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Qian X, Tan RLY, Chuang LH, Luo N. Measurement Properties of Commonly Used Generic Preference-Based Measures in East and South-East Asia: A Systematic Review. PHARMACOECONOMICS 2020; 38:159-170. [PMID: 31761995 PMCID: PMC7081654 DOI: 10.1007/s40273-019-00854-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Our aim was to systematically review published evidence on the construct validity, test-retest reliability and responsiveness of generic preference-based measures (PBMs) used in East and South-East Asia. METHODS This systematic review was guided by the COSMIN guideline. A literature search on the MEDLINE, EMBASE, PsycINFO and PubMed databases up to August 2019 was conducted for measurement properties validation papers of the EuroQol-5 Dimensions (EQ-5D), Short Form-6 Dimensions (SF-6D), Health Utilities Index (HUI), Quality of Well-Being (QWB), 15-Dimensional (15D) and Assessment of Quality of Life (AQOL) in East and South-East Asian countries. Included papers were disaggregated into individual studies whose results and quality of design were rated separately. The population-specific measurement properties (construct validity, test-retest reliability and responsiveness) of each PBM were assessed separately using relevant studies. The overall methodological quality of the studies used in each of the assessments was also rated. RESULTS A total of 79 papers containing 1504 studies were included in this systematic review. The methodological quality was 'very good' or 'adequate' for the majority of the construct validity studies (99%) and responsiveness studies (61%), but for only a small portion of the test-retest reliability studies (23%). EQ-5D was most widely assessed and was found to have 'sufficient' construct validity and responsiveness in many populations, while the SF-6D and EuroQol-Visual Analog Scale (EQ-VAS) exhibited 'inconsistent' construct validity in some populations. Scarce evidence was available on HUI and QWB, but current evidence supported the use of HUI. CONCLUSIONS This systematic review provides a summary of the quality of existing generic PBMs in Asian populations. The current evidence supports the use of EQ-5D as the preferred choice when a generic PBM is needed, and continuous testing of all PBMs in the region.
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Affiliation(s)
- Xinyu Qian
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore
| | - Rachel Lee-Yin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore
| | - Ling-Hsiang Chuang
- Pharmerit International, Marten Meesweg 107, 3068 AV, Rotterdam, The Netherlands
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore.
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Hernandez G, Garin O, Dima AL, Pont A, Martí Pastor M, Alonso J, Van Ganse E, Laforest L, de Bruin M, Mayoral K, Serra-Sutton V, Ferrer M. EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma: Cross-Sectional Study. J Med Internet Res 2019; 21:e10178. [PMID: 30672744 PMCID: PMC6364208 DOI: 10.2196/10178] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 09/27/2018] [Accepted: 10/03/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The EuroQol-5 Dimension (EQ-5D), developed in 1990, is a most widely used generic tool to measure the health-related quality of life (HRQoL) and considered suitable for patients with asthma. In 2009, the EuroQol Group developed a new EQ-5D version to overcome limitations related to its consistently reported high ceiling effect. To enhance the sensitivity for assessing the HRQoL in further patient populations, the number of responses of EQ-5D was increased from 3 to 5 levels (EQ-5D-5L). Moreover, the availability of well-defined requirements for its Web-based administration allows EQ-5D-5L use to monitor the HRQoL in electronic health (eHealth) programs. No study has evaluated the metric properties of the new EQ-5D-5L in patients with asthma yet. OBJECTIVE This study aims to examine the distribution, construct validity, and reliability of the new EQ-5D-5L questionnaire administered online to adults with asthma. METHODS We evaluated patients with asthma (age: 18-40 years) from a primary care setting in France and England, who self-completed the EQ-5D-5L questionnaire online. The inclusion criteria were persistent asthma defined as >6 months of prescribed inhaled corticosteroids and long-acting beta-agonists or inhaled corticosteroids alone during the 12 months prior to inclusion. The EQ-5D index was obtained by applying the English preference value set for the new EQ-5D-5L and the French 3L-5L crosswalk value set. Both value sets produced single preference-based indices ranging from 1 (best health state) to negative values (health states valued as worse than death), where 0=death, allowing the calculation of quality-adjusted life years. Responses to dimensions and index distribution, including ceiling and floor effects, were examined. The construct validity was assessed by comparing the means of known groups by analyses of variance and calculation of effect sizes. RESULTS Of 312 patients answering the baseline Web-based survey, 290 completed the EQ-5D-5L (93%). The floor effect was null, and the ceiling effect was 26.5% (74/279). The mean EQ-5D-5L index was 0.88 (SD 0.14) with the English value set and 0.83 (SD 0.19) with the French 3L-5L crosswalk value set. In both indices, large effect sizes were observed for known groups defined by the Asthma Control Questionnaire (1.06 and 1.04, P<.001). Differences between extreme groups defined by chronic conditions (P=.002 and P=.003 for the English value set and French 3L-5L crosswalk value set, respectively), short-acting beta-agonists (SABAs) canisters in the last 12 months (P=.02 and P=.03), or SABA use during the previous 4 weeks (P=.03 and P=.01) were of moderate magnitude with effect sizes around 0.5. CONCLUSIONS The new EQ-5D-5L questionnaire has an acceptable ceiling effect, a good construct validity based on the discriminant ability for distinguishing among health-related known groups, and high reliability, supporting its adequacy for assessing the HRQoL in patients with asthma. EQ-5D-5L completion by most Web-based respondents supports the feasibility of this administration form.
