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Chang JYA, Hsu CN, Ramos-Goñi JM, Luo N, Lin HW, Lin FJ. Beyond 10-year lead-times in EQ-5D-5L: leveraging alternative lead-times in willingness-to-accept questions to capture preferences for worse-than-dead states and their implication. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:1041-1055. [PMID: 38072877 DOI: 10.1007/s10198-023-01642-2] [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: 03/25/2023] [Accepted: 10/18/2023] [Indexed: 07/28/2024]
Abstract
BACKGROUND A fixed 10-year lead-time in composite time-trade-off (C-TTO) tasks might compromise the precision of utility values below - 1. This study explored how alternative lead-times (ALTs) influence EQ-5D-5L value sets and their implications in economic evaluations. METHODS Leveraging data from Taiwan's EQ-5D-5L valuation and capitalizing on its exploratory willingness-to-accept question, we explored participants' quantification of "worse-than-dead (WTD)" health states with ALTs up to 50 years. We then derived alternative value sets incorporating these ALTs through interval regression and compared them against those from conventional models. To evaluate their impact on health change valuation, we simulated utility differences for all possible EQ-5D-5L health-state-pairs using each value set. RESULTS With a salient floor effect observed in the C-TTO values, the model with ALT led to a wider range of predicted utilities ( - 2.3897 ~ 1), compared with those of conventional models (generalized least squares (GLS): - 0.7773 ~ 1; Tobit-GLS: - 0.9583 ~ 1). Compared to the Tobit-GLS model, the model with ALT increased the numerical distance in 80% of health-state-pairs, with 11% decreasing and 9% altering direction (e.g., positive to negative) in utility differences. CONCLUSIONS While ALTs offer insights into patient preferences, their integration into economic evaluations might require rescaling. Future research should prioritize advanced rescaling methods or enhanced elicitation strategies for populations with substantial censoring. This is pivotal for improving the elicitation of extreme WTD states and accurately discerning the relative distances between health states. Countries developing EQ-5D-5L value sets should consider pilot studies and incorporating region-specific questions on social determinants, especially where pronounced floor effects are suspected.
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Grants
- EQ project 2016440 EuroQol Research Foundation
- 10542652 The Center for Drug Evaluation, Taiwan
- NSC102-2320-B-039-007 Ministry of Science and Technology, Taiwan
- MOST 109-2622-8-039-001-TB1; MOST 110-2622-8-039-004 -TB1 Ministry of Science and Technology, Taiwan
- NHRI-EX103-10318PC The National Health Research Institute, Taiwan
- NHRI-EX104-10318PC The National Health Research Institute, Taiwan
- NHRI-EX105-10318PC The National Health Research Institute, Taiwan
- NHRI-EX106-10318PC The National Health Research Institute, Taiwan
- CMU108-N-03 China Medical University, Taiwan
- CMU108-Z-7 China Medical University, Taiwan
- CMU109-Z-07 China Medical University, Taiwan
- CMU110-Z-07 China Medical University, Taiwan
- DMR-110-080 China Medical University Hospital, Taiwan
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Affiliation(s)
- Jen-Yu Amy Chang
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan.
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan.
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, USA.
| | - Fang-Ju Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
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Sullivan T, McCarty G, Ombler F, Turner R, Mulhern B, Hansen P. Creating an SF-6Dv2 social value set for New Zealand. Soc Sci Med 2024; 354:117073. [PMID: 38959817 DOI: 10.1016/j.socscimed.2024.117073] [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: 11/28/2023] [Revised: 05/15/2024] [Accepted: 06/22/2024] [Indexed: 07/05/2024]
Abstract
The SF-6D health descriptive system and its second version published in 2020, the SF-6Dv2, is used worldwide for valuing health-related quality of life (HRQoL) for economic evaluation and measuring patient-reported health outcomes. In this study, a valuation tool was developed and applied to create a social value set, comprising 18,750 health state values, for the SF-6Dv2 for New Zealand (NZ). This tool was adapted and extended from the one used to create a social value set for the EQ-5D-5L, a simpler health descriptive system with fewer dimensions and health states. The tool implements the PAPRIKA method, a type of adaptive discrete choice experiment, and a binary search algorithm to identify health states worse than dead and has extensive data quality controls to ensure the validity and reliability of the social value set derived from participants' personal value sets. The tool, accompanied by a short introductory video designed specifically for the SF-6Dv2, was distributed via an online survey to a large representative sample of adult New Zealanders in June-July 2022. The tool's data quality controls enabled participants who failed to understand or sincerely engage with the valuation tasks to be identified and excluded, resulting in the participants being pared down to a sub-sample of 2985 'high-quality' participants whose personal value sets were averaged for the social value set. These results, including participants' positive feedback, demonstrate the feasibility and acceptability of using the tool to value larger health descriptive systems such as the SF-6Dv2. Having successfully created an SF-6Dv2 social value set for NZ, the valuation tool can be readily applied to other countries, used to generate personal value sets for personalised medicine and adapted to create value sets for other health descriptive systems.
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Affiliation(s)
- Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Georgia McCarty
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | | | - Robin Turner
- Biostatistics Centre, University of Otago, Dunedin, New Zealand
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Australia
| | - Paul Hansen
- 1000minds Ltd, Dunedin, New Zealand; Department of Economics, University of Otago, Dunedin, New Zealand
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Khanal S, Nghiem S, Miller M, Scuffham P, Byrnes J. Development of a Prioritization Framework to Aid Healthcare Funding Decision Making in Health Technology Assessment in Australia: Application of Multicriteria Decision Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024:S1098-3015(24)02784-0. [PMID: 39094691 DOI: 10.1016/j.jval.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/18/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES This study develops a prioritization framework to aid healthcare funding decision making in health technology assessment (HTA) in Australia using a multiple criteria decision analysis (MCDA) approach. METHODS MCDA frameworks for HTAs were reviewed through literature survey to identify the initial criteria and levels within each criterion. Key stakeholders and experts were consulted to confirm these criteria and levels. A conjoint analysis using 1000Minds was undertaken with policy makers from the Department of Health to establish ranking criteria and weighting scores. Monte Carlo simulations were used to examine the sensitivity of findings to factors affecting the ranking and weighting scores. The MCDA was then applied to 6 examples of chronic care models or technologies projects to demonstrate the performance of this approach. RESULTS Five criteria (clinical efficacy/effectiveness, safety and tolerability, severity of the condition, quality/uncertainty, and direct impact on healthcare costs) were consistently ranked highest by healthcare decision makers. Among the criteria, patient-level health outcomes were considered the most important, followed by social and ethical values. The analyses were robust to inform the uncertainty in the parameter. CONCLUSIONS This study has developed an MCDA tool that effectively integrates key priorities for HTA reviews, reflecting the values and preferences of healthcare stakeholders in Australia. Although this tool aims to align the assessment process more closely with health benefits, it also highlights the importance of considering other criteria.
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Affiliation(s)
- Saval Khanal
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia.
| | - Son Nghiem
- Department of Health Economics, Wellbeing and Society, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mel Miller
- Siggins Miller Consultants, Brisbane, Queensland, Australia
| | - Paul Scuffham
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia.
