 days, and the number of participating radiologists was 11 and 18, respectively. There was no difference in individual measured domains (pain, fear, or anxiety before procedure; pain, embarrassment, fear, or anxiety during procedure; mental or physical impact after procedure; all P >.00625) or in overall patient morbidity (0.83 [95% CI, 0.81-0.85] vs 0.82 [95% CI: 0.80-0.84], P = .66). CONCLUSION Continuity of care between diagnostic breast imaging and image-guided breast biopsy did not affect morbidity associated with breast biopsy, suggesting that patients should be scheduled for the soonest available biopsy appointment rather than waiting for the same radiologist.
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Affiliation(s)
| | | | - Chen Yin
- Inland Imaging, Spokane, WA, USA
| | - Prasad R Shankar
- Michigan Medicine, Department of Radiology, Ann Arbor, MI, USA
- Cleveland Clinic, Imaging Institute, Cleveland, OH, USA
| | | | - Colleen H Neal
- Michigan Medicine, Department of Radiology, Ann Arbor, MI, USA
| | - Renee W Pinsky
- Michigan Medicine, Department of Radiology, Ann Arbor, MI, USA
| | - Akshat C Pujara
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA, USA
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Fazeli S, Snyder BS, Gareen IF, Lehman CD, Khan SA, Romanoff J, Gatsonis CA, Miller KD, Sparano JA, Comstock CE, Wagner LI, Carlos RC. Patient-Reported Testing Burden of Breast Magnetic Resonance Imaging Among Women With Ductal Carcinoma In Situ: An Ancillary Study of the ECOG-ACRIN Cancer Research Group (E4112). JAMA Netw Open 2021; 4:e2129697. [PMID: 34726748 PMCID: PMC8564581 DOI: 10.1001/jamanetworkopen.2021.29697] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE The use of magnetic resonance imaging (MRI) in pretreatment planning of ductal carcinoma in situ (DCIS) remains controversial. Understanding changes in short-term health-related quality of life associated with breast MRI would allow for a more complete comparative effectiveness assessment. OBJECTIVE To assess whether there are changes in patient-reported quality of life associated with breast MRI among women diagnosed with DCIS. DESIGN, SETTING, AND PARTICIPANTS This cohort study was a substudy of a nonrandomized clinical trial conducted at 75 participating US institutions from March 2015 to April 2016. Women recently diagnosed with unilateral DCIS who were eligible for wide local excision and had a diagnostic mammogram within 3 months of study registration were included. A total of 355 women met the eligibility criteria and underwent the study MRI. Data analysis was performed from June 3, 2020, to July 1, 2021. EXPOSURES Participants underwent bilateral breast MRI within 30 days of study registration and before surgery. Information on patient-reported testing burden for breast MRI was collected after MRI and before surgery. MAIN OUTCOMES AND MEASURES The primary outcome of this substudy was the patient-reported testing burden of breast MRI, measured by the Testing Morbidities Index (TMI) summated scale score. The TMI is a 7-item instrument that evaluates the temporary changes in quality of life associated with imaging before, during, and after the test (0 represents the worst possible, 100 the hypothetical ideal test experience). RESULTS Of the 355 women who met the eligibility criteria, 244 (69%) completed both questionnaires and were included in this analysis. The median age was 59 years (range, 34-85 years). The mean MRI TMI summated scale score was 85.9 (95% CI, 84.6-87.3). Of the 244 women, 142 (58%) experienced at least some fear and anxiety before the examination, and 120 women (49%) experienced fear and anxiety during the examination. A total of 156 women (64%) experienced pain or discomfort during the examination. In multivariable analyses, greater test-related burden was associated with higher levels of cancer worry (regression coefficient, -2.75; SE, 0.94; P = .004). CONCLUSIONS AND RELEVANCE In this cohort study, a clinically meaningful breast MRI testing burden among women with DCIS was revealed that was significantly associated with cancer worry. Understanding the potential quality-of-life reduction associated with MRI, especially when used in combination with mammography, may allow development of targeted interventions to improve the patient experience.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Anxiety/psychology
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/psychology
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/psychology
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/psychology
- Clinical Trials as Topic
- Fear/psychology
- Female
- Humans
- Magnetic Resonance Imaging/methods
- Magnetic Resonance Imaging/psychology
- Middle Aged
- Quality of Life/psychology
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Affiliation(s)
- Soudabeh Fazeli
- Department of Radiology, University of California, San Diego
| | - Bradley S. Snyder
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Ilana F. Gareen
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
| | - Constance D. Lehman
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Seema A. Khan
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Justin Romanoff
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Constantine A. Gatsonis
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | | | - Joseph A. Sparano
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | | | - Lynne I. Wagner
- Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, North Carolina
| | - Ruth C. Carlos
- Department of Radiology, University of Michigan, Ann Arbor