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Affiliation(s)
- Gimena Hernandez
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Olatz Garin
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Alexandra L Dima
- Health Services and Performance Research, Université Claude Bernard Lyon 1, Lyon, France
| | - Angels Pont
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Marc Martí Pastor
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Eric Van Ganse
- Health Services and Performance Research, Université Claude Bernard Lyon 1, Lyon, France.,Pharmaco-Epidemiology Lyon, Lyon, France
| | | | - Marijn de Bruin
- Institute of Applied Health Sciences, University of Aberdeen, Scotland, United Kingdom
| | - Karina Mayoral
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vicky Serra-Sutton
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain.,Agència de Qualitat i Avaluació Sanitàries de Catalunya, Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.,Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
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Nishimura K, Nakamura S, Kusunose M, Nakayasu K, Sanda R, Hasegawa Y, Oga T. Comparison of patient-reported outcomes during acute exacerbations of chronic obstructive pulmonary disease. BMJ Open Respir Res 2018; 5:e000305. [PMID: 30397483 PMCID: PMC6203045 DOI: 10.1136/bmjresp-2018-000305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/21/2018] [Indexed: 11/10/2022] Open
Abstract
Introduction The aim of this study was to investigate which patient-reported outcome measure was the best during the recovery phase from severe exacerbation of chronic obstructive pulmonary disease (COPD). Methods The Exacerbations of Chronic Pulmonary Disease Tool (EXACT), the COPD Assessment Test (CAT), the St George’s Respiratory Questionnaire (SGRQ), the Dyspnoea-12 (D-12) and the Hyland Scale (global scale) were recorded every week for the first month and at 2 and 3 months in 33 hospitalised subjects with acute exacerbation of COPD (AECOPD). Results On the day of admission (day 1), the internal consistency of the EXACT total score was high (Cronbach’s alpha coefficient=0.89). The EXACT total, CAT, SGRQ total and Hyland Scale scores obtained on day 1 appeared to be normally distributed. Neither floor nor ceiling effects were observed for the EXACT total and SGRQ total scores. The EXACT total score improved from 50.5±12.4 to 32.5±14.3, and the CAT score also improved from 24.4±8.5 to 13.5±8.4 during the first 2 weeks, and the effect sizes (ES) of the EXACT total and CAT score were −1.40 and −1.36, respectively. The SGRQ, Hyland Scale and D-12 were less responsive, with ES of −0.59, 0.96 and −0.90, respectively. Discussion The EXACT total and CAT scores are shown to be more responsive measures during the recovery phase from severe exacerbation. Considering the conceptual framework, it is recommended that the EXACT total score may be the best measure during the recovery phase from AECOPD. The reasons for the outstanding responsiveness of the CAT are still unknown.