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Zhang X, Vermeulen KM, Veeger NJGM, Jabrayilov R, Krabbe PFM. Generating Utilities for the Château-Santé Base: A Novel, Generic, and Patient-Centered Health-Outcome Measure. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024:S1098-3015(24)02752-9. [PMID: 38977185 DOI: 10.1016/j.jval.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/22/2024] [Accepted: 06/18/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVES We have developed a new patient-centered, preference-based generic health-outcome measure, Château-Santé Base (CS-Base), which is based on a novel multiattribute preference response (MAPR) measurement framework. This study aimed to generate a first utility set for the CS-Base, making it suitable for use in health-economic evaluations. METHODS CS-Base comprises 12 health attributes: mobility, vision, hearing, cognition, mood, anxiety, pain, fatigue, social functioning, daily activities, self-esteem, and independence, each with 4 levels. Our methodology to generate utilities for the CS-Base was 2-fold. First, we derived coefficients from patient MAPR data to calculate CS-Base values. Subsequently, these were normalized to a 0.0 to 1.0 utility scale, in which 0.0 signifies dead. The dead position was estimated using general population data from a discrete choice experiment (discrete choice experiment + dead), using a division-value strategy, which localize the position of states better or worse than dead. RESULTS We analyzed MAPR data from 3222 patients and discrete choice experiment + dead data from 1995 respondents. All MAPR coefficients were negative, logically ordered, and significantly different from the reference level. The dead position was denoted by a division value of -148.385. Utility values spanned from -0.071 to 1.0, and only 53 of 16 777 216 states were deemed worse than dead. CONCLUSIONS This study introduced the first CS-Base utility set, underlining a 2-step utility derivation method. This method, blending societal and patient views, surpasses traditional preference-based approaches, yielding firmer results. However, improvement of the normalization procedure is expected. Estimating CS-Base utilities is an ongoing process that gains precision over time.
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Affiliation(s)
- Xin Zhang
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Nic J G M Veeger
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Paul F M Krabbe
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands; Château Santé, Zeist, The Netherlands.
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Schneider P, Devlin N, van Hout B, Brazier J. Exploring health preference heterogeneity in the UK: Using the online elicitation of personal utility functions approach to construct EQ-5D-5L value functions on societal, group and individual level. HEALTH ECONOMICS 2024; 33:894-910. [PMID: 38243895 DOI: 10.1002/hec.4805] [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: 08/25/2022] [Revised: 11/07/2023] [Accepted: 12/06/2023] [Indexed: 01/22/2024]
Abstract
A new method has recently been developed for valuing health states, called 'Online elicitation of Personal Utility Functions' (OPUF). In contrast to established methods, such as time trade-off or discrete choice experiments, OPUF does not require hundreds of respondents, but allows estimating utility functions for small groups and even at the individual level. In this study, we used OPUF to elicit EQ-5D-5L health state preferences from a (not representative) sample of the UK general population, and then compared utility functions on the societal-, group-, and individual level. A demo version of the survey is available at: https://eq5d5l.me. Data from 874 respondents were included in the analysis. For each respondent, we constructed a personal EQ-5D-5L value set. These personal value sets predicted respondents' choices in three hold-out discrete choice tasks with an accuracy of 78%. Overall, preferences varied greatly between individuals. However, PERMANOVA analysis showed that demographic characteristics explained only a small proportion of the variability between subgroups. While OPUF is still under development, it has important strengths: it can be used to construct value sets for patient reported outcome instruments such as EQ-5D-5L, while also allowing examination of underlying preferences in an unprecedented level of detail. In the future, OPUF could be used to complement existing methods, allowing valuation studies in smaller samples, and providing more detailed insights into the heterogeneity of preferences across subgroups.
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Affiliation(s)
- Paul Schneider
- ScHARR, The University of Sheffield, Sheffield, UK
- Valorem Health, Bochum, Germany
| | - Nancy Devlin
- University of Melbourne, Melbourne, Victoria, Australia
| | - Ben van Hout
- ScHARR, The University of Sheffield, Sheffield, UK
- Open Health, York, UK
| | - John Brazier
- ScHARR, The University of Sheffield, Sheffield, UK
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6
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Schneider P, Blankart K, Brazier J, van Hout B, Devlin N. Using the Online Elicitation of Personal Utility Functions Approach to Derive a Patient-Based 5-Level Version of EQ-5D Value Set: A Study in 122 Patients With Rheumatic Diseases From Germany. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:376-382. [PMID: 38154596 DOI: 10.1016/j.jval.2023.12.009] [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: 05/25/2023] [Revised: 11/06/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES Traditional preference elicitation methods, such as discrete choice experiments or time trade-off, usually require large sample sizes. This can limit their applicability in patient populations, where recruiting enough participants can be challenging. The objective of this study was to test a new method, called the Online elicitation of Personal Utility Functions (OPUF) approach, to derive an EQ-5D-5L value set from a relatively small sample of patients with rheumatic diseases. METHODS OPUF is a new type of online survey that implements compositional preference elicitation techniques. Central to the method are 3 valuation steps: (1) dimension weighting, (2) level rating, and (3) anchoring. An English demo version of the OPUF survey can be accessed at https://valorem.health/eq5d5l. From the responses, a personal EQ-5D-5L utility function can be constructed for each participant, and a group-level value set can be derived by aggregating model coefficients across participants. RESULTS A total of 122 patients with rheumatic disease from Germany completed the OPUF survey. The survey was generally well received; most participants completed the survey in less than 20 minutes and were able to derive a full EQ-5D-5L value set. The precision of mean coefficients was high, despite the small sample size. CONCLUSIONS Our findings demonstrate that OPUF can be used to derive an EQ-5D-5L value set from a relatively small sample of patients. Although the method is still under development, we think that it has the potential to be a valuable preference elicitation tool and to complement traditional methods in several areas.
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Affiliation(s)
- Paul Schneider
- ScHARR, University of Sheffield, Sheffield, England, UK; CINCH, University of Duisburg/Essen, Essen, Germany; Valorem Health, Bochum, Germany.
