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Yuan W, Chen M, Chen Y, Xu D, Li Z, Bai H, Xu Q, Jiang Y, Gu J, Li S, Su C, Gu L, Fang J, Zhu X, Sun J, Chen J. Effects of soy protein-rich meals on muscle health of older adults in long-term care: A randomized clinical trial. Nutrition 2024; 126:112507. [PMID: 39003895 DOI: 10.1016/j.nut.2024.112507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 05/09/2024] [Accepted: 05/30/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE This study investigated the effects of a soy protein-rich meal intervention on the muscle health of older adults in long-term care facilities. METHODS A 12-week single-center randomized controlled trial with a control-group and open-label design was conducted. Eighty-four older adults from a long-term care facility participated in the study. The chefs at the facility cooked three meals using soy protein-rich recipes designed by dieticians. For 12 weeks, the intervention group participants consumed three meals with 30 g of soy protein (10 g/meal) per day, and the control group participants maintained their habitual diets. RESULTS The 84 participants (mean age, 84.9 ± 7.0 years; 61.9% female) were randomly assigned to an intervention group (43 participants) and a control group (41 participants). The intervention group exhibited significant increases in several lean mass indicators, namely soft lean mass (mean, 1.43 kg; 95% confidence interval [CI]: 0.20-1.65 kg), skeletal muscle mass (mean, 1.20 kg; 95% CI: 0.43-1.96 kg), appendicular skeletal muscle mass (mean, 0.79 kg; 95% CI: 0.07-1.52 kg), and skeletal muscle index (mean, 0.37 kg/m2; 95% CI: 0.05-0.68 kg/m2) (all P < 0.05). These changes were not observed in the control group (all P > 0.05). Notably, calf circumference decreased significantly in the control group (mean, -0.98 cm; 95% CI: -1.61 to -0.36 cm) but was maintained in the intervention group. The differences in the calf circumference and 6-m walk performance of the two groups were significant (P < 0.05). CONCLUSIONS The 12-week soy protein-rich meal intervention improved the muscle mass and 6-m walk performance of older adults in a long-term care facility.
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Affiliation(s)
- Wuke Yuan
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China; School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China; School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Chen
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Yanqiu Chen
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Danfeng Xu
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Zhen Li
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Huijing Bai
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China
| | - Qi Xu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanrong Jiang
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Jie Gu
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Shengqi Li
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Chenxi Su
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | - Lili Gu
- Shanghai XiJiao Union Retirement Center, Shanghai, China
| | - Jiaxin Fang
- Shanghai XiJiao Union Retirement Center, Shanghai, China
| | - Xinyao Zhu
- Shanghai XiJiao Union Retirement Center, Shanghai, China
| | - Jianqin Sun
- Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China; Clinical Nutrition Center, Fudan University Affiliated to Hua Dong Hospital, Shanghai, China.
| | - Jie Chen
- Shanghai Elderly Nutrition and Health Quality Control Center, Shanghai, China; Department of Geriatrics, Fudan University Affiliated to HuaDong Hospital, Shanghai, China
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Cao Y, Xu J, Norman R, King MT, Kemmler G, Huang W, Luo N. Chinese utility weights for the EORTC cancer-specific utility instrument QLU-C10D. Qual Life Res 2024:10.1007/s11136-024-03776-z. [PMID: 39269580 DOI: 10.1007/s11136-024-03776-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE The aim of this study is to provide Chinese utility weights for the European Organization for Research and Treatment of Cancer Quality of Life Utility Measure-Core 10 Dimensions (EORTC QLU-C10D) which is a preference-based cancer-specific utility instrument derived from the EORTC QLQ-C30. METHODS We conducted an online survey of the general population in China, with quota sampling for age and gender. Each respondent was asked to complete a discrete choice experimental survey consisting of 16 randomly selected choice sets. The conditional logit model and mixed logit model were used to analyze respondents' preferences, and the goodness of fit of the model was tested. RESULTS A total of 2003 respondents were included in the analysis. Utility decrements within dimensions were typically monotonic. Monotonic inconsistency issues in the Fatigue, Sleep, and Nausea dimensions were normalized by monotonicity correction. Physical functioning, Pain, and Role functioning were associated with the greatest utility weights, with the smallest decrements being in Bowel problems and Emotional functioning. The utility value for the worst health state was 0.083, i.e. slightly higher than being dead. CONCLUSIONS This study provides the first China-specific set of value for the QLU-C10D based on societal preferences of the Chinese adult general population. The value set can be used as a cancer-specific scoring system for economic evaluations of new oncology therapies and technologies in China.
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Affiliation(s)
- Yiyin Cao
- School of Health Management, Harbin Medical University, Harbin, China
| | - Juan Xu
- School of Health Management, Harbin Medical University, Harbin, China
- Shenzhen Center, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen, China
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Australia
| | - Madeleine T King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, Australia
| | - Georg Kemmler
- Department of Psychiatry 1, Innsbruck Medical University, Innsbruck, Austria
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, China.
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Ding Y, Zhang H, Hu Z, Sun Y, Wang Y, Ding B, Yue G, He Y. Perceived Social Support and Health-Related Quality of Life Among Hypertensive Patients: A Latent Profile Analysis and the Role of Delay Discounting and Living Alone. Risk Manag Healthc Policy 2024; 17:2125-2139. [PMID: 39246592 PMCID: PMC11380862 DOI: 10.2147/rmhp.s476633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 08/27/2024] [Indexed: 09/10/2024] Open
Abstract
Background Improving health-related quality of life (HRQoL) among hypertensive individuals has emerged as a significant public health issue. However, current research has ignored the individual heterogeneity of perceived social support (PSS) among hypertensive patients. The potential mechanism of delay discounting (DD), living alone, and PSS on HRQoL remains unclear, and further exploration is required. Aim This study aimed to ascertain PSS profiles among hypertensive patients and examine the hypotheses that DD mediates the relationship between PSS and HRQoL and that this mediating process is moderated by living alone in hypertensive patients. Methods A cross-sectional study was carried out in Jiangsu, China. In total, 1815 hypertensive patients completed socio-demographic and HRQoL questionnaires, a PSS scale, and a DD task. Data analyses included a latent profile analysis, χ2-test, Spearman correlation analysis, and PROCESS macro for regression analysis. Results Four potential PSS profiles were identified: lowest (3.2%), moderate-low (26.6%), moderate-high (42.4%), and highest (27.8%). DD mediated the association between PSS and HRQoL. The first half of this mediating process was moderated by living alone. Conclusion Our findings indicated that PSS, DD, and living alone significantly influence the HRQoL of individuals with hypertension. Healthcare professionals should consider variations in PSS among hypertensive patients and implement interventions to reduce DD by enhancing PSS, in order to improve the HRQoL of this population.
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Affiliation(s)
- Yueming Ding
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Huiying Zhang
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhiqing Hu
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yanjun Sun
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yiping Wang
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
| | - Baolong Ding
- School of Pharmacy, Nanjing Medical University, Nanjing, People's Republic of China
| | - Guofeng Yue
- School of Health Policy and Management, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuan He
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, People's Republic of China
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Li X, Liu S, Guo Y, Zu H, Xiang H, Yang S, Zhang X, Meng F, Bianba Y, Li J, Liu F, Lei C, Lv J, Yang Q, Fu W, Ye W, Chen J, Gao Y, Wu C, Wang N, Zheng Q, Wang F, Yu J, Wang J, Yang X, Wang X, Liu Y, Zhao X, Wu C, Gou W, Bajaj JS, Wang F, Fu J, Qi X. Detection of minimal hepatic encephalopathy in patients with cirrhosis based on the Stroop-CN model (NCRCID-CHESS 2106): a prospective multicenter study. MedComm (Beijing) 2024; 5:e627. [PMID: 39015557 PMCID: PMC11247336 DOI: 10.1002/mco2.627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 07/18/2024] Open
Abstract
Minimal hepatic encephalopathy (MHE) has a substantial impact on the clinical outcomes and quality of life (QOL) of patients with cirrhosis. However, timely diagnosis and intervention are challenging due to sophisticated diagnostic methods. In this study, 673 healthy controls and 905 patients with cirrhosis were screened, and 660 healthy controls and 757 patients with cirrhosis, divided into the test (292 patients) and validation (465 patients) cohort, were analyzed after screening. A diagnostic model of the Stroop test (Stroop-CN) was constructed by multivariate linear regression based on the results of healthy controls. The prevalence of MHE and the comparison results with psychometric hepatic encephalopathy score through the Stroop-CN model were stable in the test and validation cohorts. Moreover, the prevalence of MHE remained significantly higher in patients with worse disease conditions marked as high Child-Pugh grades and the Model for End-stage Liver Disease and Sodium (MELD-Na) scores in the test and validation cohort. The EuroQol 5-D questionnaire revealed that patients with MHE had a worse QOL than those without MHE both in the test and validation cohort. In conclusion, an easy and practical Stroop-CN model for MHE diagnosis based on the EncephalApp is established. It is found that a considerable number of Chinese patients with cirrhosis experience MHE, which significantly impacts their QOL.
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Affiliation(s)
- Xiaoyan Li
- Medical School of Chinese PLABeijingChina
- Senior Department of Infectious DiseasesThe Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious DiseasesBeijingChina
| | - Shanghao Liu
- Center of Portal HypertensionDepartment of RadiologyZhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University)NanjingChina
- Basic Medicine Research and Innovation Center of Ministry of EducationZhongda HospitalSoutheast UniversityNanjingChina
- State Key Laboratory of Digital Medical EngineeringNanjingChina
| | - Ying Guo
- Department of HepatologyThe Third People's Hospital of TaiyuanTaiyuanChina
| | - Hongmei Zu
- Department of GastroenterologyThe Fourth People's Hospital of Qinghai ProvinceXiningChina
| | - Huiling Xiang
- Department of Gastroenterology and HepatologyTianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary DiseaseTianjinChina
| | - Shaoqi Yang
- Department of GastroenterologyThe General Hospital of Ningxia Medical UniversityYinchuanChina
| | - Xiaoning Zhang
- Senior Department of Infectious DiseasesThe Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious DiseasesBeijingChina
| | - Fanping Meng
- Senior Department of Infectious DiseasesThe Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious DiseasesBeijingChina
| | - Yangzhen Bianba
- Department of HepatologyThe Third People's Hospital of Tibet Autonomous RegionLhasaChina
| | - Jie Li
- Department of Infectious DiseasesNanjing Drum Tower Hospital, The Affiliated Hospital of Medical SchoolNanjing UniversityNanjingChina
| | - Fei Liu
- Department of Infectious DiseasesHunan Key Laboratory of Viral HepatitisXiangya HospitalCentral South UniversityChangshaChina
| | - Chuang Lei
- Department of Infectious DiseasesThe First People's Hospital of Changde CityChangdeChina
| | - Jiaojian Lv
- Department of Infectious DiseaseLishui City People's HospitalLishuiChina
| | - Qiao‐hua Yang
- Hepatology Department of Infectious Diseases CenterThe First People's Hospital of HuaihuaHuaihuaChina
| | - Wei Fu
- Department of HepatologyShenyang 739 HospitalShenyangChina
| | - Wei Ye
- Liver Cirrhosis Treatment CenterNanjing Hospital Affiliated to Nanjing University of Traditional Chinese MedicineNanjingChina
| | - Jiafang Chen
- Department of GastroenterologyDatong City Fourth People's HospitalDatongChina
| | - Yanjing Gao
- Department of GastroenterologyQilu Hospital of Shandong UniversityJinanChina
| | - Caiyun Wu
- Department of HepatologyThird People′s Hospital of Linfen CityLinfenChina
| | - Ningning Wang
- Department of GastroenterologyThe First Hospital of China Medical UniversityShenyangChina
| | - Qi Zheng
- Department of HepatologyHepatology Research InstituteThe First Affiliated HospitalFujian Medical UniversityFuzhouChina
| | - Fang Wang
- Department of HepatologyShenzhen Third People's Hospital, National Clinical Research Center for Infectious Disease, The Second Affiliated Hospital, School of Medicine, Southern University of Science and TechnologyShenzhenChina
| | - Jiali Yu
- Department of GastroenterologyThe First Affiliated Hospital of Dalian Medical UniversityDalianChina
| | - Jing Wang
- Department of GastroenterologyThe Second Affiliated Hospital of Baotou Medical CollegeBaotouChina
| | - Xiaoting Yang
- Department of GastroenterologyWuzhong People's HospitalWuzhongChina
| | - Xiangmei Wang
- Department of Severe HepatologyMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Yayuan Liu
- Department of GastroenterologyCentral hospital of DandongDandongChina
| | - Xuelan Zhao
- Department of Gastroenterology Liver DiseasesChongqing Public Health Medical CenterChongqingChina
| | - Chenxi Wu
- Liver Disease Diagnosis and Treatment CenterYiyang Fourth People's HospitalYiyangChina
| | - Wei Gou
- Qingdao Sixth People's HospitalQingdaoChina
| | - Jasmohan S. Bajaj
- Division of Gastroenterology, Hepatology and NutritionVirginia Commonwealth University and Central Virginia Veterans Healthcare SystemRichmondVirginiaUSA
| | - Fu‐Sheng Wang
- Medical School of Chinese PLABeijingChina
- Senior Department of Infectious DiseasesThe Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious DiseasesBeijingChina
| | - Junliang Fu
- Medical School of Chinese PLABeijingChina
- Senior Department of Infectious DiseasesThe Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious DiseasesBeijingChina
| | - Xiaolong Qi
- Center of Portal HypertensionDepartment of RadiologyZhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University)NanjingChina
- Basic Medicine Research and Innovation Center of Ministry of EducationZhongda HospitalSoutheast UniversityNanjingChina
- State Key Laboratory of Digital Medical EngineeringNanjingChina
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Fang S, Xu L, Liu J, Zhang X, Li M, Zhang T, Lu M. Self-rated health and health-related quality of life among cancer patients: the serial multiple mediation of anxiety and depression. BMC Psychol 2024; 12:415. [PMID: 39080782 PMCID: PMC11290125 DOI: 10.1186/s40359-024-01919-y] [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: 08/08/2023] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) in cancer patients has attracted increasing attention, which may be associated with self-rated health (SRH), anxiety, and depression. However, limited studies have focused on the mediating role of anxiety and depression in the relationship between SRH and HRQOL among cancer patients. Therefore, this study aims to explore the serial multiple mediating effects of anxiety and depression between SRH and HRQOL in cancer patients. METHODS This cross-sectional study investigated a total of 565 hospitalized cancer patients in Anhui province in China from November 2020 to October 2021. SRH was assessed using a single-item measure, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Socio-demographic and clinical characteristics were analyzed using descriptive statistics. The relationships between SRH, anxiety, depression, and HRQOL were evaluated by Pearson correlation analysis. The serial multiple mediation of anxiety and depression was assessed by SPSS PROCESS macro. RESULTS SRH, anxiety, depression and HRQOL were significantly correlated(P < 0.001). In comparison to the fair SRH, the good SRH exhibited a significantly positive direct effect (Effect = 0.2366, Bootstrap 95%CI: 0.0642 ~ 0.4090) and total effect on HRQOL (Effect = 0.4761, Bootstrap 95%CI: 0.2975 ~ 0.6546). Conversely, the poor SRH demonstrated a significantly negative total effect on HRQOL (Effect= -0.4321, Bootstrap 95%CI: -0.7544~ -0.1099). When considering the fair SRH as the reference group, the poor SRH displayed a negative indirect effect on HRQOL through the single mediation of anxiety (Effect= -0.1058, Bootstrap 95%CI: -0.2217~ -0.0107) and the serial mediation of anxiety and depression (Effect= -0.0528, Bootstrap 95%CI: -0.1233~ -0.0035). Conversely, the good SRH had a positive indirect impact on HRQOL through the single mediation of anxiety (Effect = 0.1153, Bootstrap 95%CI: 0.0583 ~ 0.1900) and depression (Effect = 0.0667, Bootstrap 95%CI: 0.0206 ~ 0.1234), as well as the serial mediation of anxiety and depression (Effect = 0.0575, Bootstrap 95%CI: 0.0192 ~ 0.1030). CONCLUSION SRH can improve HRQOL through the decrease of anxiety and depression in cancer patients. Focusing on SRH would be beneficial for their mental health and HRQOL in cancer patients.