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Affiliation(s)
- Koichi Nishimura
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Saya Nakamura
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaaki Kusunose
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Ryo Sanda
- Department of Respiratory Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Yoshinori Hasegawa
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toru Oga
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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McQueen RB, Sheehan DN, Whittington MD, van Boven JFM, Campbell JD. Cost-Effectiveness of Biological Asthma Treatments: A Systematic Review and Recommendations for Future Economic Evaluations. PHARMACOECONOMICS 2018; 36:957-971. [PMID: 29736895 DOI: 10.1007/s40273-018-0658-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Recently developed asthma biological therapies have been shown to provide relief for severe asthma patients not controlled by inhaled treatment. Given the relatively high costs of biological therapies, cost-effectiveness analyses (CEAs) may be required as a prerequisite for coverage and reimbursement. OBJECTIVE We aimed to systematically review published literature on the economic impact of biological asthma therapies and to identify key drivers that impact cost-effectiveness in order to provide recommendations for future economic evaluations. METHODS We conducted a systematic literature search in PubMed and Google Scholar. We included studies that assessed the cost-effectiveness of asthma biologics and were published in English between 2000 and 2018. The Quality of Health Economic Studies (QHES) instrument was used to evaluate quality. RESULTS Twenty asthma biological CEAs were identified. Nineteen studies analyzed the cost-effectiveness of omalizumab, and one study analyzed mepolizumab. Ten studies concluded that omalizumab was cost-effective in base-case scenarios, four studies concluded omalizumab was not cost-effective, and the remaining studies concluded omalizumab or mepolizumab was cost-effective only when targeted to specific severe subgroups or given considerable price discounts. Key drivers of cost-effectiveness included day-to-day health-related quality of life (HRQoL), asthma-related mortality, acquisition price of the biological therapy, and time horizon. CONCLUSIONS Most studies recommended carefully targeting biological therapy to specific populations such as responders or discounting acquisition price in order to further improve value. The quality of the studies was generally satisfactory, but improved evidence is needed linking HRQoL to utilities as well as understanding interventions' impact on asthma-related mortality. Key recommendations from this review may allow for greater comparability across future cost-effectiveness studies.
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Affiliation(s)
- R Brett McQueen
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Mail Stop C238, 12850 E. Montview Blvd., Aurora, CO, 80045, USA.
| | - Danielle N Sheehan
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Mail Stop C238, 12850 E. Montview Blvd., Aurora, CO, 80045, USA
| | - Melanie D Whittington
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Mail Stop C238, 12850 E. Montview Blvd., Aurora, CO, 80045, USA
| | - Job F M van Boven
- Department of General Practice and Elderly Care, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jonathan D Campbell
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Mail Stop C238, 12850 E. Montview Blvd., Aurora, CO, 80045, USA
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Payakachat N, Ali MM, Tilford JM. Can The EQ-5D Detect Meaningful Change? A Systematic Review. PHARMACOECONOMICS 2015; 33:1137-54. [PMID: 26040242 PMCID: PMC4609224 DOI: 10.1007/s40273-015-0295-6] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND The EQ-5D is one of the most frequently used, generic, preference-based instruments for measuring the health utilities of patients in economic evaluations. It is recommended for health technology assessment by the National Institute for Health and Clinical Excellence. Because the EQ-5D plays such an important role in economic evaluations, useful information on its responsiveness to detect meaningful change in health status is required. OBJECTIVE This study systematically reviewed and synthesized evidence on the responsiveness of the EQ-5D to detect meaningful change in health status for clinical research and economic evaluations. METHODS We searched the EuroQol website, PubMed, PsychINFO, and EconLit databases to identify studies published in English from the inception of the EQ-5D until August 15, 2014 using keywords that were related to responsiveness. Studies that used only the EQ-VAS were excluded from the final analysis. Narrative synthesis was conducted to summarize evidence on the responsiveness of the EQ-5D by conditions or physiological functions. RESULTS Of 1401 studies, 145 were included in the narrative synthesis and categorized into 19 categories for 56 conditions. The EQ-5D was found to be responsive in 25 conditions (45 %) with the magnitude of responsiveness varying from small to large depending on the condition. There was mixed evidence of responsiveness in 27 conditions (48 %). Only four conditions (7 %) (i.e., alcohol dependency, schizophrenia, limb reconstruction, and hearing impairment) were identified where the EQ-5D was not responsive. CONCLUSION The EQ-5D is an appropriate measure for economic evaluation and health technology assessment in conditions where it has demonstrated evidence of responsiveness. In conditions with mixed evidence of responsiveness, researchers should consider using the EQ-5D with other condition-specific measures to ensure appropriate estimates of effectiveness. These conditions should be a main focus for future research using the new EQ-5D version with five response levels.