| | | | - John Brazier
- ScHARR, University of Sheffield, Sheffield, England, UK
| | - Ben van Hout
- ScHARR, University of Sheffield, Sheffield, England, UK; Open Health, York, England, UK
| | - Nancy Devlin
- University of Melbourne, Melbourne, VIC, Australia
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7
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Chan AHY, Tao M, Marsh S, Petousis-Harris H. Vaccine decision making in New Zealand: a discrete choice experiment. BMC Public Health 2024; 24:447. [PMID: 38347498 PMCID: PMC10863187 DOI: 10.1186/s12889-024-17865-8] [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: 03/31/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Vaccine hesitancy is a significant threat to global health. A key part of addressing hesitancy is to ensure that public health messaging prioritises information that is considered important to the public. This study aimed to examine how different vaccine characteristics affect public preferences for vaccines in New Zealand, what trade-offs they are willing to make between different vaccine characteristics, and how their preferences are affected by their vaccine-related conspiracy beliefs and COVID-19 vaccination status. METHODS An online discrete choice experiment (DCE) was designed to elicit individual preferences about vaccines using the 1000minds platform. Members of the general population of New Zealand aged ≥ 18 years were invited to complete the DCE. Participants were asked to indicate their preference between two options showing different combinations of vaccine characteristics. Data on sociodemographic characteristics were collected. Beliefs were measured using the vaccine conspiracy beliefs scale (VCBS) with scores ≥ 19 indicating strong vaccine-related conspiracy beliefs. The DCE was analysed using the PAPRIKA method (Potentially All Pairwise RanKings of all possible Alternatives) and preferences compared between respondents with high versus low VCBS scores and vaccinated versus unvaccinated respondents for COVID-19. RESULTS A total of 611 respondents from 15 regions completed the DCE. Mean (SD) age was 45.9 (14.7) years with most having had 2 or more doses of the coronavirus vaccine (86%). Mean (SD) VCBS score was 18.5 (12.4) indicating moderate vaccine-related conspiracy beliefs. Risk of severe adverse effects was the most highly valued vaccine characteristic, followed by vaccine effectiveness and duration of protection. Vaccine origin and route of administration were ranked least important. Respondents scoring high on the VCBS placed less value on the effectiveness of vaccines but greater value on development time and total number of doses (p < 0.001). COVID-19 unvaccinated respondents ranked development time and total number of doses more highly than those vaccinated respondents (p < 0.001). CONCLUSIONS Risk of severe adverse effects, vaccine effectiveness and duration of protection were rated by the New Zealand public as the top three most important vaccine characteristics. This information is important for informing public health messaging to promote vaccine uptake and inform vaccine decision-making.
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Affiliation(s)
- Amy Hai Yan Chan
- School of Pharmacy, University of Auckland, Level 3, Building 505, 85 Park Road, Grafton, 1023, Auckland, New Zealand.
| | - Marvin Tao
- School of Medicine, University of Auckland, Building 505, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - Samantha Marsh
- School of Population Health, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand
| | - Helen Petousis-Harris
- School of Population Health, University of Auckland, 85 Park Road, Grafton, 1023, Auckland, New Zealand
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Rogowski W, John J. Preferences as fairness judgments: a critical review of normative frameworks of preference elicitation and development of an alternative based on constitutional economics. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:10. [PMID: 38291472 PMCID: PMC10826070 DOI: 10.1186/s12962-024-00510-x] [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] [Received: 05/27/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Preference elicitation is widely used within health economic evaluations to inform coverage decisions. However, coverage decisions involve questions of social justice and it is unclear what role empirical evidence about preferences can play here. This study reviews the prevalent normative frameworks for using population-based preference elicitation and the criticisms they face, and proposes an alternative based on constitutional economics. The frameworks reviewed include a supposedly value-neutral framework of preferences as predictors of choice, preference utilitarian frameworks that aim to maximize preference satisfaction, and substantive consequentialist frameworks that aim to maximize happiness, health, or capabilities. The proposed alternative implements the idea that indices of social value are tools for conflict resolution, rather than tools for maximization. Preference elicitation is used for validating values generated by multi-criteria decision analysis results within representative processes of stakeholder deliberation.
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Affiliation(s)
- Wolf Rogowski
- Department of Health Care Management, Institute of Public Health and Nursing Research, Health Sciences, University of Bremen, Grazer Str. 2a, 28359, Bremen, Germany.
- Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München (GmbH) German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Jürgen John
- Institute of Health Economics and Health Care Management (IGM), Helmholtz Zentrum München (GmbH) German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
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Taylor WJ, Tuffaha H, Hawley CM, Peyton P, Higgins AM, Scuffham PA, Nemeh F, Balagurunathan A, Hansen P, Jacques A, Morton RL. Embedding stakeholder preferences in setting priorities for health research: Using a discrete choice experiment to develop a multi-criteria tool for evaluating research proposals. PLoS One 2023; 18:e0295304. [PMID: 38060475 PMCID: PMC10703277 DOI: 10.1371/journal.pone.0295304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
We determined weights for a multi-criteria tool for assessing the relative merits of clinical-trial research proposals, and investigated whether the weights vary across relevant stakeholder groups. A cross-sectional, adaptive discrete choice experiment using 1000minds online software was administered to consumers, researchers and funders affiliated with the Australian Clinical Trials Alliance (ACTA). We identified weights for four criteria-Appropriateness, Significance, Relevance, Feasibility-and their levels, representing their relative importance, so that research proposals can be scored between 0% (nil or very low merit) and 100% (very high merit). From 220 complete survey responses, the most important criterion was Appropriateness (adjusted for differences between stakeholder groups, mean weight 28.9%) and the least important was Feasibility (adjusted mean weight 19.5%). Consumers tended to weight Relevance more highly (2.7% points difference) and Feasibility less highly (3.1% points difference) than researchers. The research or grant writing experience of researchers or consumers was not associated with the weights. A multi-criteria tool for evaluating research proposals that reflects stakeholders' preferences was created. The tool can be used to assess the relative merits of clinical trial research proposals and rank them, to help identify the best proposals for funding.
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Affiliation(s)
- William J. Taylor
- Department of Medicine, University of Otago, Wellington, New Zealand
- Hutt Valley District Health Board, Lower Hutt, New Zealand
- Tairawhiti District Health Board, Gisborne, New Zealand
| | - Haitham Tuffaha
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Carmel M. Hawley
- Australasian Kidney Trials Network (AKTN), Brisbane, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Philip Peyton
- Australia and New Zealand College of Anaesthetists Clinical Trials Network, Melbourne, Australia
| | - Alisa M. Higgins
- Australia and New Zealand Intensive Care-Research Centre, Monash University, Melbourne, Australia
| | | | - Fiona Nemeh
- Australian Clinical Trials Alliance, Melbourne, Australia
| | | | - Paul Hansen
- Department of Economics, University of Otago, Dunedin, New Zealand
| | - Angela Jacques
- Institute for Health Research, The University of Notre Dame, Freemantle, Australia
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Darlow B, Brown M, Stanley J, Abbott JH, Briggs AM, Clark J, Frew G, Grainger R, Hood F, Hudson B, Keenan R, Marra C, McKinlay E, Pask A, Pierobon A, Simmonds S, Vincent L, Wilson R, Dean S. Reducing the burden of knee osteoarthritis through community pharmacy: Protocol for a randomised controlled trial of the Knee Care for Arthritis through Pharmacy Service. Musculoskeletal Care 2023; 21:1053-1067. [PMID: 37212721 DOI: 10.1002/msc.1785] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Knee osteoarthritis (OA) negatively impacts the health outcomes and equity, social and employment participation, and socio-economic wellbeing of those affected. Little community-based support is offered to people with knee OA in Aotearoa New Zealand. Identifying Māori and non-Māori with knee OA in community pharmacy and providing co-ordinated, evidence- and community-based care may be a scalable, sustainable, equitable, effective and cost-effective approach to improve health and wellbeing. AIM Assess whether the Knee Care for Arthritis through Pharmacy Service (KneeCAPS) intervention improves knee-related physical function and pain (co-primary outcomes). Secondary aims assess impacts on health-related quality of life, employment participation, medication use, secondary health care utilisation, and relative effectiveness for Māori. METHODS AND ANALYSIS A pragmatic randomised controlled trial will compare the KneeCAPS intervention to the Pharmaceutical Society of New Zealand Arthritis Fact Sheet and usual care (active control) at 12 months for Māori and non-Māori who have knee OA. Participants will be recruited in community pharmacies. Knee-related physical function will be measured using the function subscale of the Short Form of the Western Ontario and McMaster Universities Osteoarthritis Index. Knee-related pain will be measured using an 11-point numeric pain rating scale. Primary outcome analyses will be conducted on an intention-to-treat basis using linear mixed models. Parallel within-trial health economic analysis and process evaluation will also be conducted. ETHICS AND TRIAL DISSEMINATION Ethical approval was obtained from the Central Health and Ethics Committee (2022-EXP-11725). The trial is registered with ANZCTR (ACTRN12622000469718). Findings will be submitted for publication and shared with participants.