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Affiliation(s)
- Shuowen Fang
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Lingfeng Xu
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Jingsong Liu
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Xinzhou Zhang
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Mimi Li
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China
| | - Tao Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Manman Lu
- School of Health Service Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, Anhui, 230032, China.
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Sun Y, Wang Y, Zhang H, Hu Z, Ma Y, He Y. What Breast Cancer Screening Program do Rural Women Prefer? A Discrete Choice Experiment in Jiangsu, China. THE PATIENT 2024; 17:363-378. [PMID: 38483691 DOI: 10.1007/s40271-024-00684-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Chinese rural women aged 35-64 years are encouraged to complete breast cancer screening (BCS) free of charge. However, it is challenging to reach a satisfying BCS uptake rate. In this study, rural women's preferences and preferences heterogeneity were measured for the development of strategies to enhance participation in BCS. METHODS A cross-sectional survey with a discrete choice experiment (DCE) was conducted via convenience sampling via face-to-face interviews in Jiangsu, China. Six DCE attributes were identified through a systematic literature review; our previous study of Chinese rural women's BCS intentions; a qualitative work involving in-depth interviews with rural women (n = 13), medical staff (n = 4), and health care managers (n = 2); and knowledge of realistic and actionable policy. The D-efficient design was generated using Ngene 1.3.0. A mixed logit model (MXL) in Stata 18.0 was used to estimate the main effect of attribute levels on rural women's preferences. The relative importance and willingness to utilize BCS services (WTU) were also estimated. The heterogeneous preferences were analyzed by a latent class model (LCM). Sociodemographic status was used to predict the characteristics of class membership. The WTU for different classes was also calculated. RESULTS A total of 451 rural women, aged 35-64 years, were recruited. The MXL results revealed that the screening interval (SI) was the most important attribute for rural women with regard to utilizing BCS services, followed by the level of screening, the attitude of medical staff, ways to get knowledge and information, people who recommend screening, and time spent on screening (TSS). Rural women preferred a BCS service with a shorter TSS; access to knowledge and information through multiple approaches; a shorter SI; a recommendation from medical staff or workers from the village or community, and others; the enthusiasm of medical staff; and medical staff with longer tenures in the field. Two classes named "process driven" and "efficiency driven" were identified by the preference heterogeneity analysis of the LCM. CONCLUSION There is a higher uptake of breast cancer screening when services are tailored to women's preferences. The screening interval was the most important attribute for rural women in China with a preference for a yearly screening interval versus longer intervals.
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Affiliation(s)
- Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yiping Wang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Huiying Zhang
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yuhao Ma
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yuan He
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China.
- School of Marxism, Nanjing Medical University, Nanjing, China.
- School of Nursing, Nanjing Medical University, Nanjing, China.
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, China.
- School of Public Health, Nanjing Medical University, Nanjing, China.
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Ren XQ, Zhao GM, Fang SW, Xu LF, Wang LD, Zhao LH, Lu MM. Mediating roles of activities of daily living and depression on the relationship between sleep quality and health-related quality of life. Sci Rep 2024; 14:14057. [PMID: 38890451 PMCID: PMC11189409 DOI: 10.1038/s41598-024-65095-0] [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: 09/16/2023] [Accepted: 06/17/2024] [Indexed: 06/20/2024] Open
Abstract
This study aimed to explore the mediating effects of ADL and depression on the relationship between sleep quality and HRQOL among older people in rural China, while also exploring the moderating impact of loneliness. The study gathered data from a household survey conducted among 1587 Chinese rural older adults (mean age = 73.63 years). The collected data was analyzed using SPSS version 23.0 software (IBM, New York, USA) and the PROCESS macro version 4.0 program. The findings indicated a significant correlation between sleep quality, ADL, depression, loneliness and HRQOL. ADL and depression exhibited a chain mediation effect on the relationship between sleep quality and HRQOL. Notably, the association between sleep quality and HRQOL was entirely mediated by ADL and depression. Additionally, loneliness acted as a moderator in the relationship between ADL and HRQOL. The findings of this study suggest that interventions focusing on sleep quality should prioritize strategies for enhancing older adults' ADL and depression as integral components of promoting older adults' HRQOL.
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Affiliation(s)
- Xiao-Qing Ren
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Gong-Ming Zhao
- School of Public Health, Fudan University, Shanghai, 200032, China
| | - Shuo-Wen Fang
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Ling-Feng Xu
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Li-Dan Wang
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- Health Policy Research Center, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Lin-Hai Zhao
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- Health Policy Research Center, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Man-Man Lu
- School of Health Management, Anhui Medical University, No.81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- Health Policy Research Center, Anhui Medical University, Hefei, 230032, Anhui, China.
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Li X, Li R, Xiao F, Zhao K, Zhang X, Wang X, Li M, Guo K, Wang L, Wu Y, Van Spall H, Gao T, Fu Q, Xie F. Validation of China Health-Related Outcomes Measures-Cardiovascular Disease. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:490-499. [PMID: 38244982 DOI: 10.1016/j.jval.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES China Health-Related Outcomes Measures (CHROME) was an initiative aimed at developing a system of preference-based health-related quality of life instruments for China. CHROME-cardiovascular disease (CVD) is a CVD-specific instrument with 14 items developed under this initiative. This study aimed to test the psychometric properties of CHROME-CVD. METHODS This validation study was conducted using cross-sectional questionnaire survey in China. Eligible patients with CVD were recruited and asked to complete the CHROME-CVD, the EQ-5D-5L, and a CVD-specific nonpreference-based health-related quality of life instrument selected according to the confirmed diagnosis of the patients. Item evaluation, internal consistency, measurement invariance, test-retest reliability, structural validity, and construct validity were tested using classic test theory. Item response theory was used to evaluate item-level performance. RESULTS A total of 444 patients with CVD (coronary artery disease, n = 276, heart failure, n = 104, angina, n = 33, and atrial fibrillation, n = 16) from 6 provinces in China were enrolled for the validation. Exploratory factor analysis identified 4 factors: chest pain, other symptoms, physical health, and mental and social health. Cronbach's alpha and intraclass correlation coefficient were >0.8. A total of 20 of 26 (76.9%), and 90 of 95 (94.7%) predefined hypotheses were met for convergent and discriminant validities, respectively. No important difference was identified between subgroups of gender and residency. Response options of 10 items were found overlapped based on categorical response curves, which led to modification to 4-level response options. Wording of 3 items were modified by referring wordings of reference instruments. CONCLUSION The validation of the CHROME-CVD demonstrated generally good psychometric properties. Further validation on the modified CHROME-CVD is needed.
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Affiliation(s)
- Xue Li
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Health Technology Assessment, China National Health Development Research Center, Beijing, Beijing, China
| | - Rui Li
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, Beijing, China; Evidence Based Social Science Research Center/Health Technology Assessment Center, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
| | - Feiyi Xiao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, Beijing, China
| | - Kun Zhao
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, Beijing, China
| | - Xiaolu Zhang
- School of Business Administration, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Xinyi Wang
- School of Business Administration, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Meichen Li
- School of Business Administration, Shenyang Pharmaceutical University, Shenyang, Liaoning, China
| | - Ke Guo
- Evidence Based Social Science Research Center/Health Technology Assessment Center, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
| | - Li Wang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Yanan Wu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, Lanzhou University, Lanzhou, Gansu, China
| | - Harriette Van Spall
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Research Institute of St Joseph's and Population Health Research Institute, Hamilton, Ontario, Canada
| | - Tiantian Gao
- Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qiang Fu
- Department of Health Technology Assessment, China National Health Development Research Center, Beijing, Beijing, China; China National Health Development Research Center, Beijing, Beijing, China
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
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Lyu X, Zeng J, Lin J, Song Y, Yang T, Hou W. Validation of the Chinese version of the diabetes health profile to predict the impact of mobile health education on quality of life in type 2 diabetes patients. Front Public Health 2024; 12:1330154. [PMID: 38450133 PMCID: PMC10915233 DOI: 10.3389/fpubh.2024.1330154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024] Open
Abstract
Purpose The Diabetes Health Profile (DHP18), initially created in the United Kingdom, currently lacks a Chinese version. This study endeavors to authenticate the Chinese adaptation of the DHP18 and assess the influence of mobile health (mHealth) education intervention on the quality of life of individuals living with diabetes. Patients and methods The study included 470 Type 2 diabetes Mellitus (T2DM) patients (204 men, 266 women), spanning an age range of 19-79 years, with an average age of 54 ± 12.40 years. Data analysis employed Jamovie and Mplus software. Moreover, test-retest reliability was evaluated in 52 hospitalized T2DM patients through two repeated measurements taken 4 weeks apart. Results The Chinese version DHP18 scale exhibited high reliability, evidenced by a Cronbach's alpha of 0.88, and coefficient of test-retest reliability of 0.84. Individual subscales also demonstrated strong reliability, ranging from 0.76 to 0.84, with test-retest reliability spanning from 0.71 to 0.74. Confirmatory Factor Analysis (CFA) employing a three-factor structure (χ2 = 294.69, GFI = 0.92, TLI = 0.91, RMSEA = 0.05, SRMR = 0.06) validated the scale's construct validity. Notably, there was a statistically significant difference (p < 0.05) in the quality of life between Type 2 diabetes patients using mHealth education intervention and those without mHealth education intervention. Mediation analysis revealed that Appraisal of Diabetes (ADS) and Self-Management Efficacy (SED) mediated the effects of Psychological Distress (PD) and Behavior Adherence (BA) on quality of life, both significant direct and indirect effects (p < 0.001). In addition, Dietary Abstinence (DE) displayed significant overall impact (β = -0.13, p < 0.001) and indirect influence (β = -0.10, p < 0.01) on diabetic patients' quality of life, though lacking a significant direct effect (β = -0.03, p = 0.38). Conclusion The Chinese version of the Diabetes Health Profile Scale meets stringent psychometric standards and stands as an appropriate measurement tool for Chinese T2DM patients, maintaining comparable results to the original scale's structure. The mHealth education intervention yielded a notably positive impact on the quality of life among T2DM patients. Mediation analysis revealed that the three dimensions of the DHP were mediated by Appraisal of Diabetes and Diabetes Self-Management Efficacy, partially mediated by Psychological Distress and Behavior Adherence, and fully mediated by Dietary Abstinence, providing insight into the positive effects of the mHealth model on the quality of life of diabetic patients.
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Affiliation(s)
- Xiaokang Lyu
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Jinmei Zeng
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Jingna Lin
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Yixuan Song
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
| | - Tingting Yang
- Department of Social Psychology, Nankai University, Tianjin, China
| | - Wenjing Hou
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, China
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Sang S, Liao W, Kang N, Wu X, Hu Z, Liu X, Zhang H, Wang C. Health-related quality of life assessed by EQ-5D-5L and its determinants among rural adults: result from the Henan rural cohort study. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:21-30. [PMID: 36715888 DOI: 10.1007/s10198-023-01565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Evidence on the health-related quality of life (HRQoL) among Chinese rural populations and its influence factors were limited. This study aimed to describe the distribution of HRQoL assessed by EQ-5D-5L and its determinants among a Chinese rural population. METHODS A total of 23,510 eligible participants (9542 men and 13,968 women) from the Henan rural cohort study were included. Tobit regression and generalized linear models were performed to investigate the associations between demographic characteristics, lifestyle factors, common chronic diseases, and HRQoL. RESULTS Of all respondents, the most frequently reported problem was pain/discomfort dimension (23.05%), followed by mobility (12.72%), anxiety/depression (7.77%), and usual activities (6.45%), while the least reported was the self-care dimension (3.84%). The more problems reported in all dimensions with age increased except anxiety/depression. The mean (standard deviation) utility index and VAS score were 0.954 (0.111) and 78.34 (14.80), respectively. The regression analysis indicated that increasing age, former drinkers, poor sleep quality, and suffering from common chronic diseases were significantly associated with low HRQoL, while high education level, average monthly income, and physical activity were significantly associated with high HRQoL. CONCLUSION This study described the distribution of HRQoL and its influence factors among the Chinese rural population, which was helpful for medical institutions and policymakers to allocate medical resources and better understand HRQoL among the Chinese rural population.
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Affiliation(s)
- Shengxiang Sang
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Shandong Cancer Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, People's Republic of China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, People's Republic of China
| | - Xueyan Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, People's Republic of China
| | - Ze Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, People's Republic of China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, People's Republic of China
| | - Hongjian Zhang
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, Henan, People's Republic of China.
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Espinosa O, Drummond MF, Orozco LE, Ordóñez A, Sanmartín D, Mora L, Ochalek J. Estimation of Societal Values of Health States Preferences at the National Level for Low- and Middle-Income Countries. Value Health Reg Issues 2024; 39:40-48. [PMID: 37976776 DOI: 10.1016/j.vhri.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/21/2023] [Accepted: 07/24/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Social preference values of health states are a fundamental input for the preparation of studies in health economics. Several countries have undertaken studies to obtain these values. Our objective was to conduct a structured and systematic literature review of articles that calculates this set of representative values at the national level in low- and middle-income countries (LMICs). METHODS In this systematic review, we searched the Embase, MEDLINE, Ovid, SciELO, and LILACS databases, among others, for studies published up to June 2022 that estimated nationally representative health states preferences values for LMICs. We summarized the information qualitatively and assessed the risk of bias in each article using the consensus-based standards for selecting health measurement instruments checklist tool. RESULTS Of the 23 663 articles identified, 35 studies were eligible for inclusion. The studies were from 19 countries in Latin-American, Europe, Africa, and Asia. No studies were found for low-income countries. The most commonly applied generic instrument for measuring health-related quality of life was the 5-level version of EQ-5D and 3-level version of EQ-5D. Preference was given to face-to-face administration of these instruments. The sociodemographic variables with the most significant negative correlation versus utility were older adults, marital status (widowed or divorced), and low educational level and income. CONCLUSIONS Worldwide, there have been few studies that have estimated, in a nationally representative manner, the social values of health states preferences in LMICs. We consider the local estimate of this set of societal values relevant for any society to improve decision making in allocating resources in health budgets.