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Affiliation(s)
- Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #522, Little Rock, AR, 72205, USA.
| | - Mir M Ali
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - J Mick Tilford
- Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #522, Little Rock, AR, 72205, USA
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Neijenhuis MK, Gevers TJG, Nevens F, Hogan MC, Torres VE, Kievit W, Drenth JPH. Somatostatin analogues improve health-related quality of life in polycystic liver disease: a pooled analysis of two randomised, placebo-controlled trials. Aliment Pharmacol Ther 2015; 42:591-8. [PMID: 26129925 DOI: 10.1111/apt.13301] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 02/23/2015] [Accepted: 06/10/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Polycystic liver disease is associated with impaired health-related quality of life (HRQL). Somatostatin analogues reduce hepatomegaly in polycystic liver disease. AIM To determine whether somatostatin analogues improve HRQL and to identify factors associated with change in HRQL in polycystic liver disease. METHODS We pooled data from two randomized, double-blind, placebo-controlled trials that evaluated HRQL using the Short-Form 36 (SF-36) in 96 polycystic liver disease patients treated 6-12 months with somatostatin analogues or placebo. The SF-36 contains a summarizing physical and mental component score and was administered at baseline and at the end of treatment. We used random effect models to delineate the effect of somatostatin analogues on HRQL. We determined the effect of demographics, height-adjusted liver volume, change in liver volume, somatostatin analogue-associated side effects with change in HRQL. In patients with autosomal dominant polycystic kidney disease, we estimated the effect of height-adjusted kidney volume and change in kidney volume in relation to HRQL. RESULTS Physical component scores improved with somatostatin analogues, but remained unchanged with placebo (3.41 ± 1.29 vs. -0.71 ± 1.54, P = 0.044). Treatment had no impact on the mental component score. Large liver volume was independently associated with larger HRQL decline during follow up (-4.04 ± 2.02 points per logarithm liver volume, P = 0.049). In autosomal dominant polycystic kidney disease, patients with large liver and kidney volumes had larger decline in HRQL (5.36 ± 2.54 points per logarithm liver volume; P = 0.040 and -4.00 ± 1.88 per logarithm kidney volume; P = 0.039). CONCLUSION Somatostatin analogues improve HRQL in symptomatic polycystic liver disease. Halting the progressive nature of polycystic liver disease is necessary to prevent further decline of HRQL in severe hepatomegaly.
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Affiliation(s)
- M K Neijenhuis
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - T J G Gevers
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - F Nevens
- Department of Hepatology, University Hospital Leuven, Leuven, Belgium
| | - M C Hogan
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - V E Torres
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - W Kievit
- Department of Health Evidence, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - J P H Drenth
- Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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Chronic Pain in the Japanese Community--Prevalence, Characteristics and Impact on Quality of Life. PLoS One 2015; 10:e0129262. [PMID: 26076135 PMCID: PMC4467865 DOI: 10.1371/journal.pone.0129262] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 05/06/2015] [Indexed: 11/19/2022] Open
Abstract
Background Chronic pain is recognized as a public health problem that affects the general population physically, psychologically, and socially. However, there is little knowledge about the associated factors of chronic pain, such as the influence of weather, family structure, daily exercise, and work status. Objectives This survey had three aims: 1) to estimate the prevalence of chronic pain in Japan, 2) to analyze these associated factors, and 3) to evaluate the social burden due to chronic pain. Methods We conducted a cross-sectional postal survey in a sample of 6000 adults aged ≥20 years. The response rate was 43.8%. Results The mean age of the respondents was 57.7 years (range 20–99 years); 39.3% met the criteria for chronic pain (lasting ≥3 months). Approximately a quarter of the respondents reported that their chronic pain was adversely influenced by bad weather and also oncoming bad weather. Risk factors for chronic pain, as determined by a logistic regression model, included being an older female, being unemployed, living alone, and no daily exercise. Individuals with chronic pain showed significantly lower quality of life and significantly higher psychological distress scores than those without chronic pain. The mean annual duration of absence from work of working-age respondents was 9.6 days (range 1–365 days). Conclusions Our findings revealed that high prevalence and severity of chronic pain, associated factors, and significant impact on quality of life in the adult Japanese population. A detailed understanding of factors associated with chronic pain is essential for establishing a management strategy for primary care.