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Affiliation(s)
- Ben Darlow
- University of Otago Wellington, Wellington, New Zealand
| | - Melanie Brown
- University of Otago Wellington, Wellington, New Zealand
| | - James Stanley
- University of Otago Wellington, Wellington, New Zealand
| | | | | | - Jane Clark
- Consumer Research Partner, Wellington, New Zealand
| | - Gareth Frew
- Canterbury Community Pharmacy Group, Christchurch, New Zealand
| | | | - Fiona Hood
- University of Otago Wellington, Wellington, New Zealand
| | - Ben Hudson
- University of Otago Christchurch, Christchurch, New Zealand
| | - Rāwiri Keenan
- University of Otago Wellington, Wellington, New Zealand
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Shand JAD, Young S, Verster F, Peters C. Pilot study to test the safety, tolerability and feasibility of dulaglutide during a low-energy diet for weight loss and improved glycaemic control. BMJ Nutr Prev Health 2023; 6:341-346. [PMID: 38264361 PMCID: PMC10800248 DOI: 10.1136/bmjnph-2023-000733] [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: 07/15/2023] [Accepted: 11/10/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Diabetes and obesity are significant public health concerns. Previous studies have demonstrated that low energy diets are effective in promoting weight loss and inducing diabetes remission. However, hunger is a potential barrier to adherence for such diets.Dulaglutide is a glucagon-like peptide receptor agonist used in diabetes treatment. Its use is associated with weight loss, partly through increased satiety. The use of dulaglutide may improve adherence to a low energy diet through a reduction in hunger. We undertook a pilot study to assess the safety, tolerability and feasibility of this combination in individuals with obesity and type 2 diabetes. Research design and methods We enrolled individuals with type 2 diabetes and obesity from a tertiary diabetes service in Auckland, New Zealand. Owing to their higher rates of diabetes and poorer diabetes-related health outcomes, we preferentially enrolled Māori and Pacific individuals.Participants underwent 2 weeks of dulaglutide run-in followed by 12 weeks of the combination of dulaglutide and low energy diet. The primary endpoints were the proportion of people successfully completing the dietary intervention and the rates and types of adverse events. Secondary outcomes were changes in weight, glycaemic control, quality of life and biochemical parameters. Results The intervention was well tolerated. Mild side effects were common during the first 2 weeks of the intervention but generally improved over the study period. Eighty-nine per cent of participants completed the 12-week dietary intervention. Participants achieved an average weight loss of 9.5 kg and a mean reduction in haemoglobin A1c of 15.8 mmol/mol. Quality of life metrics were unchanged. Conclusions We conclude that the combination of dulaglutide and a low energy diet is a feasible and well-tolerated intervention for individuals with diabetes and increased body weight. Future studies could be performed assessing this combination against a low energy diet alone. Trial registration number This study was registered with the Australia New Zealand Clinical Trials Registry (ACTRN1262200015279p).
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Affiliation(s)
| | - Simon Young
- Waitemata District Health Board, Auckland, New Zealand
| | | | - Carl Peters
- Waitemata District Health Board, Auckland, New Zealand
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12
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Wang H, Rowen DL, Brazier JE, Jiang L. Discrete Choice Experiments in Health State Valuation: A Systematic Review of Progress and New Trends. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:405-418. [PMID: 36997744 PMCID: PMC10062300 DOI: 10.1007/s40258-023-00794-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Discrete choice experiments (DCEs) are increasingly used in health state valuation studies. OBJECTIVE This systematic review updates the progress and new findings of DCE studies in the health state valuation, covering the period since the review of June 2018 to November 2022. The review reports the methods that are currently being used in DCE studies to value health and study design characteristics, and, for the first time, reviews DCE health state valuation studies published in the Chinese language. METHODS English language databases PubMed and Cochrane, and Chinese language databases Wanfang and CNKI were searched using the self-developed search terms. Health state valuation or methodology study papers were included if the study used DCE data to generate a value set for a preference-based measure. Key information extracted included DCE study design strategies applied, methods for anchoring the latent coefficient on to a 0-1 QALY scale and data analysis methods. RESULTS Sixty-five studies were included; one Chinese language publication and 64 English language publications. The number of health state valuation studies using DCE has rapidly increased in recent years and these have been conducted in more countries than prior to 2018. Wide usage of DCE with duration attributes, D-efficient design and models accounting for heterogeneity has continued in recent years. Although more methodological consensus has been found than in studies conducted prior to 2018, this consensus may be driven by valuation studies for common measures with an international protocol (the 'model' valuation research). Valuing long measures with well-being attributes attracted attention and more realistic design strategies (e.g., inconstant time preference, efficient design and implausible states design) were identified. However, more qualitative and quantitative methodology study is still necessary to evaluate the effect of those new methods. CONCLUSIONS The use of DCEs in health state valuation continues to grow dramatically and the methodology progress makes the method more reliable and pragmatic. However, study design is driven by international protocols and method selection is not always justified. There is no gold standard for DCE design, presentation format or anchoring method. More qualitative and quantitative methodology study is recommended to evaluate the effect of new methods before researchers make methodology decisions.
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Affiliation(s)
- Haode Wang
- School of Health and Related Research (ScHARR), University of Sheffield, 30 Regent St, Sheffield City Centre, Sheffield, S1 4DA, UK.