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Affiliation(s)
- Oscar Espinosa
- Economic Models and Quantitative Methods Research Group (IMEMC), Centro de Investigaciones para el Desarrollo, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
| | | | - Luis-Esteban Orozco
- School of Economics, Universidad de Antioquia, Medellín, Colombia; Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud, Medellín, Colombia
| | - Angélica Ordóñez
- Directorate of Analytical, Economic and Actuarial Studies in Health, Instituto de Evaluación Tecnológica en Salud, Medellín, Colombia
| | - Daysi Sanmartín
- School of Economics, Universidad de Antioquia, Medellín, Colombia
| | - Laura Mora
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Jessica Ochalek
- Centre for Health Economics, University of York, York, England, UK
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Dou L, Shi Z, Cuomu Z, Zhuoga C, Li C, Dawa Z, Li S. Health-related quality of life and its changes of the Tibetan population in China: based on the 2013 and 2018 National Health Services Surveys. BMJ Open 2023; 13:e072854. [PMID: 37984958 PMCID: PMC10660197 DOI: 10.1136/bmjopen-2023-072854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE Health-related quality of life (HRQoL) was an important health outcome measure for evaluating an individual's overall health status. However, there was limited in the literature on HRQoL and its long-term changes of the Tibetan population. This study aimed to assess HRQoL of Tibetan and its changes over time, and explore the differences in HRQoL for residents at different altitudes. DESIGN Data for the cross-sectional study were extracted from the fifth and sixth waves of the National Health Services Surveys which were conducted in 2013 and 2018. A multistage stratified cluster random sampling strategy was used to select representative participants. SETTING Tibet Autonomous Region in China. PARTICIPANTS This study recruited 14 752 participants in 2013 and 13 106 participants in 2018, and after excluding observations with missing values for key variables, 10 247 in 2013 and 6436 in 2018 were included in the study analysis. PRIMARY AND SECONDARY OUTCOME MEASURES The EQ-5D-3L was used to measure participants' HRQoL. RESULTS The mean health state utility scores of the participants were 0.969±0.078 and 0.966±0.077 in 2013 and 2018, respectively. Pain/discomfort was the most frequently prevalent issue reported in 18.1% and 17.9% of the participants in 2013 and 2018, respectively. Tibetans living 3500-4000 m altitude had the best HRQoL. Age, sex, employment status, educational attainment, chronic disease and weekly physical exercise were influencing factors associated with HRQoL. CONCLUSIONS The HRQoL of the Tibetan population was lower than the general Chinese population, and decreased over time between 5 years. There were differences in HRQoL among Tibetan at different altitudes, with residents living at 3500-4000 m having the best quality of life. More attention should be paid to those Tibetans who are older, female, unemployed and without formal education.
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Affiliation(s)
- Lei Dou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
| | - Zhao Shi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
| | - Zhaxi Cuomu
- Medical College of Tibet University, Lhasa, China
- Center of Tibetan Studies (Everest Research Institute), Tibet University, Lhasa, China
| | - Cidan Zhuoga
- Medical College of Tibet University, Lhasa, China
- Center of Tibetan Studies (Everest Research Institute), Tibet University, Lhasa, China
| | - Chaofan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
| | - Zhaxi Dawa
- Medical College of Tibet University, Lhasa, China
- Center of Tibetan Studies (Everest Research Institute), Tibet University, Lhasa, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
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Malik M, Gu NY, Hussain A, Roudijk B, Purba FD. The EQ-5D-3L Valuation Study in Pakistan. PHARMACOECONOMICS - OPEN 2023; 7:963-974. [PMID: 37702988 PMCID: PMC10721573 DOI: 10.1007/s41669-023-00437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND To utilize EQ-5D in economic evaluations, a societal-based value set is needed. To date, no value sets exist for any EQ-5D instrument in Pakistan. Previous EQ-5D studies conducted in Pakistan 'borrowed' health preferences developed in other countries. However, for a value set to be valid for Pakistani population, it should represent the preferences of the Pakistani population, and culture and living standards of Pakistan. OBJECTIVE The aim of this study was to derive a Pakistani EQ-5D-3L value set. METHODS A moderately representative sample aged 18 years and over was recruited from the Pakistani general population. A multi-stage stratified quota method with respect to ethnicity, gender, age and religion was utilized. Two elicitation techniques, the composite time trade-off (cTTO) and discrete choice experiments (DCE) were applied. Interviews were undertaken by trained interviewers using computer-assisted face-to-face interviews with the EuroQol Portable Valuation Technology (EQ-PVT) platform. To estimate the value set, a hybrid regression model combining cTTO and DCE data was used. RESULTS A total of 289 respondents who completed the interviews were included for the analysis. The hybrid model correcting for heteroskedasticity without a constant was selected as the final model for the value set. It is shown that being unable to do usual activities (level 3) was assigned the largest weight, followed by mobility level 3, self-care level 3, pain/discomfort level 3 and anxiety/depression level 3. The worst health state was assigned the value - 0.171 in the final model. CONCLUSIONS A Pakistani country-specific EQ-5D-3L value set is now available. The availability of this value set may help promote and facilitate health economic evaluations and health-related quality-of-life (HRQoL) research in Pakistan.
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Affiliation(s)
- Madeeha Malik
- Cyntax Health Projects, Contract Research Organization (CRO) and Corporate Firm, Islamabad, Pakistan.
| | - Ning Yan Gu
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Azhar Hussain
- Pak-AustriaFachhochschule: Institute of Applied Sciences and Technology, Haripur, Pakistan
| | - Bram Roudijk
- The EuroQol Research Foundation, Rotterdam, The Netherlands
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Yang Y, Wang H, Sha W, Guo X, Deng W, Wang J, Fu C. Short Video-Based Mental Health Intervention for Depressive Symptoms in Junior High School Students: A Cluster Randomized Controlled Trial. Psychol Res Behav Manag 2023; 16:4169-4181. [PMID: 37868654 PMCID: PMC10588807 DOI: 10.2147/prbm.s433467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/06/2023] [Indexed: 10/24/2023] Open
Abstract
Purpose Digital interventions for adolescent mental health are emerging in high-income countries, but have faced challenges and are scarce in China. This study investigated the effect of a short video-based mental health intervention on depressive symptoms in Chinese adolescents. Methods A three-arm cluster randomized controlled trial was conducted in four junior high schools in Shanghai from December 2020 to December 2021 with the measurement at baseline, 6 months after study entry, and 12 months. Outcomes were collected by self-completed questionnaires administered by teachers masked to allocation. The primary outcome was depressive symptoms assessed by the Depression Self-Rating Scale for Children (DSRSC). Mixed effects models were used to compare psychologist-led intervention (n=428 students) and teacher-led intervention (n=385) including six short video-based sessions to usual school provision (n=751). Results Using intention-to-treat analyses, psychologist-led intervention showed more reduction in depressive symptoms compared to usual school provision at 6 months (coefficient -1.00, 95% CI -1.94 to -0.05), but not at 12 months. Using per-protocol analyses among participants who watched at least three video episodes, both psychologist-led (-1.14, -2.20 to -0.09) and teacher-led intervention (-1.23, -2.45 to -0.02) reduced depressive symptoms compared to usual school provision at 6 months, and the effect of teacher-led intervention persisted at 12 months (-1.58, -3.13 to -0.03). Further exploration found that compared with urban students, the between-group differences for depressive symptoms in rural students were more significant (p<0.05 for interaction) and the effects were maintained at 12 months. Conclusion The short video-based mental health intervention showed potential to reduce depressive symptoms among Chinese adolescents, and the effects were more significant if the minimum video viewing frequency was reached.
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Affiliation(s)
- Yuting Yang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Hao Wang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Wen Sha
- Shanghai Municipal Center for Health Promotion, Shanghai, People’s Republic of China
| | - Xiaoqin Guo
- Songjiang District Center for Health Promotion, Shanghai, People’s Republic of China
| | - Wei Deng
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Jingyi Wang
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
| | - Chaowei Fu
- School of Public Health; NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, People’s Republic of China
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Song D, Fan S, Zhou Q, Yang X, Li S, Lohfeld L, Zhou W, Congdon N, Liang Y, Wang N. Impact of primary glaucoma on health-related quality of life in China: the handan eye study. BMC Ophthalmol 2023; 23:377. [PMID: 37710186 PMCID: PMC10503180 DOI: 10.1186/s12886-023-03106-w] [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: 11/29/2022] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND We assessed health-related quality of life (HRQOL) and its determinants among rural glaucoma participants compared to age-matched normal controls in the population-based Handan Eye Study (HES), in rural Yongnian County, northern China. METHODS We enrolled 99 adults with glaucoma (mean age 63.0 ± 11.0 years), including primary open-angle glaucoma (POAG, n = 67) and primary angle-closure glaucoma (PACG, n = 32) and 102 controls (mean age 58.5 ± 5.3 years) with normal visual acuity and visual field and no history of glaucoma. Results of ophthalmic examinations and socioeconomic data were recorded. HRQOL was measured using the EQ-5D (converted to utility valves, UVs), and visual function (VF) and vision-related quality of life (VRQOL) were evaluated using the visual function-quality of life (VF-QOL) instrument. PRIMARY AND SECONDARY OUTCOME MEASURES EQ-5D and VF-QOL scores. RESULTS The mean UVs, VF, and VRQOL scores for glaucoma cases were 0.98 ± 0.04, 87.9 ± 15.2, and 95.5 ± 12.8, respectively, significantly worse than VF (94.4 ± 4.4) and VRQOL (100.0 ± 0.0) among controls, even after adjusting for age, gender, educational level, and family income (P = 0.015, P = 0.033). UVs were significantly lower among glaucoma participants with impaired VRQOL (55.4 ± 11.5) compared to those with normal VRQOL scores (99.1 ± 2.8) (UVs: 0.92 ± 0.08 vs. 0.99 ± 0.03, P = 0.036), also after adjustment for age and family income (P = 0.006). Participants with PACG had significantly lower VF and VRQOL scores compared to POAG (77.8 ± 21.4 vs. 92.9 ± 6.8, P < 0.001; 89.0 ± 18.1 vs. 98.7 ± 7.5, P < 0.001). CONCLUSION Participants with glaucoma have worse visual function and related quality of life compared to age-matched normal population controls. Participants with PACG have lower VF and VRQOL compared to those with POAG. UVs can be used for cost-effectiveness research and to support public health strategies for glaucoma in rural China.
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Affiliation(s)
- Di Song
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teacher College, Huzhou, Zhejiang, China
| | - Sujie Fan
- Handan Eye Hospital, Handan, Hebei, China
| | - Qiang Zhou
- Beijing Chaoyang Hospital, Beijing, China
| | - Xiaohui Yang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Sizhen Li
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Lynne Lohfeld
- Centre for Public Health, Queen's University, Belfast, UK
| | - Weihe Zhou
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University, Belfast, UK
- Orbis International, New York, NY, USA
| | - Yuanbo Liang
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Ningli Wang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Yifan T, Yanling H, Weiyun W, Xiaolin H, Zejuan G, Rong W, Chunhong G. Mediation analysis of activities of daily living and kinesiophobia in association between cardiac function and health status of patients with chronic heart failure. Clin Cardiol 2023; 46:1049-1058. [PMID: 37706605 PMCID: PMC10540005 DOI: 10.1002/clc.24147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
AIMS To explore the mediational effect of activities of daily living (ADL) and kinesiophobia on the cardiac function and health status of patients with chronic heart failure (CHF). METHODS From October 2021 to January 2022, a total of 244 CHF patients treated in the Department of Cardiology of general hospitals were recruited by the convenience sampling method. They were investigated with the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Barthel index for assessing ADL, and the EuroQol five-dimensional questionnaire (EQ-5D) for assessing the health status. RESULTS The cardiac function and kinesiophobia of CHF patients were both negatively correlated with their health status (r = -.390 and -0.410, respectively, both p < .01). Besides, the ADL of CHF patients was positively correlated with the health status (r = .320, p < .01). The cardiac function of CHF patients was negatively correlated with the ADL (r = -.412, p < .01), but positively correlated with kinesiophobia (r = .180, p < .01). The mediation proportion of ADL plus kinesiophobia between the cardiac function and health status of CHF patients was 43.48%. Both ADL and kinesiophobia partially mediated the effect of cardiac function on health status in CHF patients, but their mediational effects showed no significant difference (p = .777). CONCLUSION Both ADL and kinesiophobia exert obvious mediational effects between cardiac function and health status in CHF patients. Individualized cardiac rehabilitation (CR) programs based on the cardiac function, ADL and kinesiophobia of CHF patients may contribute to reduce the medical burden and improve the well-being of affected people.
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Affiliation(s)
- Tang Yifan
- Department of Geriatric CardiologyThe First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsu ProvincePR China
| | - Huang Yanling
- Department of NephrologyThe First Affiliated Hospital, Sun Yat‐sen UniversityGuangdongPR China
| | - Wang Weiyun
- Department of Cardiovascular SurgeryThe First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsuPR China
| | - Hu Xiaolin
- Department of Geriatric CardiologyThe First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsu ProvincePR China
| | - Gu Zejuan
- Secretariat of Party Committee, The First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsuPR China
| | - Wang Rong
- Nursing DepartmentThe First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsuPR China
| | - Gao Chunhong
- Nursing DepartmentThe First Affiliated Hospital with Nanjing Medical UniversityNanjingJiangsuPR China
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Tan J, Chen N, Bai J, Yan P, Ma X, Ren M, Maitland E, Nicholas S, Cheng W, Leng X, Chen C, Wang J. Ambient air pollution and the health-related quality of life of older adults: Evidence from Shandong China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 336:117619. [PMID: 36924708 DOI: 10.1016/j.jenvman.2023.117619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Ambient air pollution is a major public health concern impacting all aspects of human health. There is a lack of studies on the impact of ambient air pollution on health-related quality of life (HRQoL) of older Chinese adults. Our study answers two questions: How concentrations of ambient air pollutants are associated with HRQoL among older adults in China and, second, what are the possible mechanisms through which ambient air pollution affects HRQoL. From the 2018 National Health Service Survey, we sampled 5717 aged 65 years or older residents for the eastern province of Shandong, China. Data on individual exposures to PM2.5 and PM10 (particulate matter with diameter less than or equal to 2.5 μm and 10 μm) and sulfur dioxide (SO2) were collected from the ChinaHighAirPollutants (CHAP) datasets. Mixed-effects Tobit regression models and mixed-effects ordered Probit regression models were employed to examine the associations of long-term exposure to ambient air pollution with the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) scale comprising mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Socioeconomic, demographic and behavioral factors relating to HRQoL were also examined. The results show that for each 1 μg/m3 increase, EQ-5D-3L scores fell 0.002 for PM2.5; 0.001 for PM10 and 0.002 for SO2. Long term exposure to PM2.5, PM10 and SO2 were also associated with increased prevalence of pain/discomfort and anxiety/depression. The reduced HRQoL effects of ambient air pollution were exacerbated by higher socioeconomic status (affluent, urban and higher level of education). Our findings suggested that HRQoL of older Chinese adults was not only associated with demographic, socioeconomic, and health-related factors, but also negatively correlated with air pollution, especially through increased pain/discomfort and anxiety/depression. The paper proposes policy recommendations.