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Aggarwal AN, Agarwal R, Gupta D. Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref) in north Indian patients with bronchial asthma: an evaluation using Rasch analysis. NPJ Prim Care Respir Med 2014; 24:14001. [PMID: 24921608 PMCID: PMC4373256 DOI: 10.1038/npjpcrm.2014.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/07/2014] [Accepted: 01/08/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is no disease-specific instrument to describe health-related quality of life (HRQoL) in Indian patients with asthma. However, an abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-Bref), a generic Hindi HRQoL measure, has been developed and validated in India. AIMS To evaluate the WHOQOL-Bref in adult patients with asthma and to test possible modifications to the instrument to improve its psychometric adequacy. METHODS Sixty-seven patients with asthma completed the WHOQOL-Bref. Rasch analysis was used to explore the psychometric performance of the four domains (physical, psychological, social relationships and environment) of the scale. Overall fit of data to model expectations, appropriate category ordering, presence of differential item functioning, individual item fit and targeting of item difficulty to patient ability were explored for each domain. Item deletion and rescoring were applied to misfitting items to improve overall performance. RESULTS The overall fit of the WHOQOL-Bref data was adequate. Item 3 (pain prevents doing work) displayed a large positive fit residual value (indicating violation of unidimensionality), resulting in poor construct validity for the physical domain. No item exhibited differential item functioning. Ten items had disordered thresholds. The WHOQOL-Bref was modified by dropping item 3 and rescoring category structures of 16 items. The modified scale had good construct validity for all domains, ordered thresholds for all items and good targeting of items to persons. CONCLUSIONS The WHOQOL-Bref performed inadequately in describing HRQoL in the asthma patients studied. However, when modified by Rasch analysis, the scale proved better than the original scale.
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Affiliation(s)
- Ashutosh N Aggarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritesh Agarwal
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dheeraj Gupta
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Zengin N, Ören B, Gül A, Üstündağ H. Assessment of quality of life in haemodialysis patients: a comparison of the Nottingham Health Profile and the Short Form 36. Int J Nurs Pract 2013; 20:115-125. [PMID: 24713007 DOI: 10.1111/ijn.12130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to compare the psychometric properties of the Nottingham Health Profile (NHP) and the Medical Outcomes Study Short Form Health Survey (SF-36), which evaluates health-related quality of life in haemodialysis patients. Data were gathered using the NHP and the SF-36. Quality of life scores obtained from the NHP and the SF-36 were compared according to sociodemographic characteristics. It was found that the internal consistency values of the NHP and the SF-36 were similar. The floor effect of the two NHP subscales and the ceiling effect of all the NHP subscales were higher than those pertaining to the. It was observed that the NHP mean subscale scores were higher than those of the SF-36, except for one subscale of the SF-36. There was a significant positive correlation between the similar subscales of the NHP and the SF-36 and between the total scores. These results seem to support the utility of the NHP and the SF-36 in evaluating quality of life in haemodialysis patients.
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Affiliation(s)
- Neriman Zengin
- Department of Midwifes, Faculty of Health Sciences, Istanbul University, Bakirköy, Istanbul, Turkey
| | - Besey Ören
- Department of Midwifes, Faculty of Health Sciences, Istanbul University, Bakirköy, Istanbul, Turkey
| | - Asiye Gül
- Department of Midwifes, Faculty of Health Sciences, Istanbul University, Bakirköy, Istanbul, Turkey
| | - Hülya Üstündağ
- Department of Nursing, School of Health Sciences, Istanbul Bilgi University, Bakirköy, Istanbul, Turkey
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A comparison of quality of life in adolescents with epilepsy or asthma using the Short-Form Health Survey (SF-36). Epilepsy Res 2012; 101:157-65. [PMID: 22512895 DOI: 10.1016/j.eplepsyres.2012.03.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 02/06/2012] [Accepted: 03/21/2012] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare the quality of life (QOL) in adolescents with epilepsy or asthma. METHODS Eighty-five epileptic adolescents, 81 adolescents with asthma and 71 normal controls were recruited from the Affiliated Children's Hospital of FuDan University from June, 2007 to December, 2007. These adolescents received the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS F-36) in order to evaluate QOL. RESULTS Although the onset age for adolescents with asthma was younger (P=0.032), there were no significant differences in clinical characteristics between adolescents with epilepsy and asthma. The results of MOS SF-36 demonstrated the following: (1) For the adolescents with epilepsy, the total QOL score and sub-scores for 8 items were significantly different between epilepsy patients and healthy controls, and the total QOL score and sub-scores for 4 items were significantly different between controlled and uncontrolled epilepsy groups; (2) for the adolescents with asthma, the total QOL score and sub-scores for 4 items were significantly different between asthma patients and healthy controls, and the total QOL score and sub-scores for 4 items were significantly different between controlled and uncontrolled asthma groups; (3) the QOL of adolescents with epilepsy was poorer than that of the adolescents with asthma regardless of the remission stage and disease stage; (4) the emotional and mental health of adolescents with epilepsy was inferior to that of adolescents with asthma. CONCLUSIONS The QOL of adolescents with chronic paroxysmal diseases including epilepsy and asthma deserves close attention and should be included as a key parameter when evaluating disease status.