- Program for Women’s Health Effectiveness Research, University of Michigan, Ann Arbor
- Institute for Health Policy and Innovation, University of Michigan, Ann Arbor
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Feng YS, Kohlmann T, Janssen MF, Buchholz I. Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res 2021; 30:647-673. [PMID: 33284428 PMCID: PMC7952346 DOI: 10.1007/s11136-020-02688-y] [Citation(s) in RCA: 291] [Impact Index Per Article: 97.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This systematic review summarizes the available published scientific evidence on the psychometric properties of the EQ-5D-5L. METHODS Pre-determined key words and exclusion criteria were used to systematically search publications from 2011 to 2019. Information on study characteristics and psychometric properties were extracted: specifically, EQ-5D-5L distribution (including ceiling and floor), missing values, reliability (test-retest), validity (convergent, known-groups, discriminate) and responsiveness (distribution, anchor-based). EQ-5D-5L index value means, ceiling and correlation coefficients (convergent validity) were pooled across the studies using random-effects models. RESULTS Of the 889 identified publications, 99 were included for review, representing 32 countries. Musculoskeletal/orthopedic problems and cancer (n = 8 each) were most often studied. Most papers found missing values (17 of 17 papers) and floor effects (43 of 48 papers) to be unproblematic. While the index was found to be reliable (9 of 9 papers), individual dimensions exhibited instability over time. Index values and dimensions demonstrated moderate to strong correlations with global health measures, other multi-attribute utility instruments, physical/functional health, pain, activities of daily living, and clinical/biological measures. The instrument was not correlated with life satisfaction and cognition/communication measures. Responsiveness was addressed by 15 studies, finding moderate effect sizes when confined to studied subgroups with improvements in health. CONCLUSIONS The EQ-5D-5L exhibits excellent psychometric properties across a broad range of populations, conditions and settings. Rigorous exploration of its responsiveness is needed.
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Affiliation(s)
- You-Shan Feng
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany.
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Silcherstraße 5, 72076, Tübingen, Germany.
| | - Thomas Kohlmann
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany
| | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Erasmus University, Rotterdam, The Netherlands
| | - Ines Buchholz
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany
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Gorin MA, Meyer AR, Zimmerman M, Harb R, Joice GA, Schwen ZR, Allaf ME. Transperineal prostate biopsy with cognitive magnetic resonance imaging/biplanar ultrasound fusion: description of technique and early results. World J Urol 2019; 38:1943-1949. [PMID: 31679065 DOI: 10.1007/s00345-019-02992-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 10/18/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To describe our technique and early results performing transperineal prostate biopsy using cognitive magnetic resonance imaging (MRI)/biplanar ultrasound fusion. Key components of this technique include use of the PrecisionPoint Transperineal Access System (Perineologic, Cumberland, MD) and simultaneous transrectal ultrasound guidance in the axial and sagittal planes. PATIENTS AND METHODS In total, 95 patients (38 studied retrospectively and 57 studied prospectively) underwent a transperineal MRI-targeted prostate biopsy using the technique detailed in this manuscript. All biopsies were performed by a single urologist (MAG). Data were collected with respect to cancer detection rates, tolerability, and complications. The subset of patients who were studied prospectively was assessed for complications by telephone interviews performed at 4-6 days and 25-31 days following the prostate biopsy. RESULTS Between February 2018 and June 2019, 95 men underwent a transperineal prostate biopsy using MRI/biplanar ultrasound fusion guidance. Patients had a total of 124 PI-RADS 3-5 lesions that were targeted for biopsy. In total, 108 (87.1%) lesions were found to harbor prostate cancer of any grade. Grade group ≥ 2 prostate cancer was found in 81 (65.3%) of targeted lesions. The detection rates for grade group ≥ 1 and grade group ≥ 2 prostate cancer rose with increasing PI-RADS score. In 65 (68.4%) cases, the patient's highest grade prostate cancer was found within an MRI target. Additionally, 12 of 55 (21.8%) patients who were found to have no or grade group 1 prostate cancer on systematic biopsy were upgraded to grade group ≥ 2 prostate cancer with MRI targeting. Only 1 (1.1%) patient received periprocedural antibiotics and no patient experienced an infectious complication. Self-limited hematuria and hematospermia were commonly reported following the procedure (75.4% and 40.4%, respectively) and only 1 (1.1%) patient developed urinary retention. CONCLUSIONS We demonstrate the safety and feasibility of performing transperineal prostate biopsy using cognitive MRI/biplanar ultrasound fusion guidance. The described technique affords the safety benefits of the transperineal approach as well as obviates the need for a formal fusion platform. Additionally, this method can conveniently be performed under local anesthesia with acceptable tolerability.