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Affiliation(s)
- Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Nuo Chen
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Jing Bai
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Peizhe Yan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Xinyu Ma
- Economics and Management School, Wuhan University, Wuhan, China
| | - Meiling Ren
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, England, United Kingdom
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, New South Wales, Australia; Newcastle Business School, University of Newcastle, Newcastle, New South Wales, Australia
| | - Wenjing Cheng
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Xue Leng
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Chen Chen
- School of Public Health, Wuhan University, Wuhan, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China; Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Wuhan, China.
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18
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Zhang Y, Li J, Yang L. Health-related quality of life of Chinese patients with chronic kidney disease: a study based on four EQ-5D-3L value sets. Sci Rep 2023; 13:7863. [PMID: 37188868 DOI: 10.1038/s41598-023-35002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
Provide reference data on which EQ-5D-3L value set should be used with Chinese patients with chronic kidney disease (CKD); assess differences in health-related quality of life (HRQoL) based on the use of the Chinese (from 2014 and 2018), the UK, and the Japanese value sets; and examine differences in utility scores for key preventive influencing factors. Data from 373 patients with CKD recruited for a cross-sectional multicenter HRQoL survey were used. Differences among utility scores based on the four value sets were determined using Wilcoxon signed rank test. Intra-class correlation coefficient (ICCs) and Bland-Altman plots were used to evaluate consistency among utility scores and Tobit regression model was used to analyze the influencing factors of utility scores. There were significant differences between utility scores based on the four value sets, with the Chinese 2018 value set yielding the highest utility (0.957). ICCs between the value sets for China 2014, the UK, and Japan were all greater than 0.9, whereas the ICCs between the value sets for China 2018 and the other three were all less than 0.7. The influencing factors of utility scores included CKD stages, age, education level, city, and primary renal disease. This was the first study to report findings on the health utility of patients with CKD based on the two Chinese EQ-5D-3L value sets. Overall, the Chinese value sets performed similarly to the other two value sets (UK and Japan) commonly used in the Chinese population; however, value sets for different countries were not interchangeable. In Chinese contexts, the two value sets for China were recommended and the choice of which one should consider whether the value set of choice was established with a sample that is consistent with the targeted population.
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Affiliation(s)
- Ye Zhang
- Population Development Studies Center, Renmin University of China, Beijing, 100872, People's Republic of China
- School of Sociology and Population Studies, Renmin University of China, Beijing, 100872, People's Republic of China
| | - Jinyue Li
- School of Statistics, Renmin University of China, Beijing, 100872, People's Republic of China
| | - Li Yang
- School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, People's Republic of China.
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19
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Liao M, Luo N, Rand K, Yang Z. Urban/rural differences in preferences for EQ-5D-5L health states: a study of a multi-ethnic region in China. Qual Life Res 2023:10.1007/s11136-023-03394-1. [PMID: 36944783 DOI: 10.1007/s11136-023-03394-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study aimed to compare health preferences for EQ-5D-5L health states between urban and rural populations in China. METHODS This study used pooled secondary data from two EQ-5D-5L valuation studies. Participants were recruited from Guizhou province and Chongqing municipality, China using quota sampling. Each participant was interviewed face-to-face to value a set of 15 or 16 out of 30 EQ-5D-5L health states using time trade-off (TTO) methods including composite TTO and other two variants. Regression analysis was used to compare health state preferences between urban and rural participants. RESULTS A total of 597 participants (urban: 55.44%; rural: 44.56%) completed the valuation interviews. Both univariate and multivariable linear regression analyses showed that rural participants tended to value health states lower than urban participants regardless of severity of health states. The unadjusted and adjusted overall mean differences between the two groups were - 0.041 (95% confidence interval [CI] - 0.077, - 0.004, p-value = 0.031) and - 0.040 (95% CI - 0.078, - 0.002, p-value = 0.038), respectively. Predictions for the 3125 health states based on rural participants' health preferences were lower than those based on urban participants' health preferences. CONCLUSION There were small, yet statistically significant, differences in EQ-5D-5L health states preferences between urban and rural populations in China. Future study aiming at establishing a national value set should pay more attention to the sample representativeness.
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Affiliation(s)
- Meixia Liao
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nan Luo
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Kim Rand
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Maths in Health B.V., Rotterdam, The Netherlands
| | - Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Guiyang, China.
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Quality of life and mortality in older adults with sepsis after one-year follow up: A prospective cohort study demonstrating the significant impact of frailty. Heart Lung 2023; 60:74-80. [PMID: 36931009 DOI: 10.1016/j.hrtlng.2023.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/27/2023] [Accepted: 03/04/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Survivors of sepsis often develop chronic critical illness after the inflammatory stage, resulting in death or hospital readmission. The long-term prognosis of older patients with sepsis and the associated factors, particularly frailty, are not well studied. OBJECTIVES To investigate the effect of frailty on the quality of life (QoL) and mortality in older patients after one year of sepsis diagnosis. METHODS This prospective study included patients admitted to a specialized geriatric intensive care unit between May 2018 and April 2019. Patients were grouped according to the Clinical Frailty Scale as severely frail, mildly to moderately frail, and non-frail/vulnerable. The primary outcome was QoL one year after sepsis diagnosis, measured using the European QoL 5-Dimension (EQ-5D) and 12-item Short Form. The secondary outcome was one-year survival. RESULTS Of the 211 participants, 75 (35.5%) completed the QoL surveys. Of them, 37 (49.3%) did not return to their baseline QoL one year after sepsis diagnosis. The rate of reported mobility problems (a dimension of the EQ-5D) increased by 100% during the year. Additionally, survivors in the severely frail group exhibited poorer QoL at one year than those in the mildly to moderately frail and non-frail/vulnerable groups. The one-year mortality in the severely frail group was 75.9%, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.02-2.82, p = 0.041). CONCLUSIONS Frailty significantly impacts the one-year prognosis in older patients with sepsis. This research highlights the need for frailty management and physical rehabilitation in frail older patients at risk of poor prognosis, with implications for improving transitional and post-acute care services.
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Kalra S, Jiwan T, Singh G, Gautam PL, Bansal A. A Comparison of the Quality of Life of People With Epilepsy Receiving Home-Based and Clinic-Based Epilepsy Care Using the European Quality of Life Five-Dimension Three-Level (EQ-5D-3L) Scale. Cureus 2023; 15:e35045. [PMID: 36938287 PMCID: PMC10023070 DOI: 10.7759/cureus.35045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 02/18/2023] Open
Abstract
Background and objective Epilepsy is a chronic neurological condition that, both physically and psychologically, puts a person at risk for poor quality of life (QOL). People with epilepsy (PWE) may experience shame, fear, and rejection and feel discriminated against, hence avoiding social interactions. To avoid being labeled as having epilepsy, patients may conceal their disease and refuse medical attention, which can lead to treatment discontinuation and significantly impact the quality of life. Epilepsy care in India has fallen back on primary care physicians because there are not enough neurologists available to treat the condition. Home-based care (HBC) may overcome many barriers by providing free antiepileptic drugs (AEDs), eliminating the "distance to a health facility," and providing correct information that may improve QOL. This study is therefore conducted to compare the QOL between people with epilepsy receiving home-based care (HBC) and routine clinic-based care (CBC). Methodology The people with epilepsy enrolled in this study were already part of a community-based randomized controlled trial conducted to compare the effect of regular home-based epilepsy care with routine clinic-based epilepsy care on antiepileptic adherence among urban and peri-urban areas of Ludhiana, Punjab, India (explained further in the study). The present study is a cohort study where the two cohorts, one receiving home-based epilepsy care (n = 97) and the other receiving routine clinic-based epilepsy care (n = 76), were compared for QOL at two points in time, i.e., at baseline (at enrolment) and after 24 months of receiving epilepsy care, using the European Quality of Life Five-Dimension Three-Level (EQ-5D-3L) scale. Results The mean EQ-5D-3L index scores for the HBC group at baseline were 0.88 ± 0.15, and after 24 months, the scores increased to 0.94 ± 0.17. The baseline mean index scores for the CBC group were 0.89 ± 0.21, and after 24 months, the value increased to 0.90 ± 0.19. The mean difference in QOL in the HBC group showed a higher difference than in the CBC group (0.06 ± 0.1 versus 0.01 ± 0.1), but the difference was found to be statistically not significant (p = 0.067). As per the five dimensions of the EQ-5D-3L scale, i.e., mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, there was a decrease in the number of PWE reporting problems among both groups after 24 months of epilepsy care. Sociodemographic and clinical variables such as level of education, working status, age at the onset of seizures, frequency of seizures, treatment regimen, presence of comorbidities, and adverse drug reactions significantly affect the QOL of people with epilepsy at p < 0.05. Conclusion The results of the study emphasize that epilepsy has a negative impact on QOL. The results showed a higher QOL among the people in the HBC group as compared to the CBC group, but the difference was not statistically significant. There was an improvement in QOL from baseline after dedicated care in both groups. The problems related to mobility, self-care, usual activities, pain/discomfort, and anxiety/depression have been significantly reduced in the HBC group. Having low levels of education, not having a job, starting to have seizures at a young age, having seizures more often, receiving more than one type of treatment, and the presence of other health problems and side effects are factors associated with poor QOL among people with epilepsy.
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Affiliation(s)
- Shivani Kalra
- Critical Care, Shaheed Kartar Singh Sarabha (SKSS) College of Nursing, Ludhiana, IND
| | - Triza Jiwan
- Psychiatry and Nursing, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Gagandeep Singh
- Neurology, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Parshotam L Gautam
- Critical Care Medicine, Dayanand Medical College and Hospital, Ludhiana, IND
| | - Amit Bansal
- Gastrointestinal (GI) and Liver Sciences, Satguru Partap Singh (SPS) Hospitals, Ludhiana, IND
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22
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Zhang P, Ge X, Li Z, Nie M, Yu J, Ou W, Wu K, Li J, Wang L, Ni W, Shi Z, Song J, Li S, Dai C. The proGnostic role of caRdiac rehAbilitation in patients with left ventriCular anEurysm formation after anterior myocardial infarction (the GRACE study): Study rationale and design of a prospective randomized controlled trial. Front Cardiovasc Med 2023; 9:991521. [PMID: 36704464 PMCID: PMC9871449 DOI: 10.3389/fcvm.2022.991521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
Background Cardiac rehabilitation (CR) is an essential intervention after acute myocardial infarction (MI). However, it is still unclear whether patients with left ventricular aneurysm (LVA) formation after anterior MI would benefit from CR programs. This clinical trial is designed to assess the role of CR in patients with LVA formation after anterior MI. Trial design The GRACE study is a single-center, single-blind, prospective, randomized controlled clinical trial in China. 100 subjects aged 18-75 years with LVA formation after anterior MI will be recruited and randomized 1:1 to the CR or control group. Both groups will receive standard drug treatment and routine health education according to the guidelines. Participants in the CR group will additionally receive tailored CR programs delivered over a period of 36 sessions. These participants will then be followed up for 1-year. The primary outcome is peak oxygen uptake measured by cardiopulmonary exercise testing after CR programs. The secondary outcomes are cardiac function and EuroQol 5-Dimension-3 Level index scores after CR program and 1-year and major adverse cardiac cerebrovascular events, a composite of cardiovascular mortality, non-fatal MI, non-fatal stroke, malignant arrhythmia or hospitalization for heart failure during the follow-up period. Conclusions This single-center, single-blind, prospective, randomized controlled clinical trial will determine whether CR improves physical capacity and clinical outcomes in patients with LVA formation after anterior MI. Trial registration Chinese Clinical Trial Registry ChiCTR2200058852. Registered on 18 April 2022.
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Affiliation(s)
- Peng Zhang
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xiaofeng Ge
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zhaokai Li
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Meiling Nie
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Jing Yu
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Weimei Ou
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Kaimin Wu
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Jiahua Li
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Lin Wang
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Wei Ni
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Zaixing Shi
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Juan Song
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,*Correspondence: Juan Song ✉
| | - Suiji Li
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Suiji Li ✉
| | - Cuilian Dai
- Department of Cardiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Xiamen Key Laboratory of Cardiovascular Disease, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China,Cuilian Dai ✉
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23
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Xiao J, Wang Q, Tan S, Chen L, Tang B, Huang S, Zhou Y, Xu P. Analysis of patient medication compliance and quality of life of physician-pharmacist collaborative clinics for T2DM management in primary healthcare in China: A mixed-methods study. Front Pharmacol 2023; 14:1098207. [PMID: 37033638 PMCID: PMC10080104 DOI: 10.3389/fphar.2023.1098207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/16/2023] [Indexed: 04/11/2023] Open
Abstract
Background: Physician-pharmacist collaboration is a well-established care mode for the management of type 2 diabetes mellitus (T2DM) in developed countries, but no study has been conducted in primary healthcare in China. This study aims to evaluate the effects of physician-pharmacist collaborative clinics to manage T2DM in primary healthcare in China, and to better understand the factors influencing the implementation of physician-pharmacist collaborative clinics. Methods: Two hundred and sixty-seven patients involved in a 12-month randomized controlled trial were assigned to physician-pharmacist collaborative clinics and usual clinics, completing surveys regarding medication compliance, quality of life (QoL) and care-seeking behavior at the baseline, 3rd, 6th, 9th and 12th month respectively, and diabetes knowledge at baseline and 12th month. A sample of twenty-two Patients, nine physicians and twelve pharmacists participated in semi-structured face-to-face interviews. The quantitative and qualitative data was integrated by triangulation. Results: Patients in physician-pharmacist collaborative clinics had significant improvements in medication compliance (p = 0.009), QoL (p = 0.036) and emergency visits (p = 0.003) over the 12-month. Pairwise comparison showed the medication compliance score in the intervention group had been significantly improved at 3rd month (p = 0.001), which is more rapidly than that in the control group at 9th month (p = 0.030). Factors influencing the implementation of physician-pharmacist collaborative clinics were driven by five themes: pharmaceutical service, team-base care, psychological support, acceptability of care and barriers to implementation. Conclusion: Integration of quantitative and qualitative findings showed the effectiveness of physician-pharmacist collaborative clinics in patient medication compliance and QoL in primary healthcare. The qualitative study uncovered barriers in insufficient clinical experience and understaffing of pharmacist. Therefore, the professional training of the primary pharmacist team should be improved in the future. Clinical Trial Registration: clinicaltrials.gov, identifier ChiCTR2000031839.