| | - Donna L Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, 30 Regent St, Sheffield City Centre, Sheffield, S1 4DA, UK
| | - John E Brazier
- School of Health and Related Research (ScHARR), University of Sheffield, 30 Regent St, Sheffield City Centre, Sheffield, S1 4DA, UK
| | - Litian Jiang
- Health Policy Research Unit, Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong Province, China
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13
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Maddison R, Hargreaves EA, Jiang Y, Calder AJ, Wyke S, Gray CM, Hunt K, Lubans DR, Eyles H, Draper N, Heke I, Kara S, Sundborn G, Arandjus C, Gao L, Lee P, Lim M, Marsh S. Rugby Fans in Training New Zealand (RUFIT NZ): a randomized controlled trial to assess the effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs. Int J Behav Nutr Phys Act 2023; 20:37. [PMID: 36978139 PMCID: PMC10043512 DOI: 10.1186/s12966-022-01395-w] [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] [Received: 06/29/2022] [Accepted: 12/03/2022] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND A healthy lifestyle program that appeals to, and supports, overweight and obese New Zealand (NZ) European, Māori (indigenous) and Pasifika men to achieve weight loss is urgently needed. A pilot program inspired by the successful Football Fans in Training program but delivered via professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, adherence to healthy lifestyle behaviors, and cardiorespiratory fitness in overweight and obese men. A full effectiveness trial is now needed. AIMS To determine the effectiveness and cost effectiveness of Rugby Fans In Training-NZ (RUFIT-NZ) on weight loss, fitness, blood pressure, lifestyle change, and health related quality of life (HRQoL) at 12- and 52-weeks. METHODS We conducted a pragmatic, two-arm, multi-center, randomized controlled trial in NZ with 378 (target 308) overweight and obese men aged 30-65 years, randomized to an intervention group or wait-list control group. The 12-week RUFIT-NZ program was a gender-sensitised, healthy lifestyle intervention delivered through professional rugby clubs. Each intervention session included: i) a 1-h workshop-based education component focused on nutrition, physical activity, sleep, sedentary behavior, and learning evidence-based behavior change strategies for sustaining a healthier lifestyle; and 2) a 1-h group-based, but individually tailored, exercise training session. The control group were offered RUFIT-NZ after 52-weeks. The primary outcome was change in body weight from baseline to 52-weeks. Secondary outcomes included change in body weight at 12-weeks, waist circumference, blood pressure, fitness (cardiorespiratory and musculoskeletal), lifestyle behaviors (leisure-time physical activity, sleep, smoking status, and alcohol and dietary quality), and health-related quality of life at 12- and 52-weeks. RESULTS Our final analysis included 200 participants (intervention n = 103; control n = 97) who were able to complete the RUFIT-NZ intervention prior to COVID-19 restrictions. At 52-weeks, the adjusted mean group difference in weight change (primary outcome) was -2.77 kg (95% CI -4.92 to -0.61), which favored the intervention group. The intervention also resulted in favorable significant differences in weight change and fruit and vegetable consumption at 12-weeks; and waist circumference, fitness outcomes, physical activity levels, and health-related quality of life at both 12 and 52 weeks. No significant intervention effects were observed for blood pressure, or sleep. Incremental cost-effective ratios estimated were $259 per kg lost, or $40,269 per quality adjusted life year (QALY) gained. CONCLUSION RUFIT-NZ resulted in sustained positive changes in weight, waist circumference, physical fitness, self-reported physical activity, selected dietary outcomes, and health-related quality of life in overweight/obese men. As such, the program should be recommended for sustained delivery beyond this trial, involving other rugby clubs across NZ. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered 18 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376740 Universal Trial Number, U1111-1245-0645.
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Affiliation(s)
- Ralph Maddison
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand.
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Elaine Anne Hargreaves
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Amanda Jane Calder
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, Scotland
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, Scotland
| | - Kate Hunt
- Institute for Social Marketing and Health, Faculty of Health and Sports Sciences, University of Stirling, Stirling, Scotland
| | - David Revalds Lubans
- School of Education, Centre for Active Living and Learning, University of Newcastle, Hunter Medical Research Institute, Newcastle, Australia
| | - Helen Eyles
- Department of Epidemiology and Biostatistics, National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Nick Draper
- Faculty of Health, SHARRC, University of Canterbury, Christchurch, New Zealand
| | | | - Stephen Kara
- Axis Sport Medicine Clinic, Auckland, New Zealand
| | - Gerhard Sundborn
- Department of Pacific Health, University of Auckland, Auckland, New Zealand
| | - Claire Arandjus
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Lan Gao
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Peter Lee
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Megumi Lim
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Samantha Marsh
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
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Wilson D, Tweedie F, Rumball-Smith J, Ross K, Kazemi A, Galvin V, Dobbie G, Dare T, Brown P, Blakey J. Lessons learned from developing a COVID-19 algorithm governance framework in Aotearoa New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2121290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Daniel Wilson
- School of Computer Science, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
| | | | | | - Kevin Ross
- Precision Driven Health, Auckland, New Zealand
| | - Alex Kazemi
- Critical Care Complex, Middlemore Hospital, Auckland, New Zealand
| | | | - Gillian Dobbie
- School of Computer Science, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
| | - Tim Dare
- Department of Philosophy, Waipapa Taumata Rau/University of Auckland, Auckland, New Zealand
| | | | - Judy Blakey
- Precision Driven Health Independent Advisory Group, Auckland, New Zealand
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McBride D, Samaranayaka A, Richardson A, Gardner D, Shepherd D, Wyeth E, de Graaf B, Derrett S. Factors associated with self-reported health among New Zealand military veterans: a cross-sectional study. BMJ Open 2022; 12:e056916. [PMID: 35613796 PMCID: PMC9134175 DOI: 10.1136/bmjopen-2021-056916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To identify factors associated with better or poorer self-reported health status in New Zealand military Veterans. DESIGN A cross-sectional survey. PARTICIPANTS The participants of interest were the 3874 currently serving Veterans who had been deployed to a conflict zone, but all Veterans were eligible to participate. STUDY VARIABLES The EQ-5D-5L, asking about problems across five dimensions (mobility, self-care, usual activities, pain or discomfort and anxiety or depression), with five levels of severity (eg, no, slight, moderate, severe or extreme problems), also containing a Visual Analogue Scale (EQ-VAS) to self-assess health state, scaled from 0 (worst) to 100 (best) imagined health.Hypothetical relationships with better health were positive social support, sleep and psychological flexibility; with poorer health, post-traumatic stress, exposure to psychological trauma, distress and hazardous drinking. RESULTS The EQ5-D-5L was completed by 1767 Veterans, 1009 serving, a response rate of 26% from that group, 1767 completing the EQ5-D, 1458 who had deployed, 288 who had not and the 21 who did not provide deployment data. Of these, 247 were not used in the analysis due to missing values in one or more variables, leaving 1520 for analysis.A significantly higher proportion of Veterans reported 'any problems' rather than 'no problems' with four EQ-5D dimensions: mobility, self-care, usual activities and pain or discomfort, but no difference in anxiety or depression. Age, length of service, deployment, psychological flexibility and better sleep quality were associated with higher EQ-VAS scores; distress with lower EQ-VAS scores. CONCLUSION In this sample of New Zealand Veterans, psychological flexibility and good sleep are associated with better self-rated health, and distress and poor sleep with diminished health. These factors might be used as sentinel health indicators in assessing Veteran health status, and cognitive-behavioural therapy encompassing these domains may be useful in improving the health of New Zealand Veterans.
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Affiliation(s)
- David McBride
- Department of Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Ariyapala Samaranayaka
- Biostatistics Centre, University of Otago Division of Health Sciences, Dunedin, New Zealand
| | - Amy Richardson
- Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Dianne Gardner
- Department of Psychology, Massey University, Palmerston North, New Zealand
| | - Daniel Shepherd
- Health Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Emma Wyeth
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand
| | - Brandon de Graaf
- Injury Prevention Research Unit, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
| | - Sarah Derrett
- Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
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16
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Taylor JE, McLean R, Samaranayaka A, Connolly MJ. How Does Driving Anxiety Relate to the Health and Quality of Life of Older Drivers? J Appl Gerontol 2022; 41:1312-1320. [PMID: 35302401 DOI: 10.1177/07334648211072540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES 11% of drivers aged 65+ report moderate to extreme driving anxiety, with associated reduction in driving. Knowledge about the relationships of driving anxiety with health and quality of life for older people is minimal. The present study examined these relationships. METHOD 1170 community dwelling drivers aged 65+ in New Zealand completed a population survey. RESULTS After adjusting for socio-demographic variables, higher driving anxiety was associated with lower quality of life and lower odds of 'very good' self-reported health, but no difference in odds of multi-comorbidity. DISCUSSION Further research is needed to examine the influence of driving anxiety on health and quality of life outcomes with a broader range of older people who experience more challenges to their health and wellbeing, especially to mental health.