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McDonough CM, Tosteson TD, Tosteson AN, Jette AM, Grove MR, Weinstein JN. A longitudinal comparison of 5 preference-weighted health state classification systems in persons with intervertebral disk herniation. Med Decis Making 2011; 31:270-80. [PMID: 21098419 PMCID: PMC3535472 DOI: 10.1177/0272989x10380924] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the longitudinal validity of widely used preference-weighted measurement systems for economic studies of intervertebral disk herniation (IDH). METHODS Using data at baseline and 1 year from 1000 Spine Patient Outcomes Research Trial (SPORT) participants with IDH and complete data, the authors considered the EQ-5D with UK and US values (EQ-5D-UK and EQ-5D-US), 2 versions of the Health Utilities Index (HUI3 and HUI2), the SF-6D, and a regression-estimated quality of well-being score (eQWB). Differences in mean change scores (MCS) were assessed using signed rank tests, and Spearman correlations were calculated for change scores by system pairs. Using the Oswestry Disability Index, symptom satisfaction, progress rating, and self-perceived health ratings as criterion measures, the authors tested for trend in MCS across levels of change in criteria. They calculated floor and ceiling effects, effect size (ES), standardized response mean, and minimal important difference estimates. RESULTS All systems demonstrated linear trends with external criteria and moderate to strong correlations between systems. However, differences in performance were evident. SF-6D and eQWB were most responsive (ES: 1.9 and 2.3, respectively), whereas EQ-5D-US and EQ-5D-UK were least responsive (ES: 1.23/1.20). Ceiling and floor effects were noted for all systems within key dimensions and for EQ-5D-UK and EQ-5D-US for overall score. MCS ranged from 0.40 (0.38) for EQ-5D-UK to 0.13 (0.09) for eQWB and differed significantly, except between EQ-5D-US and HUI2. CONCLUSIONS This research supports the validity of all systems for measuring change in persons with IDH, without finding a clearly superior system. The unique characteristics of each system revealed in this study should guide system choice.
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Affiliation(s)
- Christine M. McDonough
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH,Health & Disability Research Institute, Boston University School of Public Health, Boston, MA
| | - Tor D. Tosteson
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH,Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
| | - Anna N.A. Tosteson
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH,Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon NH,Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH
| | - Alan M. Jette
- Health & Disability Research Institute, Boston University School of Public Health, Boston, MA
| | - Margaret R. Grove
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH
| | - James N. Weinstein
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH,Department of Orthopaedics, Dartmouth Medical School, Hanover NH,Dartmouth-Hitchcock Medical Center, Lebanon NH
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12
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Tarride JE, Burke N, Bischof M, Hopkins RB, Goeree L, Campbell K, Xie F, O'Reilly D, Goeree R. A review of health utilities across conditions common in paediatric and adult populations. Health Qual Life Outcomes 2010; 8:12. [PMID: 20105304 PMCID: PMC2828427 DOI: 10.1186/1477-7525-8-12] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 01/27/2010] [Indexed: 01/27/2023] Open
Abstract
Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI) or EuroQoL-5Dimensions (EQ-5D) questionnaires or using time trade off (TTO) or standard gamble (SG) techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL). Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25), cancer (n = 23), diabetes mellitus (n = 11), skin diseases (n = 19) or chronic diseases (n = 2), with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33), EQ-5D (n = 26), TTO (n = 12), and SG (n = 14), with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin diseases. Although few studies provided comparative information on utility values between children and adults, results seem to indicate that utilities may be similar in adolescents and young adults with asthma and acne. Differences in results were observed depending on methods and proxies. Conclusions This review highlights the need to conduct future research regarding measurement of utilities in children.