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Affiliation(s)
- Jie Xiao
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qing Wang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shenglan Tan
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lei Chen
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Bingjie Tang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shuting Huang
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yangang Zhou
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ping Xu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Ping Xu,
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Hu J, Zhu L, Bao H, Liu Y, Xing H, Kang Q, Jin C. Utility estimations of different health states of patients with type I, II, and III spinal muscular atrophy in China: A mixed approach study with patient and proxy-reported data. Front Public Health 2022; 10:1054931. [PMID: 36605247 PMCID: PMC9809905 DOI: 10.3389/fpubh.2022.1054931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Spinal muscular atrophy (SMA) is a rare autosomal-recessive neuromuscular disease. Health state utility values (HSUV) are used in health economic evaluation regarding the desirability of health outcomes such as a certain health state or change in health states over time. There is no utility data of Chinese patients with SMA. Materials and methods Vignettes were developed for 10 pediatric neurologists to value the utility of Chinese patients with Type I SMA. A mixed patient/proxy derived approach using EQ-5D-Y-3L, EQ-5D-3L, and CHU9D was adopted to estimate the HSUV data of patients with Type II and III SMA, including 112 patients and 301 caregivers. Result The utility of Type I SMA patients ranged from 0.19 to 0.72 with the health state improved from "permanent ventilation" to "walking". The utility of children patients with Type II and III SMA derived from EQ-5D-Y-3L ranged from 0.33 to 0.82 while that derived from CHU9D ranged from 0.46 to 0.75. The utility of adult patients with Type II and III SMA measured by EQ-5D-3L ranged from 0.30 to 0.83. Conclusion The better health states the patients with SMA were in, the higher were the HSUV. The utilities derived from population with different age and disease subtypes were not statistically different when patients with SMA were in the same health states. We recommend further studies on the Chinese specific value set for EQ-5D-Y-3L and other PBMs for children to derive more robust utility data.
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Affiliation(s)
- Jiahao Hu
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China
| | - Lin Zhu
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China
| | - Han Bao
- Institute of Pharmaceutical Economics, Sun Yat-sen University, Guangzhou, China
| | - Yuhan Liu
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China
| | - Huanping Xing
- Meier Advocacy & Support Centre for SMA, Beijing, China
| | - Qi Kang
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China,*Correspondence: Qi Kang
| | - Chunlin Jin
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China,Chunlin Jin
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Jiang D, Yan Y, Zhou H, Wang Q. The association between personal social capital and health-related quality of life among Chinese older people: A cross-sectional study. Front Nutr 2022; 9:995729. [PMID: 36570148 PMCID: PMC9773083 DOI: 10.3389/fnut.2022.995729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background Lower health-related quality of life (HRQoL) can result in adverse effects on the health of older people. This study aims to explore the relationship between personal social capital (PSC) and HRQoL among Chinese elderly people from rural-and-urban perspective. Materials and methods 4,802 samples were included from China's health-related quality of life Survey for Older Adults 2018 (CHRQLS-OA 2018). The PSC, including bonding and bridging social capital (BOC and BRC), was measured by the Chinese version of the Personal Social Capital Scale (PSCS-16). The HRQoL was evaluated by the European Five Dimensions Questionnaire (EQ-5D-3L). Linear and Tobit regression models were conducted to examine the relationship between PSC and HRQoL. Results The BOC and BRC of rural older people were significantly lower than those of urban older people. Pain/discomfort and anxiety/depression were the most significant health problems affecting the older samples. In the five dimensions, the proportion of rural older people with problems was higher than that of urban older people. Among rural older people, BOC was significantly related to self-rated health and EQ-5D utility index (p < 0.05); while BRC was insignificantly associated with self-rated health (p > 0.05) but related to EQ-5D utility index (p < 0.05). Both BOC and BRC were significantly correlated with self-rated health and EQ-5D utility index (p < 0.05) among urban older people. Conclusion Our study reveals older people's worrying PSC and HRQoL status. The relationship between PSC and HRQoL suggested that more social support and care of intimates should be encouraged to increase the PSC of older people, especially rural older people.
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Affiliation(s)
- Dongdong Jiang
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China,School of Public Health, Zhejiang University, Hangzhou, China
| | - Yajie Yan
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China
| | - Han Zhou
- Nanjing Lishui District Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Quan Wang
- Global Health Institute, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Quan Wang,
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Liu Y, Zhang H, Yuan G, Yao M, Li B, Chen J, Fan Y, Mo R, Lai F, Chen X, Li M, Chen B, Lord JM, Peng S, Cheng K, Xiao H. The impact of circadian rhythms on the immune response to influenza vaccination in middle-aged and older adults (IMPROVE): a randomised controlled trial. Immun Ageing 2022; 19:46. [PMID: 36253778 PMCID: PMC9574181 DOI: 10.1186/s12979-022-00304-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Vaccination is important in influenza prevention but the immune response wanes with age. The circadian nature of the immune system suggests that adjusting the time of vaccination may provide an opportunity to improve immunogenicity. Our previous cluster trial in Birmingham suggested differences between morning and afternoon vaccination for some strains in the influenza vaccine in older adults. Whether this effect is also seen in a younger age group with less likelihood of compromised immunity is unknown. We therefore conducted an individual-based randomized controlled trial in Guangzhou to test the hypothesis that influenza vaccination in the morning induces a stronger immune response in older adults than afternoon vaccination. We included adults in middle age to determine if the effect was also seen in younger age groups. RESULTS Of the 418 participants randomised, 389 (93.1%, 191 middle-aged adults aged 50-60 years and 198 older adults aged 65-75 years) were followed up. Overall, there was no significant difference between the antibody titers (geometric mean /95% CI) after morning vs afternoon vaccination (A/H1N1: 39.9 (32.4, 49.1) vs. 33.0 (26.7, 40.7), p = 0.178; A/H3N2: 92.2 (82.8, 102.7) vs. 82.0 (73.8, 91.2), p = 0.091; B: 15.8 (13.9, 17.9) vs. 14.4 (12.8, 16.3), p = 0.092), respectively. However, in pre-specified subgroup analyses, post-vaccination titers for morning versus afternoon vaccination in the 65-75 years subgroup were (A/H1N1): 49.5 (36.7, 66.6) vs. 32.9 (24.7, 43.9), p = 0.050; (A/H3N2): 93.5 (80.6, 108.5) vs. 73.1 (62.9, 84.9), p = 0.021; (B): 16.6 (13.8, 20.1) vs. 14.4 (12.3, 17.0), p = 0.095, respectively. Among females, antibody titers for morning versus afternoon vaccination were (A/H1N1): 46.9 (35.6, 61.8) vs. 31.1 (23.8, 40.7), p = 0.030; (A/H3N2): 96.0 (83.5, 110.3) vs. 84.7 (74.4, 96.5), p = 0.176; (B): 14.8 (12.7, 17.3) vs. 13.0 (11.3, 14.9), p = 0.061, respectively. In the 50-60 years old subgroup and males, there were no significant differences between morning and afternoon vaccination. CONCLUSIONS Morning vaccination may enhance the immunogenicity to influenza vaccine in adults aged over 65 and women. An intervention to modify vaccination programs to vaccinate older individuals in the morning is simple, cost free and feasible in most health systems.
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Affiliation(s)
- Yihao Liu
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.,Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Hui Zhang
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.,Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Gang Yuan
- Phase I Clinical Trial Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China.,Department of Geriatrics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Mi Yao
- Institute of Applied Health Research, University of Birmingham, Public Health Building, Edgbaston, Birmingham, B15 2TT, UK
| | - Bin Li
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Jianying Chen
- Baiyun Street Community Health Service Center, Guangzhou, 510080, People's Republic of China
| | - Yuling Fan
- Shipai Street Community Health Service Center, Guangzhou, 510080, People's Republic of China
| | - Ruohui Mo
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Fenghua Lai
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Xinwen Chen
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China
| | - Mengyuan Li
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Binfeng Chen
- Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Janet M Lord
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre, University Hospital Birmingham and University of Birmingham, Birmingham, UK
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.
| | - KarKeung Cheng
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China. .,Institute of Applied Health Research, University of Birmingham, Public Health Building, Edgbaston, Birmingham, B15 2TT, UK.
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-Sen University, No. 58, ZhongShan Road 2, Guangzhou, Guangdong, 510080, People's Republic of China.
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Sun Y, Ma Y, Cao M, Hu Z, Lin W, Chen M, He Y. Breast and cervical cancer screening adherence in Jiangsu, China: An ecological perspective. Front Public Health 2022; 10:967495. [PMID: 36033808 PMCID: PMC9403787 DOI: 10.3389/fpubh.2022.967495] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/18/2022] [Indexed: 01/25/2023] Open
Abstract
Background High screening coverage can effectively reduce the mortality in breast and cervical cancer. Further research on extending the coverage of breast and cervical cancer screening in China is required. This study explored factors influencing women's "two-cancer" screening service utilization using an ecological approach. Methods Data were obtained from the National Health Services Survey (NHSS) conducted in 2018 in Jiangsu, China. A total of 3,500 women aged 18-64 years were included in the analysis. Chi-squared test, hierarchical multiple logistic regression analysis, and binary logistic regression analysis were performed. Results In total, 44.1% of the women had been screened for breast cancer (BC) and 40.9% for cervical cancer (CC). Breast cancer screening (BCS) and cervical cancer screening (CCS) differed significantly in the following common categories: age, gestational experiences, chronic disease status, body mass index (BMI), exercise, health checkup, marital status, number of children, employment, education, family doctors, and health records. In the results of hierarchical multiple logistic regression analysis, the explanatory power of the final model was 37.5% and the area under the receiver operating characteristic curve was 0.812. The results showed that being in the age group of 35-64 years, having gestational experiences, having chronic diseases, exercising, having a health checkup, being married, having children, and being employed were statistically significant positive predictors of "two-cancer" screening adherence. The household size was a barrier. For BCS, obesity was also a negative factor, and a higher overall self-related health status was a positive factor. Being married and living in households of three or more families were not predictors. For CCS, having health records was also positively significant, while having chronic disease did not influence adherence. Conclusion The findings provide an ecological explanation for women's BCS and CCS service utilization. Both proximal and distal factors should be considered to achieve a high coverage rate.
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Affiliation(s)
- Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yuhao Ma
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Menghan Cao
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Wei Lin
- Department of Students Affairs, Nanjing Medical University, Nanjing, China
| | - Mingsheng Chen
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Yuan He
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, China
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Carter N, Li J, Xu M, Li L, Fan X, Zhu S, Chahal P, Chattopadhyay K. Health-related quality of life of people with type 2 diabetes and its associated factors at a tertiary care clinic in Ningbo, China: A cross-sectional study. Endocrinol Diabetes Metab 2022; 5:e353. [PMID: 35780497 PMCID: PMC9471595 DOI: 10.1002/edm2.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/21/2022] [Accepted: 05/28/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The burden of type 2 diabetes (T2DM) in China is increasing, with potential impacts on the health-related quality of life (HRQoL) of those who develop the disease. Context-specific assessment of HRQoL and its associated factors informs the development of contextually appropriate interventions to improve HRQoL. This study aimed to determine the HRQoL and its associated factors in people with T2DM at a tertiary care clinic in Ningbo, China. METHODS A cross-sectional survey was undertaken among 406 people with T2DM in 2020-21. The primary outcome was HRQoL measured using EQ VAS and EQ-5D index from the EQ-5D-3L questionnaire. Multivariable regression analysis was used to determine the factors associated with HRQoL scores. RESULTS The mean (± standard deviation) EQ VAS score was 68.7 (13.8). Median (interquartile range) EQ-5D index was 1 (0.027). Prevalence of problems in HRQoL domains was as follows: pain/discomfort (15.7%), anxiety/depression (13.3%), mobility (5.4%), self-care (3.5%) and managing usual activities (5.2%). The ≥60 years age group had a mean EQ VAS score 8.7 points higher (95% CI 3.4, 13.9; p < .001) than the 18-39 years age group. Those with T2DM >10 years had a mean EQ VAS score 8.6 points lower than those with a duration <1 year (-12.8, -4.4; p = .001). A T2DM duration >10 years was associated with a reduction in the EQ-5D index of 0.029 (-0.041, -0.016; p < .001) compared with a duration <1 year. CONCLUSIONS Depression/anxiety and pain/discomfort are important domains of reduced HRQoL for this population. A longer duration of T2DM is associated with reduced HRQoL scores, including both EQ VAS and EQ-5D index. Increasing age may be counterintuitively associated with an increase in EQ VAS score in this population, potentially reflecting a 'paradox of aging' process. Future work should focus on developing, evaluating and implementing interventions to improve HRQoL in T2DM, such as strategies to manage pain and mental health conditions.
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Affiliation(s)
- Naomi Carter
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jialin Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Xuelan Fan
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Shuyan Zhu
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Pritpal Chahal
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK.,Health Education England, Leeds, UK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK.,The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, UK
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He Z, Liang W, Xu W, Huang W, Wang X, Huang K, Yang L. Mapping the FACT-G to EQ-5D-3L utility index in cancer with the Chinese values set. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1103-1116. [PMID: 35711123 DOI: 10.1080/14737167.2022.2091546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The purpose of this research was to create a function for mapping the cancer-specific instrument (FACT-G) to a preference-based measure (EQ-5D-3L) utility index for health-related quality of life, with utility scores generated using the Chinese value set. METHOD A cross-sectional study among 243 Chinese patients with cancer was conducted through EQ-5D-3L and FACT-G questionnaires survey. The EQ-5D-3L utility index values wad predicted based on OLS, GLM, CLAD, and Tobit model regression approaches. The performance and predictive power of each model were also evaluated using r2 and adj- r2, MAE, RMSE, ICC, and MID. Linear equating was used to avoid regression of the OLS model to mean. The model was validated using a 10-fold cross-validation method. RESULTS Among all regression models for the FACT-G, the OLS 5 model predicted mean EQ-5D-3L values the best, in terms of model goodness of fit (r2= 0.6230, r2= 58.93%, MAE = 0.0448, RMSE = 0.0624). The OLS model proved to be the most accurate for the mean, and the linear equating scores were much closer to observed scores. CONCLUSION Our results suggest that the best algorithm for FACT-G mapping to EQ-5D-3L utility index is OLS model, based on the survey of Chinese patients with cancer.
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Affiliation(s)
- ZhiKui He
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - WenJie Liang
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - WenJia Xu
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - WenXiu Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - XiaoMin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - KaiYong Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - Li Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
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Zhang RY, Wang W, Zhou HJ, Xuan JW, Luo N, Wang P. A head-to-head comparison of the EQ-5D-3L index scores derived from the two EQ-5D-3L value sets for China. Health Qual Life Outcomes 2022; 20:80. [PMID: 35590333 PMCID: PMC9118844 DOI: 10.1186/s12955-022-01988-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/01/2022] [Indexed: 12/04/2022] Open
Abstract
Objective Two EQ-5D-3L (3L) value sets (developed in 2014 and 2018) co-exist in China. The study examined the level of agreement between index scores for all the 243 health states derived from them at both absolute and relative levels and compared the responsiveness of the two indices. Methods Intraclass correlations coefficient (ICC) and Bland–Altman plot were adopted to assess the degree of agreement between the two indices at the absolute level. Health gains for 29,403 possible transitions between pairs of 3L health states were calculated to assess the agreement at the relative level. Their responsiveness for the transitions was assessed using Cohen effect size. Results The mean (SD) value was 0.427 (0.206) and 0.649 (0.189) for the 3L2014 and 3L2018 index scores, respectively. Although the ICC value showed good agreement (i.e., 0.896), 88.9% (216/243) of the points were beyond the minimum important difference limit according to the Bland–Altman plot. The mean health gains for the 29,403 health transitions was 0.234 (3L2014 index score) and 0.216 (3L2018 index score). The two indices predicted consistent transitions in 23,720 (80.7%) of 29,403 pairs. For the consistent pairs, Cohen effective size value was 1.05 (3L2014 index score) or 1.06 (3L2018 index score); and the 3L2014 index score only yielded 0.007 more utility gains. However, the results based on the two measures varied substantially according to the direction and magnitude of health change. Conclusion The 3L2014 and 3L2018 index scores are not interchangeable. The choice between them is likely to influence QALYs estimations.