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Temporary Health Impact of Prostate MRI and Transrectal Prostate Biopsy in Active Surveillance Prostate Cancer Patients. J Am Coll Radiol 2019; 16:1385-1392. [PMID: 30733160 DOI: 10.1016/j.jacr.2018.11.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/12/2018] [Accepted: 11/22/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE To assess the temporary health impact of prostate multiparametric MRI (mpMRI) and transrectal prostate biopsy in an active surveillance prostate cancer population. METHODS A two-arm institutional review board-approved HIPAA-compliant prospective observational patient-reported outcomes study was performed from November 2017 to July 2018. Inclusion criteria were men with Gleason 6 prostate cancer in active surveillance undergoing either prostate mpMRI or transrectal prostate biopsy. A survey instrument was constructed using validated metrics in consultation with the local patient- and family-centered care organization. Study subjects were recruited at the time of diagnostic testing and completed the instrument by phone 24 to 72 hours after testing. The primary outcome measure was summary testing-related quality of life (summary utility score), derived from the testing morbidities index (TMI) (scale: 0 = death and 1 = perfect health). TMI is stratified into seven domains, with each domain scored from 1 (no health impact) to 5 (extreme health impact). Testing-related quality-of-life measures in the two cohorts were compared with Mann-Whitney U test. RESULTS In all, 122 subjects were recruited, and 90% (110 of 122 [MRI 55 of 60, biopsy 55 of 62]) successfully completed the survey instrument. The temporary quality-of-life impact of transrectal biopsy was significantly greater than that of prostate mpMRI (0.82, 95% confidence interval [CI] 0.79-0.85, versus 0.95, 95% CI 0.94-0.97; P < .001). The largest mean domain-level difference was for intraprocedural pain (transrectal biopsy 2.6, 95% CI 2.4-2.8, versus mpMRI 1.3, 95% CI 1.1-1.5; P < .001). CONCLUSION Transrectal prostate biopsy has greater temporary health impact (lower testing-related quality-of-life measure) than prostate mpMRI.
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Shankar PR, Davenport MS, Woolen SA, Carlos RC, Maturen KE. Survey Research: A Primer for the Academic Radiologist. Acad Radiol 2018; 25:751-756. [PMID: 29555571 DOI: 10.1016/j.acra.2018.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 02/04/2018] [Accepted: 02/08/2018] [Indexed: 11/30/2022]
Abstract
Survey research is appealing to many clinical researchers, including radiologists. Emerging interest in patient preferences and patient-centered outcomes related to imaging likely will stimulate additional use of questionnaires in our field. However, like other quantitative methods, survey-based research requires meticulous planning, execution, and analysis to generate reliable results and support meaningful conclusions. The purpose of this review is to provide a guideline for radiologists embarking on this type of research, with attention to questionnaire design, sampling, survey administration, and analysis.