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Affiliation(s)
- Joanne E Taylor
- School of Psychology, 6420Massey University, Palmerston North, New Zealand
| | - Rebecca McLean
- Department of Preventive and Social Medicine, Otago Medical School, 193179University of Otago, Dunedin, New Zealand
| | - Ari Samaranayaka
- Biostatistics Centre, Division of Health Sciences, 2495University of Otago, Dunedin, New Zealand
| | - Martin J Connolly
- Department of Geriatric Medicine, School of Medicine, 56382University of Auckland, Auckland, New Zealand
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17
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Aslam A, Shah S, Abbas G, Rehman AU, Malhi TH, Alotaibi NH, Alzarea AI, Rasool MF, Khurram H, Noureen S, Saeed Bokhari MT. Assessment of health-related quality of life in hypertensive hemodialysis patients. PeerJ 2022; 10:e12690. [PMID: 35036092 PMCID: PMC8734469 DOI: 10.7717/peerj.12690] [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: 07/02/2021] [Accepted: 12/04/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Globally, the prevalence of hypertension (HTN) with the coexistence of chronic kidney disease (CKD) is increasing, resulting in poor quality of life. The main objective of the study was to measure the health-related quality of life (HRQoL) of hypertensive hemodialysis patients. METHODS A multicenter follow-up study was carried out in six public and two private dialysis centers in Pakistan. A total of 517 hypertensive hemodialysis patients responded by completing the questionnaire at baseline and two subsequent phases. The quality of life of these patients was assessed using the EQ-5D-5L questionnaire (a standardized instrument for measuring generic health status). Statistical analysis was done using a multivariate linear regression model, Friedman test and Kruskal Wallis test. RESULTS The majority of patients (58.2%) had normal body mass index and about 60.5% of the patients were taking less salt due to HTN. Friedman test gave the statistically significant results (p ≤ 0.001) in systolic blood pressure (BP), diastolic BP and EQ-5D visual analogue scale (VAS) score between three phases (initial visit, first follow-up and second follow-up). A significant improvement was observed in self-care and usual activities from initial visit to first follow-up (p < 0.05). The most problematic dimension among the hypertensive patients with CKD was pain/discomfort (86.5%). CONCLUSIONS HTN with coexisting CKD in hemodialysis patients severely affected HRQoL. Pain/discomfort was the most problematic dimension among the participants.
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Affiliation(s)
- Ayesha Aslam
- Department of Neurology, King Edward Medical University, Lahore, Pakistan
| | - Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Ghulam Abbas
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Anees ur Rehman
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Tauqeer Hussain Malhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf Province, Kingdom of Saudi Arabia
| | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf Province, Kingdom of Saudi Arabia
| | - Abdulaziz Ibrahim Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf Province, Kingdom of Saudi Arabia
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Haris Khurram
- Department of Sciences and Humanities, National University of Computer and Emerging Sciences, Faisalabad, Pakistan
| | - Sibgha Noureen
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Talha Saeed Bokhari
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
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Poudel N, Fahim SM, Qian J, Garza K, Chaiyakunapruk N, Ngorsuraches S. Methodological similarities and variations among EQ-5D-5L value set studies: a systematic review. J Med Econ 2022; 25:571-582. [PMID: 35416095 DOI: 10.1080/13696998.2022.2066441] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES (1) To descriptively compare the selected elements of valuation methods for EQ-5D-5L value set studies, (2) to compare the characteristics of the value sets, and (3) to examine the associations between the selected elements of valuation methods and the EQ-5D-5L value sets. METHODS A systematic literature search of EQ-5D-5L valuation studies from 1 January 2009 to 22 April 2021 was conducted in selected databases. Following the initial search, we also explored additional studies published during the completion of the final version of the manuscript. Similarities and variations for selected elements of valuation methods were descriptively compared. The relative importance of dimensions, utility decrements between the levels, and distribution of the utility scores were used to compare value sets. A meta-regression analysis examined the associations between the selected methodological elements and the utility scores and dimension levels of EQ-5D-5L. RESULTS A total of 31 studies were included in this review. Methodological similarities centered around data collection and preference elicitation method. On the other hand, variations include sampling technique, sample size, and value set modeling. The variations in value sets based on the relative importance of dimension, decrement in utility score, and distribution of utility score across countries were observed. Although the distribution of the utility scores differed across countries, higher levels of each dimension tended to have a larger decrement in the utility scores. Mean utility scores for the experience-based value sets were higher than those estimated using stated choice methods. The selected methodological elements were not significantly associated with the mean predicted utility scores or most dimension-level coefficients. CONCLUSIONS EQ-5D-5L health state valuation methods and characteristics of value sets differed across studies. The impact of the variation of methodological elements on the value sets should be further investigated.
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Affiliation(s)
- N Poudel
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA
| | - S M Fahim
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA
| | - J Qian
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA
| | - K Garza
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA
| | - N Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, The University of Utah, Salt Lake City, UT, USA
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| | - S Ngorsuraches
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA
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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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20
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Sullivan T, Turner RM, Derrett S, Hansen P. New Zealand Population Norms for the EQ-5D-5L Constructed From the Personal Value Sets of Participants in a National Survey. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1308-1318. [PMID: 34452711 DOI: 10.1016/j.jval.2021.04.1280] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/10/2021] [Accepted: 04/05/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To derive New Zealand (NZ) population norms for the EQ-5D-5L and to examine the association between participants' sociodemographic characteristics and their health-related quality of life. METHODS Data from the 2018 NZ EQ-5D-5L valuation study (n = 2468) were used. Each participant's 5-digit profile was converted to a single utility value using their personal value set. The profiles, mean utility values, and mean EuroQol visual analog scale (EQ-VAS) scores were summarized by dimension and disaggregated by age group and gender. Multivariable logistic and Tobit regressions were used to investigate the association between participants' sociodemographic characteristics and the EQ-5D-5L dimensions, utility values, and EQ-VAS scores. RESULTS The mean utility value was 0.847 and the mean EQ-VAS score was 74.8. Of the 3125 possible EQ-5D-5L profiles, 25 profiles represented the current health status of the majority of participants (78%). The odds of having problems with anxiety or depression was greatest for people aged 18 to 24 years and decreased with age. People with a long-term disability or chronic illness had greater odds of problems on all dimensions and lower (poorer) utility values and EQ-VAS scores. Age, ethnicity, employment status, long-term disability, and chronic illness were associated with utility. CONCLUSION EQ-5D-5L population norms were derived for the NZ population using the personal value sets of 2468 participants. Consistent with other countries' population norms, EQ-5D-5L utility values and EQ-VAS scores were associated with age, employment status, long-term disability, and chronic illness. These norms will support resource allocation decision making and help in understanding the health-related quality of life of the NZ population.