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Affiliation(s)
- Ruo-Yu Zhang
- Shanghai Centennial Scientific Co., Ltd, Shanghai, China
| | - Wei Wang
- School of Public Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China
| | - Hui-Jun Zhou
- Business School, University of Shanghai for Science and Technology, Shanghai, China
| | - Jian-Wei Xuan
- Health Economic Research Institute, Sun Yat-Sen University, Guangzhou, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Pei Wang
- School of Public Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China. .,Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
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Short Video Viewing, and Not Sedentary Time, Is Associated with Overweightness/Obesity among Chinese Women. Nutrients 2022; 14:nu14061309. [PMID: 35334966 PMCID: PMC8955951 DOI: 10.3390/nu14061309] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 01/25/2023] Open
Abstract
Previous studies have found that the relationship between sedentary time (ST) and overweightness/obesity is unclear. The association between sedentary behavior and overweightness/obesity may depend on the type of sedentary behavior engaged in. Nowadays, in older Chinese adults, especially females, short video viewing (SVV) is the most popular leisure sedentary behavior. However, the association between SVV and overweightness/obesity remains to be determined. This study aimed to examine the associations between ST and SVV and overweightness/obesity in Chinese community-dwelling older women. A cross-sectional analysis of baseline data from the Physical Activity and Health in Older Women Study was carried out in this study. A total of 1105 older Chinese women aged 60–70 years were included. SVV was estimated using a self-reported questionnaire, and ST was objectively measured using a tri-axial accelerometer. Overweightness/obesity indicators, including body fat ratio (BFR), fat mass (FM), visceral fat mass (VFM), subcutaneous fat mass (SFM), trunk fat mass (TFM), and limb fat mass (LFM), were assessed using multi-frequency bioimpedance analysis. The covariates included socio-demographic data and a range of health-related factors. Multiple linear regression analyses were used to assess the association between ST and SVV and overweightness/obesity. ST was significantly positively associated with all indicators of overweightness/obesity; however, the associations disappeared after adjusting for moderate-to-vigorous-intensity physical activity (MVPA). A higher SVV time was associated with a higher body mass index (BMI) (β = 0.19, 95% confidence interval (CI): 0.05 to 0.32), BFR (β = 0.31, 95% CI: 0.07 to 0.56), FM (β = 0.33, 95% CI: 0.04 to 0.61), VFM (β = 0.09, 95% CI: 0.01 to 0.16), SFM (β = 0.24, 95% CI: 0.03 to 0.45), TFM (β = 0.21, 95% CI: 0.04 to 0.39), and LFM (β = 0.11, 95% CI: 0.00 to 0.23) in the fully adjusted models. Compared with non-food short videos, short food videos had a greater effect on overweightness/obesity. SVV was an independent risk factor for overweightness/obesity. A reduction in SVV (especially the food category) rather than ST might be an effective way to prevent overweightness/obesity when incorporated in future public health policy formulations.
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Xiang Z, Chen Z, Wang P, Zhang K, Liu F, Zhang C, Wong TM, Li W, Leung F. The effect of early mobilization on functional outcomes after hip surgery in the Chinese population - A multicenter prospective cohort study. J Orthop Surg (Hong Kong) 2022; 29:23094990211058902. [PMID: 34818933 DOI: 10.1177/23094990211058902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To compare the functional status and quality of life (QoL) between patients who underwent an early mobilization scheme and those who underwent a late mobilization scheme after hip fracture fixation surgery in elderly Chinese patients. METHODS This was a prospective cohort study. Patients (≥65 years old) with unstable intertrochanteric fractures treated with intramedullary nails were recruited from nine centers in China. Study centers either performed early mobilization or late mobilization scheme. All patients performed immediate in-bed mobilization after surgery and followed a standardized daily exercise program at home during the first 12 weeks. Functional status was measured by the Modified Barthel Index at postoperative visit, 6 weeks, and 12 weeks. QoL was measured by the EuroQol-5D (EQ-5D) at 12 weeks. RESULTS One hundred and forty-eight patients were enrolled to early mobilization, and 136 to late mobilization. At 6 weeks, early mobilization resulted in a significantly better Modified Barthel Index than late mobilization (mean [SD]: 83.7 [12.0] vs. 67.0 [17.5], p < .001). Adjusted mixed effects model showed significantly higher Modified Barthel Index for early mobilization at postoperative visit, 6 weeks, and 12 weeks (all p < .001). Patients in the early mobilization group had slightly better EQ-5D Index at 12 weeks than patients in the late mobilization group (mean: 0.91 vs 0.87, p = .002). CONCLUSIONS Early postoperative mobilization resulted in better functional outcomes up to 12 weeks. QoL was rated statistically significantly better in the early mobilization group, but the difference was small and may not be clinically relevant.
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Affiliation(s)
- Zhou Xiang
- 34753West China Hospital of Sichuan University, Chengdu, China
| | - Zhong Chen
- Yunnan Second People Hospital, Kunming, China
| | - Pengcheng Wang
- 74725The Third Hospital of Hebei, Medical University of Hebei, Hebei, China
| | | | - Fan Liu
- 74567Affiliated Hospital of Nantong University, Nantong City, China
| | | | - Tak-Man Wong
- The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Wilson Li
- Queen Elisabeth Hospital, Pok Fu Lam, Hong Kong
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Liu GG, Guan H, Jin X, Zhang H, Vortherms SA, Wu H. Rural population’s preferences matter: a value set for the EQ-5D-3L health states for China’s rural population. Health Qual Life Outcomes 2022; 20:14. [PMID: 35093084 PMCID: PMC8800217 DOI: 10.1186/s12955-022-01917-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
To develop an EQ-5D-3L social value set based on Chinese rural population’s preferences using the time trade-off (TTO) method, and to compare the differences in preferences on health states between China urban and rural population.
Methods
Between Sep 2013 and Nov 2013, a total of 1201 participants were recruited from rural areas of five Chinese cities (Beijing, Chengdu, Guiyang, Nanjing, and Shenyang) using a quota sampling method. Each respondent valued 13 health states using the TTO, and a total of 97 EQ-5D-3L health states were directly valued for estimating the value set. Various models with different specifications were explored at both aggregate and individual levels. The final model was determined by a set of predefined selection criteria.
Findings
An ordinary least square model at the aggregate level included 10 dummy variables for specifying the level 2 and 3 for each dimension and an N3 term presenting any dimension on level 3 was selected as the final model. The final model provides a value set ranges from − 0.218 to 0.859. The predicted utility values were highly correlated with but consistently lower than that of the published Chinese EQ-5D-3L value set (for urban population).
Conclusion
The availability of the China rural value set provides a set of social preferences weights for researchers and policy decision-makers for use in China rural area.
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Kaur MN, Skolasky RL, Powell PA, Xie F, Huang IC, Kuspinar A, O'Dwyer JL, Cizik AM, Rowen D. Transforming challenges into opportunities: conducting health preference research during the COVID-19 pandemic and beyond. Qual Life Res 2021; 31:1191-1198. [PMID: 34661806 PMCID: PMC8521079 DOI: 10.1007/s11136-021-03012-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
The disruptions to health research during the COVID-19 pandemic are being recognized globally, and there is a growing need for understanding the pandemic’s impact on the health and health preferences of patients, caregivers, and the general public. Ongoing and planned health preference research (HPR) has been affected due to problems associated with recruitment, data collection, and data interpretation. While there are no “one size fits all” solutions, this commentary summarizes the key challenges in HPR within the context of the pandemic and offers pragmatic solutions and directions for future research. We recommend recruitment of a diverse, typically under-represented population in HPR using online, quota-based crowdsourcing platforms, and community partnerships. We foresee emerging evidence on remote, and telephone-based HPR modes of administration, with further studies on the shifts in preferences related to health and healthcare services as a result of the pandemic. We believe that the recalibration of HPR, due to what one would hope is an impermanent change, will permanently change how we conduct HPR in the future.
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Affiliation(s)
- Manraj N Kaur
- Patient-Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
| | - Richard L Skolasky
- Departments of Orthopedic Surgery and Physical Medicine & Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Philip A Powell
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, and Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ayse Kuspinar
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - John L O'Dwyer
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amy M Cizik
- Department of Orthopedics, University of Utah, Salt Lake City, UT, USA
| | - Donna Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Napit IB, Shrestha D, Bishop J, Choudhury S, Dulal S, Gill P, Gkini E, Gwyther H, Hagge DA, Neupane K, Sartori J, Slinn G, Watson SI, Lilford R. An individual randomised efficacy trial of autologous blood products, leukocyte and platelet-rich fibrin (L-PRF), to promote ulcer healing in leprosy in Nepal: the TABLE trial protocol. Trials 2021; 22:453. [PMID: 34266456 PMCID: PMC8281567 DOI: 10.1186/s13063-021-05392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Leprosy is curable with multidrug therapy and treatment in the early stages can prevent disability. However, local nerve damage can lead to injury and consequently recurring and disfiguring ulcers. The aim of this study is to evaluate the treatment of leprosy ulcers using an autologous blood product; leukocyte and platelet-rich fibrin (L-PRF) to promote healing. METHODS This is a single-centre study in the Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal. Consenting patients (n=130) will be individually randomised in a single-blinded, controlled trial. Participants will be 18 years of age or older, admitted to the hospital with a clean, dry and infection-free chronic foot ulcer between 2 and 20 cm2 in size. If the ulcer is infected, it will be treated before enrolment into the study. The intervention involves the application of leukocyte and platelet-rich fibrin (L-PRF) matrix on the ulcer beds during twice-weekly dressing changes. Controls receive usual care in the form of saline dressings only during their twice-weekly dressing changes. Primary outcomes are the rate of healing assessed using standardised photographs by observers blind to allocated treatment, and time to complete re-epithelialization. Follow-up is at 6 months from randomisation. DISCUSSION This research will provide valuable information on the clinical and cost-effectiveness of L-PRF in the treatment of leprosy ulcers. An additional benefit is the evaluation of the effects of treatment on quality of life for people living with leprosy ulcers. The results will improve our understanding of the scalability of this treatment across low-income countries for ulcer healing in leprosy and potentially other conditions such as diabetic ulcers. TRIAL REGISTRATION ClinicalTrials.gov ISRCTN14933421 . Registered on 16 June 2020.
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Affiliation(s)
- Indra B. Napit
- Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal
| | - Dilip Shrestha
- Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal
| | - Jon Bishop
- Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Sopna Choudhury
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Santosh Dulal
- Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal
| | - Paramjit Gill
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Eleni Gkini
- Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Holly Gwyther
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Deanna A. Hagge
- Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal
| | - Karuna Neupane
- Anandaban Hospital, The Leprosy Mission Nepal, Kathmandu, Nepal
| | - Jo Sartori
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Gemma Slinn
- Birmingham Clinical Trials Unit, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Samuel I. Watson
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Richard Lilford
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
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Zhu Z, Yan W, Wang X, Hu D, Zhu Y, Chen J. Physical Activity, Blood Pressure Control, and Health-Related Quality of Life Among Hypertensive Individuals: A Cross-Sectional Study in Jiangsu Province, China. Asia Pac J Public Health 2021; 33:539-546. [PMID: 34018402 DOI: 10.1177/10105395211014650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hypertension has become one of the most serious chronic diseases that threaten public health. Regulating self-management is considered a priority and in which physical activity plays a vital role. Based on the Fifth National Health Service Survey (NHSS, 2013), a total of 6079 patients with hypertension were investigated by stratified cluster random sampling. This study explored the relationships between blood pressure control and physical activity, and health-related quality of life (HRQoL). Tobit regression and generalized linear regression analysis were used to explore the relationships among participants' socioeconomic characteristics, health behaviors, and HRQoL. The results showed that 4712 respondents (77.51%) had no problems in any aspect, but the proportion of respondents with problems increased significantly with age (P for trend <.001). Blood pressure control was significantly correlated with the health utility value (P < .001). Patients who participated in physical activity and maintained normal daily blood pressure also showed higher health utility value. Physical activity was significantly related to blood pressure control and HRQoL. Therefore, regular physical activity is recommended for hypertensive residents to improve HRQoL.
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Affiliation(s)
- Zhu Zhu
- Nanjing Medical University, Nanjing, China.,Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Wu Yan
- Nanjing Medical University, Nanjing, China
| | | | - Dan Hu
- Nanjing Medical University, Nanjing, China
| | - Ya Zhu
- Nanjing Medical University, Nanjing, China
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Shrestha D, Napit IB, Ansari S, Choudhury SM, Dhungana B, Gill P, Griffiths F, Gwyther H, Hagge D, Kandel S, Puri S, Sartori J, Watson SI, Lilford R. Evaluation of a self-help intervention to promote the health and wellbeing of marginalised people including those living with leprosy in Nepal: a prospective, observational, cluster-based, cohort study with controls. BMC Public Health 2021; 21:873. [PMID: 33957899 PMCID: PMC8101219 DOI: 10.1186/s12889-021-10847-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People affected by leprosy are at increased risk of ulcers from peripheral nerve damage. This in turn can lead to visible impairments, stigmatisation and economic marginalisation. Health care providers suggest that patients should be empowered to self-manage their condition to improve outcomes and reduce reliance on services. Self-care involves carrying out personal care tasks with the aim of preventing disabilities or preventing further deterioration. Self-help, on the other hand, addresses the wider psychological, social and economic implications of leprosy and incorporates, for example, skills training and microfinance schemes. The aim of this study, known as SHERPA (Self-Help Evaluation for lepRosy and other conditions in NePAl) is to evaluate a service intervention called Integrated Mobilization of People for Active Community Transformation (IMPACT) designed to encourage both self-care and self-help in marginalised people including those affected by leprosy. METHODS A mixed-method evaluation study in Province 5, Nepal comprising two parts. First, a prospective, cluster-based, non-randomised controlled study to evaluate the effectiveness of self-help groups on ulcer metrics (people affected by leprosy only) and on four generic outcome measures (all participants) - generic health status, wellbeing, social integration and household economic performance. Second, a qualitative study to examine the implementation and fidelity of the intervention. IMPACT This research will provide information on the effectiveness of combined self-help and self-care groups, on quality of life, social integration and economic wellbeing for people living with leprosy, disability or who are socially and economically marginalised in low- and middle- income countries.