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Affiliation(s)
- Prasad R Shankar
- Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109; Michigan Radiology Quality Collaborative, Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109.
| | - Matthew S Davenport
- Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109; Michigan Radiology Quality Collaborative, Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109
| | - Sean A Woolen
- Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109; Michigan Radiology Quality Collaborative, Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109
| | - Ruth C Carlos
- Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109
| | - Katherine E Maturen
- Department of Radiology, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI 48109
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Sakala MD, Carlos RC, Mendiratta-Lala M, Quint EH, Maturen KE. Understanding Patient Preference in Female Pelvic Imaging: Transvaginal Ultrasound and MRI. Acad Radiol 2018; 25:439-444. [PMID: 29241597 DOI: 10.1016/j.acra.2017.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/07/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
Abstract
RATIONALE AND OBJECTIVES Women with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity. MATERIALS AND METHODS Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included. A phone questionnaire used validated survey instruments including Uterine Fibroid Symptoms Quality of Life index, Testing Morbidities Index, and Wait Trade Off for TVUS and MRI examinations. RESULTS Using Wait Trade Off, patients preferred TVUS over MRI (3.58 vs 2.80 weeks, 95% confidence interval [CI] -1.63, 0.12; P = .08). Summary test utility of Testing Morbidities Index for MRI was worse than for TVUS (81.64 vs 87.42, 95%CI 0.41, 11.15; P = .03). Patients reported greater embarrassment during TVUS than during MRI (P <.0001), but greater fear and anxiety both before (P <.0001) and during (P <.001) MRI, and greater mental (P = .02) and physical (P = .02) problems after MRI versus TVUS. Subscale correlations showed physically inactive women rated TVUS more negatively (R = -0.32, P = .03), whereas women with more severe symptoms of loss of control of health (R = -0.28, P = .04) and sexual dysfunction (R = -0.30, P = .03) rated MRI more negatively. CONCLUSION Women with pelvic symptoms had a slight but significant preference for TVUS over MRI. Identifying specific distressing aspects of each test and patient factors contributing to negative perceptions can direct improvement in both test environment and patient preparation. Improved patient experience may increase imaging value.
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Woolen S, Kazerooni EA, Wall A, Parent K, Cahalan S, Alameddine M, Davenport MS. Waiting for Radiology Test Results: Patient Expectations and Emotional Disutility. J Am Coll Radiol 2018; 15:274-281. [DOI: 10.1016/j.jacr.2017.09.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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Patient-Centered Assessment of the Value of Oral Contrast Material. J Am Coll Radiol 2017; 14:1626-1631. [DOI: 10.1016/j.jacr.2017.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/07/2017] [Accepted: 06/27/2017] [Indexed: 11/20/2022]
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Swan JS, Furtado VF, Keller LA, Lotti JB, Saltalamacchia CA, Lennes IT, Salazar GM. Pilot Study of a Patient-Centered Radiology Process Model. J Am Coll Radiol 2016; 14:274-281. [PMID: 27927589 DOI: 10.1016/j.jacr.2016.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The Radiology Process Model (RPM) was previously described in terms of its conceptual basis and proposed survey items. The current study describes the first pilot application of the RPM in the field and the results of initial psychometric analysis. METHODS We used an Institutional Review Board-approved pilot RPM survey in 100 patients having outpatient interventional radiology procedures. The 24 survey items had 4 or 5 levels of severity. We assessed for missing data, items that patients found confusing, any suggestions by patients for additional items and clarity of items from patient feedback. Factor analysis was performed and internal consistency measured. Construct validity was assessed by correlation of patient responses to the items as a summated scale with a visual analog scale (VAS) they completed indicating their interventional radiology experience. RESULTS The visual analog scale and the RPM summated scale were strongly correlated (r = 0.7). Factor analysis showed four factors: interactions with facility and doctors/staff, time-sensitive aspects, pain, and anxiety. The items showed high internal consistency (alpha: 0.86) as a group and approximately 0.7 to 0.9 by the factors. Analysis shows that two items could be deleted (cost and communication between radiologist and referrers). Revision of two items and potential addition of others are discussed. CONCLUSIONS The RPM shows initial evidence of psychometric validity and internal consistency reliability. Minor changes are anticipated before wider use.