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Affiliation(s)
- Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Robin M Turner
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Paul Hansen
- Department of Economics, University of Otago, Dunedin, New Zealand
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21
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Blank ML, Hoek J, Gendall P. New Zealand roll-your-own smokers' reaction to novel roll-your-own tobacco packaging warning labels. Drug Alcohol Rev 2021; 40:1092-1100. [PMID: 33774890 DOI: 10.1111/dar.13280] [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: 09/07/2020] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although roll-your-own (RYO) loose tobacco is increasingly popular among smokers, no jurisdictions have used RYO-specific pictorial warning labels (PWL) on tobacco packaging. We explored how New Zealand RYO smokers, a population with over 10 years of exposure to PWLs, reacted to RYO-specific warnings featuring novel themes. METHODS We conducted an online survey of 785 RYO smokers in March 2019. Eligible participants were smokers aged 18-70 years who smoked predominantly RYO cigarettes. Participants randomly viewed two of eight RYO-specific PWLs featuring themes of health information (mouth and throat cancer), suffering (male and female), toxins, material hardship, cost, family transmission of smoking and harm to pets and answered items assessing negative emotions and perceived effectiveness. RESULTS Compared to a reference health information PWL (most similar in content and tone to New Zealand's existing PWLs), only a male suffering PWL elicited both significantly stronger negative emotion and higher perceived effectiveness. No themes performed significantly worse than the health information PWL, suggesting any of the themes could be at least as effective as existing health warnings among New Zealand RYO smokers. The individual-level factors consistently associated with negative emotion and perceived effectiveness were age, desire to quit smoking, believing quitting could reduce risk of serious disease, a quit attempt within the previous 6 months and ever-planning to quit. CONCLUSION Our findings suggest that, in the New Zealand context, a PWL emphasising male suffering could be a useful starting point for assessing RYO-specific PWLs compared to general smoking warnings.
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Affiliation(s)
- Mei-Ling Blank
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Philip Gendall
- Department of Public Health, University of Otago, Wellington, New Zealand
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22
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Thompson KJ, Young PJ, Venkatesh B, Cohen J, Finfer SR, Grattan S, Hammond NE, Jan S, Li Q, Di Tanna GL, McArthur C, Myburgh J, Rajbhandari D, Taylor CB. Long-term costs and cost-effectiveness of adjunctive corticosteroids for patients with septic shock in New Zealand. Aust Crit Care 2021; 35:241-250. [PMID: 34325975 DOI: 10.1016/j.aucc.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The aim of the study was to determine whether adjunctive hydrocortisone reduced healthcare expenditure and was cost-effective compared with placebo in New Zealand patients in the Adjunctive Glucocorticoid Therapy in Patients with Septic Shock (ADRENAL) trial. DESIGN This is a health economic analysis using data linkage to New Zealand Ministry of Health databases to determine resource use, costs, and cost-effectiveness for a 24-month period. SETTING The study was conducted in New Zealand. PARTICIPANTS AND INTERVENTION Patients with septic shock were randomised to receive a 7-day continuous infusion of 200 mg of hydrocortisone or placebo in the ADRENAL trial. MAIN OUTCOME MEASURES Healthcare expenditure was associated with all hospital admissions, emergency department presentations, outpatient visits, and pharmacy expenditure. Effectiveness outcomes included mortality at 6 months and 24 months and quality of life at 6 months. Cost-effectiveness outcomes were assessed with reference to quality-adjusted life years gained at 6 months and life years gained at 24 months. RESULTS Of 3800 patients in the ADRENAL trial, 419 (11.0%) were eligible, and 405 (96.7% of those eligible) were included. The mean total costs per patient over 24 months were $143,627 ± 100,890 and $143,772 ± 97,117 for the hydrocortisone and placebo groups, respectively (p = 0.99). Intensive care unit costs for the index admission were $50,492 and $62,288 per patient for the hydrocortisone and placebo groups, respectively (p = 0.09). The mean number of quality-adjusted life years gained at 6 months and mean number of life years gained at 24 months was not significantly different by treatment group, and the probability of hydrocortisone being cost-effective was 55% at 24 months. CONCLUSIONS In New Zealand, adjunctive hydrocortisone did not reduce total healthcare expenditure or improve outcomes compared with placebo in patients with septic shock.
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Affiliation(s)
- Kelly J Thompson
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Paul J Young
- Medical Research Institute of New Zealand, Wellington, New Zealand; Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
| | - Balasubramanian Venkatesh
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia; The Princess Alexandra Hospital, University of Queensland, Brisbane, Australia; The Wesley Hospital, Brisbane, Australia
| | - Jeremy Cohen
- The George Institute for Global Health, Sydney, Australia
| | - Simon R Finfer
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia; Imperial College, London, UK; Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Sarah Grattan
- The George Institute for Global Health, Sydney, Australia
| | - Naomi E Hammond
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia; Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Stephen Jan
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Qiang Li
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Gian Luca Di Tanna
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia
| | - Colin McArthur
- Medical Research Institute of New Zealand, Wellington, New Zealand; Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - John Myburgh
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia; St George Clinical School, University of New South Wales, Sydney, Australia
| | | | - Colman B Taylor
- The George Institute for Global Health, Sydney, Australia; University of New South Wales, Sydney, Australia.
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McCombie AM, Frampton CM, Frizelle FA. Quality of life preferences in colorectal cancer patients aged 80 and over. ANZ J Surg 2021; 91:1859-1865. [PMID: 33851517 DOI: 10.1111/ans.16739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Management of patients with colorectal cancer (CRC) is about not only survival, but also quality of life (QoL). What patients want is important but is not well researched or understood for elderly patients where it is very relevant. This study aimed to measure and compare what patients with CRC aged 80 and over and surgeons consider important in terms of survivorship after surgery for CRC. METHODS Patients aged 80 and over who were having surgery for CRC were recruited and interviewed using closed and open questions about their expectations of surgery and various QoL dimensions. These were assessed preoperatively and 3 months post-operatively. Surgeons ranked the same QoL dimensions of patients by questionnaire. RESULTS Nineteen patients (median age 87.5, range 80-95, eight males and 11 females) were recruited. Patients rated items relating to health, mobility and independence (n = 23) as top three items most often followed by people outside self (n = 13). Surgeons underestimated importance in 17 domains with the biggest discrepancy being in 'avoiding a stoma' (4.11 versus 2.3, P < 0.01). CONCLUSION With patients over 80 years having surgery for CRC, there is a lack of concordance between what surgeons think is important and what patients think is important. Despite this, CRC patients aged 80 and older are almost always satisfied with the outcome of surgery. Surgeons should ensure that they understand patients' expectations and that they are aligned with likely outcomes of surgery.