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Affiliation(s)
- Dilip Shrestha
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Indra B. Napit
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Subi Ansari
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Sopna Mannan Choudhury
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
| | - Bishnu Dhungana
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Paramjit Gill
- grid.7372.10000 0000 8809 1613Warwick Centre for Applied Health Research & Delivery (W-CAHRD), Warwick Medical School, University of Warwick, Warwick, UK
| | - Frances Griffiths
- grid.7372.10000 0000 8809 1613Warwick Centre for Applied Health Research & Delivery (W-CAHRD), Warwick Medical School, University of Warwick, Warwick, UK
| | - Holly Gwyther
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
| | - Deanna Hagge
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Shovakhar Kandel
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Suraj Puri
- grid.413718.8Anandaban Hospital, The Leprosy Mission Nepal, Tika Bhairav, Lele-9, Lalitpur, P. O. Box 151, Kathmandu, Nepal
| | - Jo Sartori
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
| | - Samuel Ian Watson
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
| | - Richard Lilford
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT UK
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Wu J, Xie S, He X, Chen G, Bai G, Feng D, Hu M, Jiang J, Wang X, Wu H, Wu Q, Brazier JE. Valuation of SF-6Dv2 Health States in China Using Time Trade-off and Discrete-Choice Experiment with a Duration Dimension. PHARMACOECONOMICS 2021; 39:521-535. [PMID: 33598860 PMCID: PMC8079294 DOI: 10.1007/s40273-020-00997-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 05/10/2023]
Abstract
OBJECTIVES Our objective was to generate a value set for the SF-6Dv2 using time trade-off (TTO) and a discrete-choice experiment with a duration dimension (DCETTO) in China. METHODS A large representative sample of the Chinese general population was recruited from eight provinces/municipalities in China, stratified by age, sex, education level, and proportion of urban/rural residence. Respondents completed eight TTO tasks and ten DCETTO tasks during face-to-face interviews. Ordinary least squares (OLS), random-effects, fixed-effects, and Tobit models were used for TTO data, and conditional logit and mixed logit models were used for DCETTO. The monotonicity of model coefficients and the consistency of the predicted values according to intraclass correlation coefficient (ICC), mean absolute difference (MAD), and mean squared difference (MSD) were compared between the two approaches. RESULTS In total, 3320 respondents (50.3% male; range 18-90 years) were recruited. The random-effects model and the conditional logit model were preferred for the TTO and DCETTO, respectively. The TTO values ranged from - 0.277 to 1, with 927 (4.94%) states considered as worse than dead (WTD). The corresponding range for DCETTO was - 0.535 to 1, with a higher WTD of 8.50%. DCETTO presented minor non-monotonicity with the coefficients in two dimensions. Values from the two approaches were highly consistent (ICC 0.9804, MAD 0.0588, MSD 0.0055), albeit those with DCETTO were slightly lower than those with TTO. The value set generated by TTO was preferred given the better monotonicity and the statistical significance of coefficients. CONCLUSIONS The Chinese value set for the SF-6Dv2 was established based on the TTO approach, but the DCETTO also performed well. Minor issues of non-monotonicity did present for DCETTO.
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Affiliation(s)
- Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Room 209, 24th building, 92th Weijin Road, Nankai District, Tianjin, 300072, China.
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
| | - Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Room 209, 24th building, 92th Weijin Road, Nankai District, Tianjin, 300072, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Xiaoning He
- School of Pharmaceutical Science and Technology, Tianjin University, Room 209, 24th building, 92th Weijin Road, Nankai District, Tianjin, 300072, China
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Gang Chen
- Monash Business School, Centre for Health Economics, Monash University, Melbourne, VIC, Australia
| | - Gengliang Bai
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Da Feng
- School of Pharmacy, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Hu
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Jie Jiang
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Xiaohui Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Hongyan Wu
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, Harbin, China
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China
| | - John E Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Omelyanovskiy V, Musina N, Ratushnyak S, Bezdenezhnykh T, Fediaeva V, Roudijk B, Purba FD. Valuation of the EQ-5D-3L in Russia. Qual Life Res 2021; 30:1997-2007. [PMID: 33713323 PMCID: PMC8233249 DOI: 10.1007/s11136-021-02804-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 11/30/2022]
Abstract
Purpose The most widely used generic questionnaire to estimate the quality of life for yielding quality-adjusted life years in economic evaluations is EQ-5D. Country-specific population value sets are required to use EQ-5D in economic evaluations. The aim of this study was to establish an EQ-5D-3L value set for Russia. Methods A representative sample aged 18+ years was recruited from the Russia`s general population. Computer-assisted face–to–face interviews were conducted based on the standardized valuation protocol using EQ-Portable Valuation Technology. Population preferences were elicited utilizing both composite time trade-off (cTTO) and discrete choice experiment (DCE) techniques. To estimate the value set, a hybrid regression model combining cTTO and DCE data was used. Results A total of 300 respondents who successfully completed the interview were included in the primary analysis. 120 (40.0%) respondents reported no health problems of any dimension, and 56 (18.7%) reported moderate health problems in one dimension of the EQ‐5D‐3L. Median self-rated health using EQ‐VAS was 80 with IQR 70–90. Comparing cTTO and DCE-predicted values for 243 health states resulted in a similar pattern. This supports the use of hybrid models. The predicted value based on the preferred model for the worst health state “33333” was −0.503. Mobility dimension had the most significant impact on the utility decrement, and anxiety/depression had the lowest decrement. Conclusion Determining a Russian national value set may be considered the first step towards promoting cost-utility analysis use to increase comparability among studies and improve the transferability of healthcare decision-making in Russia. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02804-6.
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Affiliation(s)
- Vitaly Omelyanovskiy
- Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Moscow, Russia.,Financial Research Institute at the Ministry of Finances of the Russian Federation, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Nuriya Musina
- Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Moscow, Russia.,Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russia.,Russian Presidential Academy of National Economy and Public Administration (RANEPA), Moscow, Russia.,Saint Petersburg State Chemical Pharmaceutical Academy, St. Petersburg, Russia
| | - Svetlana Ratushnyak
- Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Moscow, Russia.
| | - Tatiana Bezdenezhnykh
- Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Moscow, Russia.,Financial Research Institute at the Ministry of Finances of the Russian Federation, Moscow, Russia
| | - Vlada Fediaeva
- Center of Healthcare Quality Assessment and Control, Ministry of Health of the Russian Federation, Moscow, Russia.,Financial Research Institute at the Ministry of Finances of the Russian Federation, Moscow, Russia
| | - Bram Roudijk
- EuroQol Research Foundation, Rotterdam, the Netherlands
| | - Fredrick Dermawan Purba
- Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia.,Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia
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40
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Yao Q, Liu C, Zhang Y, Xu L. Population norms for the EQ-5D-3L in China derived from the 2013 National Health Services Survey. J Glob Health 2021; 11:08001. [PMID: 33692898 PMCID: PMC7916444 DOI: 10.7189/jogh.11.08001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background EQ-5D-3L is one of the most commonly used instruments for assessing health-related quality of life and cost-utility analyses, but it is not yet available in China. This study aims to develop population norms for the EQ-5D-3L in China in order to encourage appropriate use and interpretation of the EQ-5D-3L instrument. Methods Data were extracted from the 2013 National Health Services Survey on a nationally representative sample of 188 720 participants. The utility index based on the 2018 Chinese preference-based value sets were calculated for the participants with different demographic and socio-economic characteristics. Differences in reported problems and visual analogue scale (VAS) and utility index scores were tested using a logistic, linear and tobit regression model, respectively. Results The Chinese respondents were less likely to report problems on the EQ-5D dimensions compared with most populations in other countries. Pain/discomfort was the most commonly reported problem (12.6%). This resulted in a high ceiling effect (84.19%) on the utility index and high mean scores for the utility index (0.985 ± 0.056) and VAS (80.91 ± 13.74) in the Chinese population. Those who were younger, better educated, employed, married, had no illness condition, lived in a more developed region and had a higher income obtained higher scores in both VAS and utility index. The VAS and utility index scores were also associated with gender, residency and lifestyles, but not always in a consistent way. Male and rural residents had a higher VAS score but not in the utility index compared with their female and urban counterparts. Conclusions This study provides national population norms for the EQ-5D-3L based on the 2018 Chinese preference-based value sets. The norms can be used as a reference for health evaluation studies. Cautions need to be taken for presenting and interpreting the utility index results given the high ceiling effect of the EQ-5D-3L instrument.
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Affiliation(s)
- Qiang Yao
- School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China.,School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Yaoguang Zhang
- Centre for Health Statistics Information, National Health Commission, Beijing, China
| | - Ling Xu
- China Health Human Resources, National Health Commission, Beijing, China
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Joelson A, Sigmundsson FG, Karlsson J. Properties of the EQ-5D-3L index distribution when longitudinal data from 27,328 spine surgery procedures are applied to nine national EQ-5D-3L value sets. Qual Life Res 2021; 30:1467-1475. [PMID: 33449340 DOI: 10.1007/s11136-020-02749-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the current study was to apply a single large longitudinal EQ-5D-3L data set to several national EQ-5D-3L value sets and explore differences in EQ-5D-3L index density functions and effect sizes before and after treatment. METHODS Patients, surgically treated for lumbar spinal stenosis or lumbar disk herniation between 2007 and 2017, were recruited from the national Swedish spine register. A total of 27,328 procedures were eligible for analysis. The EQ-5D health states were coded to EQ-5D-3L summary indices using value sets for 9 countries: Argentina, Australia, Canada, China, Germany, Italy, Sweden, the UK, and the US. The EQ-5D-3L summary index distributions were then estimated with kernel density estimation. The change in EQ-5D-3L index before and after treatment was evaluated with the standardized response mean (SRM). RESULTS There was a high variability in the resulting EQ-5D-3L index density functions. There were also considerable differences in EQ-5D-3L index density functions before and after treatment using the same value set. Effect sizes of 2-year change (SRM), however, were similar when the 9 value sets were applied on pre- and post-treatment data. CONCLUSIONS We found a marked variability in EQ-5D-3L index density functions when a single large data set was applied to 9 national EQ-5D-3L value sets. Consequently, studies that aggregate international data, e.g. meta-analyses, may produce misleading results if the underlying differences in EQ-5D-3L index density functions are inadequately handled. On the basis of the results of our study, we recommend against pooling of different national EQ-5D-3L index data.
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Affiliation(s)
- Anders Joelson
- Department of Orthopedics, Orebro University School of Medical Sciences and Orebro University Hospital, Orebro, Sweden.
| | - Freyr Gauti Sigmundsson
- Department of Orthopedics, Orebro University School of Medical Sciences and Orebro University Hospital, Orebro, Sweden
| | - Jan Karlsson
- University Health Care Research Center, Faculty of Medicine and Health, Orebro University, Orebro, Sweden
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Lai S, Lu L, Zhou Z, Shen C, Yang X, Zhao Y, Zhang X. The effects of family physician-contracted service on health-related quality of life and equity in health in China. Int J Equity Health 2021; 20:15. [PMID: 33407523 PMCID: PMC7788691 DOI: 10.1186/s12939-020-01348-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background Family physician-contracted service (FPCs) has been recently implemented in Chinese primary care settings. This study was aimed at measuring the effects of FPCs on residents’ health-related quality of life (HRQoL) and equity in health among the Chinese population. Methods The study data was drawn from the 2018 household health survey (Shaanxi Province, China) using multistage, stratified cluster random sampling. We measured HRQoL using EQ-5D-3L based on the Chinese-specific time trade-off values set. Coarsened exact matching (CEM) technique was used to control for confounding factors between residents with and without a contracted family physician. The concentration index (C) was calculated to measure equity in health. Results Individuals with a contracted family physician had significantly higher HRQoL than those without, after data matching (0.9355 vs. 0.8995; P < 0.001). Additionally, the inequity in HRQoL among respondents with a contracted family physician was significantly lower than those without a contracted family physician (Cs of EQ-5D utility score: 0.0084 vs. 0.0263; p < 0.001). Conclusions This study highlights the positive effects of FPCs on HRQoL and socioeconomic-related equity in HRQoL. Future efforts should prioritize the economically and educationally disadvantaged groups, the expansion of service coverage, and the competency of family physician teams to further enhance health outcome and equity in health.
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Affiliation(s)
- Sha Lai
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, 710048, Shaanxi, China
| | - Li Lu
- Team IETO, Bordeaux Population Health Research Center, UMR U1219, INSERM, Université de Bordeaux, Bordeaux, France
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, 710048, Shaanxi, China.
| | - Chi Shen
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, 710048, Shaanxi, China
| | - Xiaowei Yang
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, 710048, Shaanxi, China.
| | - Yaxin Zhao
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, 710048, Shaanxi, China
| | - Xiaolong Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, 710048, Shaanxi, China
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Time for Tele-TTO? Lessons Learned From Digital Interviewer-Assisted Time Trade-Off Data Collection. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:459-469. [PMID: 33345290 PMCID: PMC7750113 DOI: 10.1007/s40271-020-00490-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 10/27/2022]
Abstract
The preferred mode of administration of time trade-off (TTO) in large-scale valuation studies is face-to-face (personal) interviews facilitated by a trained interviewer. Geographical, financial or situational constraints could complicate personal TTO interviews. When facing such constraints, the use of digital interviews, in which trained interviewers facilitate through videotelephony software (i.e. tele-TTO) may be considered. This paper aims to guide researchers in how to approach tele-TTO interviews and discusses their advantages and disadvantages. The main advantages of tele-TTO compared to personal TTO are decreased need for travel and increased flexibility of interview scheduling, which could reduce costs and may foster representative sampling. Possible disadvantages of tele-TTO are partial loss of visual cues, complications with building rapport and possible selection effects that result from differences in interview preparation. Furthermore, the paper reports on lessons learned from a project in which both personal TTO and tele-TTO interviews were conducted. The results of this project suggest that although they require a different recruitment and interview process, tele-TTO interviews are feasible and provide flexibility to the interviewer. Furthermore, tele-TTO interviews yield largely similar results. Future research should explore the role of possible selection effects and respondents' perspective on tele-TTO interviews.