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Affiliation(s)
- J Shannon Swan
- Massachusetts General Hospital (MGH) Institute for Technology Assessment, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | | | - Lisa A Keller
- Department of Educational Policy, Research & Administration, University of Massachusetts, Amherst, Massachusetts
| | | | | | - Inga T Lennes
- Harvard Medical School, Boston, Massachusetts; MGH Cancer Center, Boston, Massachusetts
| | - Gloria M Salazar
- Harvard Medical School, Boston, Massachusetts; MGH Imaging, Boston, Massachusetts
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Swan JS, Pandharipande PV, Salazar GM. Developing a Patient-Centered Radiology Process Model. J Am Coll Radiol 2016; 13:510-6. [DOI: 10.1016/j.jacr.2015.11.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/20/2015] [Accepted: 11/20/2015] [Indexed: 11/25/2022]
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Golicki D, Niewada M, Karlińska A, Buczek J, Kobayashi A, Janssen MF, Pickard AS. Comparing responsiveness of the EQ-5D-5L, EQ-5D-3L and EQ VAS in stroke patients. Qual Life Res 2015; 24:1555-63. [PMID: 25425288 PMCID: PMC4457098 DOI: 10.1007/s11136-014-0873-7] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2014] [Indexed: 11/25/2022]
Abstract
AIMS To date, evidence to support the construct validity of the EQ-5D-5L has primarily focused on cross-sectional data. The aims of this study were to examine the responsiveness of EQ-5D-5L in patients with stroke and to compare it with responsiveness of EQ-5D-3L and visual analogue scale (EQ VAS). METHODS We performed an observational longitudinal cohort study of patients with stroke. At 1 week and 4 months post-stroke, patients were assessed with modified Rankin Scale (mRS) and Barthel Index (BI) and were administered the EQ-5D-5L and EQ-5D-3L, including the EQ VAS. The EQ-5D-5L index scores were derived using the crosswalk methodology developed by the EuroQol Group. We classified patients according to two external criteria, based on mRS or BI, into 3 categories: 'improvement,' 'stable' or 'deterioration'. We assessed the responsiveness of each measure in each patient subgroup using: effect size (ES), standardized response mean (SRM), F-statistic, relative efficiency and area under the receiver operating characteristic curve. RESULTS A total of 112 patients (52% females; mean age 70.6 years; 93% ischemic stroke) completed all the instruments at both occasions. In subjects with clinical improvement, EQ-5D-5L was consistently responsive, showing moderate ES (0.51-0.71) and moderate to large SRM (0.69-0.86). In general, EQ-5D-3L index appeared to be more responsive (ES 0.63-0.82; SRM 0.77-1.06) and EQ VAS less responsive (ES 0.51-0.65; SRM 0.59-0.69) than EQ-5D-5L index. CONCLUSIONS The EQ-5D-5L index, based on the crosswalk value set, seems to be appropriately responsive in patients with stroke, 4 months after disease onset. As far as EQ-5D-5L index is scored according to crosswalk approach, the EQ-5D-3L index appears to be more responsive in stroke population.
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Affiliation(s)
- Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1B St., 02-097 Warsaw, Poland
| | - Maciej Niewada
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1B St., 02-097 Warsaw, Poland
| | - Anna Karlińska
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Jana III Sobieskiego 9 St, 02-957 Warsaw, Poland
| | - Julia Buczek
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Jana III Sobieskiego 9 St, 02-957 Warsaw, Poland
| | - Adam Kobayashi
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Jana III Sobieskiego 9 St, 02-957 Warsaw, Poland
| | - M. F. Janssen
- Department of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - A. Simon Pickard
- Department of Pharmacy Systems, Outcomes, and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood St, Chicago, IL MC886 USA
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Comparing Morbidities of Testing With a New Index: Screening Colonoscopy Versus Core-Needle Breast Biopsy. J Am Coll Radiol 2015; 12:295-301. [DOI: 10.1016/j.jacr.2014.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/21/2014] [Indexed: 11/17/2022]
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Conner-Spady BL, Marshall DA, Bohm E, Dunbar MJ, Loucks L, Khudairy AA, Noseworthy TW. Reliability and validity of the EQ-5D-5L compared to the EQ-5D-3L in patients with osteoarthritis referred for hip and knee replacement. Qual Life Res 2015; 24:1775-84. [DOI: 10.1007/s11136-014-0910-6] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2014] [Indexed: 11/28/2022]
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