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Affiliation(s)
- Andrew M McCombie
- Department of General Surgery, Canterbury District Health Board, Christchurch, New Zealand.,Department of Surgery, The University of Otago, Christchurch, New Zealand
| | - Chris M Frampton
- Department of Medicine, The University of Otago, Christchurch, New Zealand
| | - Frank A Frizelle
- Department of General Surgery, Canterbury District Health Board, Christchurch, New Zealand.,Department of Surgery, The University of Otago, Christchurch, New Zealand
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Babashahi S, Hansen P, Sullivan T. Creating a priority list of non-communicable diseases to support health research funding decision-making. Health Policy 2020; 125:221-228. [PMID: 33357963 DOI: 10.1016/j.healthpol.2020.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/22/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To develop and pilot a framework based on multi-criteria decision analysis (MCDA) to prioritize non-communicable diseases (NCDs) to support health research funding decision-making. METHODS The framework involves identifying NCDs to be prioritized, specifying prioritization criteria and determining their weights from a survey of stakeholders. The mean weights from the survey are applied to the NCDs' ratings on the criteria to generate a 'total score' for each NCD, by which the NCDs are prioritized. RESULTS Nineteen NCDs and five criteria were included. The criteria, in decreasing order of importance (mean weights in parentheses), are: deaths across the population (27.7 %), loss of quality-of-life across the population (23.0 %), cost to patients and families (18.6 %), cost to the health system (17.2 %), and whether vulnerable groups are disproportionately affected (13.4 %). The priority list of NCDs, stratified into four tiers of importance, is: 'Very critical' priority: coronary heart disease, back and neck pain, diabetes mellitus; 'Critical' priority: dementia and Alzheimer's disease, stroke; 'High' priority: colon and rectum cancer, depressive disorders, chronic obstructive pulmonary disease, chronic kidney disease, breast cancer, prostate cancer, arthritis, lung cancer; and 'Medium' priority: asthma, hearing loss, melanoma skin cancer, addictive disorders, non-melanoma skin cancer, headaches. CONCLUSION The results indicate the framework for prioritizing NCDs for research funding is feasible and effective. The framework could also be used for other health conditions.
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Affiliation(s)
| | - Paul Hansen
- Department of Economics, University of Otago, Dunedin, New Zealand; 1000minds Ltd, Wellington, New Zealand
| | - Trudy Sullivan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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25
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Long term outcomes of critically ill COVID-19 pneumonia patients: early learning. Intensive Care Med 2020; 47:240-241. [PMID: 33169214 PMCID: PMC7652047 DOI: 10.1007/s00134-020-06313-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2020] [Indexed: 11/08/2022]
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Shah KK, Ramos-Goñi JM, Kreimeier S, Devlin NJ. An exploration of methods for obtaining 0 = dead anchors for latent scale EQ-5D-Y values. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:1091-1103. [PMID: 32506281 PMCID: PMC7423806 DOI: 10.1007/s10198-020-01205-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 05/27/2020] [Indexed: 05/19/2023]
Abstract
OBJECTIVES Discrete choice experiments (DCEs) can be used to obtain latent scale values for the EQ-5D-Y, but these require anchoring at 0 = dead to meet the conventions of quality-adjusted life year (QALY) estimation. The primary aim of this study is to compare four preference elicitation methods for obtaining anchors for latent scale EQ-5D-Y values. METHODS Four methods were tested: visual analogue scale (VAS), DCE (with a duration attribute), lag-time time trade-off (TTO) and the location-of-dead (LOD) approach. In computer-assisted personal interviews, UK general public respondents valued EQ-5D-3L health states from an adult perspective and EQ-5D-Y health states from a 10-year-old child perspective. Respondents completed valuation tasks using all four methods, under both perspectives. RESULTS 349 interviews were conducted. Overall, respondents gave lower values under the adult perspective compared to the child perspective, with some variation across methods. The mean TTO value for the worst health state (33333) was about equal to dead in the child perspective and worse than dead in the adult perspective. The mean VAS rescaled value for 33333 was also higher in the child perspective. The DCE produced positive child perspective values and negative adult perspective values, though the models were not consistent. The LOD median rescaled value for 33333 was negative under both perspectives and higher in the child perspective. DISCUSSION There was broad agreement across methods. Potential criteria for selecting a preferred anchoring method are presented. We conclude by discussing the decision-making circumstances under which utilities and QALY estimates for children and adults need to be commensurate to achieve allocative efficiency.
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Affiliation(s)
- Koonal K Shah
- PHMR, London, UK.
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
- Office of Health Economics, London, UK.
| | - Juan Manuel Ramos-Goñi
- Axentiva Solutions, Tacoronte, Spain
- Office of the EuroQol Research Foundation, Rotterdam, Netherlands
| | - Simone Kreimeier
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Nancy J Devlin
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- Office of Health Economics, London, UK
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Waste Segregation FMEA Model Integrating Intuitionistic Fuzzy Set and the PAPRIKA Method. MATHEMATICS 2020. [DOI: 10.3390/math8081375] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Segregation is an important step in health care waste management. If done incorrectly, the risk of preventable infections, toxic effects, and injuries to care and non-care staff, waste handlers, patients, visitors, and the community at large, is increased. It also increases the risk of environmental pollution and prevents recyclable waste from being recovered. Despite its importance, it is acknowledged that poor waste segregation occurs in most health care organizations. This study therefore intends to produce, for the first time, a classification of failure modes related to segregation in the Nuclear Medicine Department of a health care organization. This will be done using Failure Mode and Effects Analysis (FMEA), by combining an intuitionistic fuzzy hybrid weighted Euclidean distance operator, and the multicriteria method Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA). Subjective and objective weights of risk factors were considered simultaneously. The failure modes identified in the top three positions are: improper storage of waste (placing items in the wrong bins), improper labeling of containers, and bad waste management (inappropriate collection periods and bin set-up).
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Gansen F, Klinger J. Reasoning in the valuation of health-related quality of life: A qualitative content analysis of deliberations in a pilot study. Health Expect 2020; 23:405-413. [PMID: 31868289 PMCID: PMC7104633 DOI: 10.1111/hex.13011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/22/2019] [Accepted: 11/27/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Group deliberation can be a pathway to understanding reasons behind judgement decisions. This pilot study implemented a deliberative process to elicit public values about health-related quality of life. In this study, participants deliberated scales and weights for a German adaption of the Short-Form Six-Dimension (SF-6D) Version 2 from a public perspective. OBJECTIVE This article examines the reasons participants stated for health state valuations and investigates the feasibility of eliciting public reasons for judgement decisions in a deliberative setting. METHODS The 1-day deliberation was guided by MACBETH as a method of multi-criteria decision analysis and involved qualitative comparisons of SF-6D health states and dimensions. Participants deliberated in parallel small groups and a subsequent plenary assembly. A qualitative content analysis was conducted to assess the value judgements and reasons behind them. RESULTS A total of 34 students participated in the study. Common reasoning was the level of impairment, marginal benefit, possibility of adjustment and expectation satisfaction. While the small groups agreed on scales for the SF-6D dimensions, the plenary assembly did not reach consensus on one scale and dimension weights. When dimensions were prioritized, these were pain and mental health. CONCLUSIONS While no consented value set was derived, this pilot study presents a promising approach for eliciting public reasoning behind judgements on health state values. Furthermore, it demonstrates that participants consider diverse motives when valuing health-related quality of life.
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Affiliation(s)
- Fabia Gansen
- Department of Health Care ManagementInstitute of Public Health and Nursing Research, Health SciencesUniversity of BremenBremenGermany
| | - Julian Klinger
- Department of Health Care ManagementInstitute of Public Health and Nursing Research, Health SciencesUniversity of BremenBremenGermany
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