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Ernstsson O, Burström K, Heintz E, Mølsted Alvesson H. Reporting and valuing one's own health: a think aloud study using EQ-5D-5L, EQ VAS and a time trade-off question among patients with a chronic condition. Health Qual Life Outcomes 2020; 18:388. [PMID: 33334348 PMCID: PMC7745504 DOI: 10.1186/s12955-020-01641-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background The EQ-5D-5L, the EQ VAS, and the time trade-off (TTO) are commonly used to report and value health. Still, there is a need to better understand how these questionnaires and methods are perceived by the respondents, as well as the thoughts and motives behind their responses. The aim of this study was to increase knowledge of how individuals think and reason when reporting and valuing their own current health, using EQ-5D-5L, EQ VAS, and an open-ended TTO question. Methods Twenty patients with type 1 diabetes participated in qualitative individual think aloud interviews in Stockholm, Sweden. Participants were asked to describe their thoughts when responding to three assessments. The interviews were transcribed verbatim and analyzed using thematic analysis. Results The analysis showed that participants conducted the assessments by contextualizing and interpreting instructions, relating the questions to their own health, using different recall periods and time perspectives, and using personal, interpersonal, or normative comparators. It was challenging to reduce the experience of everyday life into a response option, and the thoughts behind the responses differed between the assessments. Before deciding on what to include, participants thought of the purpose and context of the assessments. Current health or past experiences of health were applied in the EQ-5D descriptive system and in EQ VAS, while participants focused on the future in the TTO. Thoughts about the impact on others, personal goals, and expectations on future health were more clearly integrated in the TTO assessment. All participants considered the trade-off between life years and health. However, despite the use of different comparators, the concept of ‘full health’ was found difficult to imagine or relate to. Conclusions This study provides insights as to how responses to the EQ-5D-5L, EQ VAS, and TTO assessments are complementary and where these assessments differ in adults with a chronic condition. The findings may contribute to a better understanding when interpreting the quantitative results and contribute to the literature pertaining to possible explanations for differences in health state values depending on the valuation method.
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Affiliation(s)
- Olivia Ernstsson
- QRC Research Unit, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
| | - Kristina Burström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.,Health Care Services, Region Stockholm, 171 77, Stockholm, Sweden
| | - Emelie Heintz
- QRC Research Unit, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
| | - Helle Mølsted Alvesson
- Health Systems and Policy, Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden
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45
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Rong C, Zheng LJ, Zhang Q, Cao YD, Shen SH, Gao ZQ, Wan D, Shen WW, Xu CM, Wang XL. Factors Associated With Health-Related Quality of Life of Parents Who Lost Their Only Child: A Cross-Sectional Study in Central China. Front Public Health 2020; 8:507785. [PMID: 33344394 PMCID: PMC7738348 DOI: 10.3389/fpubh.2020.507785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/06/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose: The number of families who lost their only child was over one million in 2012 in China, and it is growing rapidly every year. Without their only child, they will inevitably worry about their health and life for their later years. It is important to explore the quality of life and influencing factors of the parents. Methods: The cluster sampling method was adopted to select the participants in Wuhu city, Anhui province, central China. The generalized linear regression models were performed to analyze factors influencing EQ-VAS scores. Results: The parents with different monthly income (P = 0.001) and self-rated health status (P < 0.001) had different EQ-VAS scores. Educational level, self-rated health status, number of chronic diseases, depression and having grandchildren were significantly associated with their EQ-VAS score. Conclusion: The government should encourage public medical institutions to provide convenient health management and medical services to this vulnerable group. Priority treatment should be given to the parents who already have multiple diseases. The parents who were depressed should be given timely intervention. The government should give more financial subsidies to the parents who need to raise their grandchildren.
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Affiliation(s)
- Chao Rong
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Li-Jie Zheng
- Hangzhou West Lake District Wenxin Street Community Health Service Center, Hangzhou, China
| | - Qian Zhang
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yi-Dan Cao
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Shu-Hua Shen
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheng-Qing Gao
- School of Economics and Management, Harbin Institute of Technology (Weihai), Weihai, China
| | - Duo Wan
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wei-Wei Shen
- School of Humanities and Management, Hunan Chinese Medical University, Changsha, China
| | - Cai-Ming Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao-Lan Wang
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
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46
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Pan CW, Zhang RY, Luo N, He JY, Liu RJ, Ying XH, Wang P. How the EQ-5D utilities are derived matters in Chinese diabetes patients: a comparison based on different EQ-5D scoring functions for China. Qual Life Res 2020; 29:3087-3094. [PMID: 32533422 DOI: 10.1007/s11136-020-02551-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES In China, multiple approaches to calculating EQ-5D utilities are available, including the two EQ-5D-3L (3L2014 and 3L2018) scoring functions, the EQ-5D-5L (5L) scoring function, and the crosswalk function linking the 3L utilities and 5L health states. The study compared utilities derived from them in terms of agreement and discriminative power; and assessed whether the use of different approaches may affect QALY estimation in Chinese type 2 diabetes (T2D) patients. METHODS Cross-sectional data of 289 T2D patients who self-completed both the 5L and 3L questions were used. Agreement were examined using intraclass correlation coefficient (ICC) and Bland-Altman plots. The ability of the EQ-5D utilities in differentiating the patients with and without clinical conditions was evaluated using F-statistics. Their influence on QALY estimation was assessed adopting mean absolute difference (MAD) in utility values between the patients. RESULTS The ICC values were 0.881 (3L2014-3L2018), 0.958 (5L-c5L2014), and 0.806 (5L-c5L2018). The two 3L utilities and the three 5L utilities had poor agreement at the lower end of utility scale according to Bland-Altman plots. The 3L2018 utilities had lower F-statistics compared to the 3L2014 utilities; the two c5L utilities had larger or similar F-statistics compared to the 5L utilities. The mean MADs were 0.138 (5L), 0.116 (3L2014), 0.115 (c5L2014), 0.055 (c5L2018), and 0.055 (3L2018). CONCLUSION The 3L2014 utilities is more discriminative than the 3L2018 utilities; and the two c5L utilities have no worse discriminative power compared with the 5L utilities. The choice of the approach to calculating the EQ-5D utilities is likely to affect QALY estimates.
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Affiliation(s)
- Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ruo-Yu Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jun-Yi He
- School of Public Health, Fudan University, Shanghai, China
| | - Rui-Jie Liu
- School of Public Health, Fudan University, Shanghai, China
| | - Xiao-Hua Ying
- School of Public Health, Fudan University, Shanghai, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China.
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
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Shams S, Pullenayegum E. Design and sample size considerations for valuation studies of multi-attribute utility instruments. Stat Med 2020; 39:3074-3104. [PMID: 32706130 DOI: 10.1002/sim.8592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 01/25/2020] [Accepted: 05/09/2020] [Indexed: 11/08/2022]
Abstract
The EQ-5D, a widely used multiattribute utility instrument, is commonly used in health economic evaluations where the goal is to decide on which treatments to reimburse. Like other instruments, value sets of the EQ-5D are constructed using valuation studies typically valuing a subset of the health states and using predicted values from a regression model for the unvalued health states. In current practice the prediction errors associated with the value sets are substantial. The goal of this work is 2-fold. First, derive a formula of the mean squared error (MSE) of a value set assuming that the value set is estimated using a linear mixed model with either an independent or a Gaussian spatial correlation on the model misspecification error. Second, explore the effect of the number of health states directly valued, the number of participants and the correlation structure on the MSE. Keeping the total number of participants and the total number of valuations fixed, valuing all 242 health states of the EQ-5D-3L was found to reduce the MSE considerably compared with the common practice of valuing only 42 health states. Furthermore, an independent correlation structure with 3773 participants valuing 42 health states produced the MSE that can be achieved with less than 600 participants valuing all 242 health states under a Gaussian spatial correlation structure. Based on the comparison of the MSE values of some of the well-known designs our suggestion is to value more health states and to use a model with spatially correlated misspecification errors.
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Affiliation(s)
- Shahriar Shams
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eleanor Pullenayegum
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Child Health Evaluative sciences, Hospital for Sick Children, Toronto, Ontario, Canada
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De Jaeger M, Goudman L, Putman K, De Smedt A, Rigoard P, Geens W, Moens M. The Added Value of High Dose Spinal Cord Stimulation in Patients with Failed Back Surgery Syndrome after Conversion from Standard Spinal Cord Stimulation. J Clin Med 2020; 9:jcm9103126. [PMID: 32992612 PMCID: PMC7601014 DOI: 10.3390/jcm9103126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 02/04/2023] Open
Abstract
Patients with Failed Back Surgery Syndrome (FBSS) report a considerably lower health- related quality of life (HRQoL), compared to the general population. Spinal cord stimulation (SCS) is an effective treatment to offer pain relief in those patients. Despite initial treatment success of SCS, its effect sometimes wears off over time. This study investigates the added value of high dose SCS (HD-SCS) in patients with unsatisfactory conventional SCS, from a quality of life perspective. Seventy-eight FBSS patients who were treated with conventional SCS that failed to provide pain relief, were recruited in 15 centers. HRQoL was assessed before converting to HD-SCS (baseline) and three times after converting to HD-SCS using the EuroQol-5D-3L. Quality adjusted life years (QALY) were calculated and compared with conventional SCS. An overall significant increase over time was seen in utility values of the EQ5D-3L, as the mean value at baseline 0.283 (±0.21) increased to 0.452 (±0.29) at 12 months of HD-SCS. This average increase in utility coincides with an average increase of 0.153 (±0.24) QALY’s in comparison to continued conventional SCS. Besides the potential of HD-SCS to salvage patients with failed responses to conventional SCS, this treatment seems to be a more efficient treatment than conventional SCS.
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Affiliation(s)
- Mats De Jaeger
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium; (M.D.J.); (L.G.); (W.G.)
| | - Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium; (M.D.J.); (L.G.); (W.G.)
- Pain in Motion International Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA),Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Faculty of Medicine & Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium;
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Koen Putman
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium;
- I-CHER, Interuniversity Center for Health Economics Research, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Ann De Smedt
- Center for Neurosciences (C4N), Faculty of Medicine & Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium;
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Philippe Rigoard
- Spine & Neuromodulation Functional Unit, Poitiers University Hospital, 86073 Poitiers, France;
- Institut Prime, UPR CNRS 3346, ISAE-ENSMA, University of Poitiers, 86073 Poitiers, France
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86073 Poitiers, France
| | - Wietse Geens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium; (M.D.J.); (L.G.); (W.G.)
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium; (M.D.J.); (L.G.); (W.G.)
- Center for Neurosciences (C4N), Faculty of Medicine & Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium;
- STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Correspondence: ; Tel.: +0032-2477-5514
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Zhu J, Yan XX, Liu CC, Wang H, Wang L, Cao SM, Liao XZ, Xi YF, Ji Y, Lei L, Xiao HF, Guan HJ, Wei WQ, Dai M, Chen W, Shi JF. Comparing EQ-5D-3L and EQ-5D-5L performance in common cancers: suggestions for instrument choosing. Qual Life Res 2020; 30:841-854. [PMID: 32930993 DOI: 10.1007/s11136-020-02636-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare the performance of three-level EuroQol five-dimensions (EQ-5D-3L) and five-level EuroQol five-dimensions (EQ-5D-5L) among common cancer patients in urban China. METHODS A hospital-based cross-sectional survey was conducted in three provinces from 2016 to 2018 in urban China. Patients with breast cancer, colorectal cancer, or lung cancer were recruited to complete the EQ-5D-3L and EQ-5D-5L questionnaires. Response distribution, discriminatory power (indicator: Shannon index [H'] and Shannon evenness index [J']), ceiling effect (the proportion of full health state), convergent validity, and health-related quality of life (HRQoL) were compared between the two instruments. RESULTS A total of 1802 cancer patients (breast cancer: 601, colorectal cancer: 601, lung cancer: 600) were included, with the mean age of 55.6 years. The average inconsistency rate was 4.4%. Compared with EQ-5D-3L (average: H' = 1.100, J' = 0.696), an improved discriminatory power was observed in EQ-5D-5L (H' = 1.473, J' = 0.932), especially contributing to anxiety/depression dimensions. The ceiling effect was diminished in EQ-5D-5L (26.5%) in comparison with EQ-5D-3L (34.5%) (p < 0.001), mainly reflected in the pain/discomfort and anxiety/depression dimensions. The overall utility score was 0.790 (95% CI 0.778-0.801) for EQ-5D-3L and 0.803 (0.790-0.816) for EQ-5D-5L (p < 0.001). A similar pattern was also observed in the detailed cancer-specific analysis. CONCLUSIONS With greater discriminatory power, convergent validity and lower ceiling, EQ-5D-5L may be preferable to EQ-5D-3L for the assessment of HRQoL among cancer patients. However, higher utility scores derived form EQ-5D-5L may also lead to lower QALY gains than those of 3L potentially in cost-utility studies and underestimation in the burden of disease.
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Affiliation(s)
- Juan Zhu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.,Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xin-Xin Yan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Cheng-Cheng Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Hong Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Le Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Su-Mei Cao
- Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Yun-Feng Xi
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, People's Republic of China
| | - Yong Ji
- Cancer Hospital, Shenzhen Center, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Hai-Fan Xiao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Hai-Jing Guan
- China Center for Health Economic Research, Peking University, Beijing, People's Republic of China
| | - Wen-Qiang Wei
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
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50
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Xia R, Zeng H, Liu Q, Liu S, Zhang Z, Liu Y, Guo G, Song G, Zhu Y, Wu X, Song B, Liao X, Chen Y, Wei W, Chen G, Chen W, Zhuang G. Health-related quality of life and health utility score of patients with gastric cancer: A multi-centre cross-sectional survey in China. Eur J Cancer Care (Engl) 2020; 29:e13283. [PMID: 32602238 DOI: 10.1111/ecc.13283] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/05/2020] [Accepted: 06/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the health-related quality of life (HRQoL) and health state utility scores of gastric cancer patients in daily life at different clinical stages after treatment, and to explore influencing factors associated with HRQoL. METHODS Gastric cancer patients discharged from hospitals and healthy controls identified by screening were recruited. The three-level EQ-5D was employed to assess HRQoL and was scored using two Chinese-specific tariffs published in 2014 and 2018. RESULTS A total of 1,399 patients and 2,179 healthy controls were recruited. The likelihood of reporting problems in the five dimensions for patients was 4.0-23.8 times higher than controls. Based on the 2014/2018 tariff, the mean EQ-5D utility score was 0.321/0.163 lower than controls, and the mean utility scores of each patient subgroup were 0.077/0.039 (high-grade intraepithelial neoplasia/carcinoma in situ), 0.254/0.121 (Stage I), 0.249/0.123 (Stage II), 0.353/0.182 (Stage III) and 0.591/0.309 (Stage IV) lower than controls (all statistically significant). Age, occupation, duration of illness, other chronic disease status and therapeutic regimen had a significant impact upon different aspects of HRQoL in patients. CONCLUSIONS Gastric cancer significantly impaired patients' HRQoL in daily life after treatment. More advanced cancer stages were associated with larger decrements on health state utility.
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Affiliation(s)
- Ruyi Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Hongmei Zeng
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian Liu
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | | | - Zhiyi Zhang
- Wuwei Cancer Hospital of Gansu Province, Wuwei, China
| | - Yuqin Liu
- Gansu Provincial Cancer Hospital, Lanzhou, China
| | | | - Guohui Song
- Cixian Institute for Cancer Prevention and Control, Cixian Cancer Hospital, Handan, China
| | - Yigong Zhu
- Luoshan Center for Disease Control and Prevention, Xinyang, China
| | - Xianghong Wu
- Center for Disease Control and Prevention of Sheyang County, Yancheng, China
| | - Bingbing Song
- Tumor Prevention and Treatment Institute, Harbin Medical University, Harbin, China
| | | | - Yanfang Chen
- Yueyang Lou District Center for Disease Prevention and Control, Yueyang, China
| | - Wenqiang Wei
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Vic., Australia
| | - Wanqing Chen
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guihua Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
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