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Affiliation(s)
- Jean-Eric Tarride
- Programs for Assessment of Technology in Health (PATH) Research Institute, St Joseph's Healthcare Hamilton, Ontario, Canada.
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Varni JW, Limbers CA. The pediatric quality of life inventory: measuring pediatric health-related quality of life from the perspective of children and their parents. Pediatr Clin North Am 2009; 56:843-63. [PMID: 19660631 DOI: 10.1016/j.pcl.2009.05.016] [Citation(s) in RCA: 232] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Health-related quality of life (HRQOL) has been recognized as an important outcome, some contend the most important outcome for children's health care interventions. The PedsQL Measurement Model was designed as a modular approach to measuring pediatric health-related quality of life, developed to integrate the relative merits of generic and disease-specific approaches. We suggest that part of the process of improving the quality of health care includes measuring HRQOL outcomes from the perspective of children and their parents on a routine basis, consistent with a consumer-based health care system approach.
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Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX 77843, USA.
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14
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Choi D, Crockard HA. How and why should we benchmark clinical outcomes and quality of life for surgery in spinal metastases? Br J Neurosurg 2009; 23:3-4. [PMID: 19234902 DOI: 10.1080/02688690802546872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- D Choi
- The National Hospital for Neurology and Neurosurgery, London, UK.
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15
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Kimura T, Yokoyama A, Kohno N, Nakamura H, Eboshida A. Perceived stress, severity of asthma, and quality of life in young adults with asthma. Allergol Int 2009; 58:71-9. [PMID: 19050373 DOI: 10.2332/allergolint.o-07-531] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 07/03/2008] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND People suffering from asthmatic symptoms have a lower quality of life than those without. The aim of this study is to clarify the association of quality of life with the severity of asthma, perceived stress, and other factors such as the comorbidity of allergic diseases among young adults with asthma. METHODS The study participants were 695 asthma patients, aged 20-44 years, from 29 medical centers in Japan. We excluded from the analysis of the result of the study 116 patients with complications of serious diseases, cough-variant asthma or aspirin-intolerant asthma. The patients completed the 8-Item Short-Form Health Survey (SF-8), the Airways Questionnaire 20 (AQ20), and the Japanese version of the Perceived Stress Scale (JPSS) and their doctors also provided clinical information including diagnosis, complications, severity of asthma, and results of pulmonary function and immunological tests. RESULTS There was a weak correlation between the generic quality of life (SF-8) and the disease-specific quality of life (AQ20). The AQ 20 revealed almost no association with the results of pulmonary function and immunological tests, and only a slight association with comorbidity of allergic rhinitis and food allergy. The AQ20 showed a moderate relation with perceived stress (JPSS) but a weak association with the severity of asthma. The multiple logistic models demonstrated that there was no relationship between the severity of asthma and the AQ20 in females, and in the age group of 20-34 years. CONCLUSIONS A major variable related to the disease-specific quality of life was perceived stress, followed by the severity of asthma. Stress management of patients with asthma may improve their quality of life.
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Affiliation(s)
- Tomoaki Kimura
- Department of Public Health and Health Policy, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
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16
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Zhao L, Leung KF, Liu FB, Chen J, Chan K. Responsiveness of the Chinese Quality of Life Instrument in patients with congestive heart failure. Chin J Integr Med 2008; 14:173-9. [PMID: 18853111 DOI: 10.1007/s11655-008-0173-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The Chinese Quality of Life Instrument (ChQOL) was developed as a valid generic health status instrument based on the well-established theory of health in Chinese medicine. Psychometric properties of the ChQOL were good. In the present study, the responsiveness of the ChQOL in patients with congestive heart failure (CHF) were investigated and compared with two generic questionnaires, the Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF), as well as one disease-specific questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHF). METHODS Thirty-nine in-patients with CHF who had undergone treatment with integrative medicine were recruited. The health status measurements were performed at enrolment and after a 4-week treatment. The following responsiveness indices were used: the effect size (ES) and standardized response mean (SRM). All patients were classified into those groups with stable measures and those groups with changes after a 4-week treatment, based upon both the doctor's global rating of changes in heart function tests, and the patient's global rating of changes in overall quality of life. RESULTS All domains of the ChQOL showed significant improvement. In the comparison of the responsiveness indices, the ChQOL was regarded as more responsive than the WHOQOL-BREF or SF-36 utility, but it was less responsive than the MLHF. CONCLUSIONS The ChQOL was better in sensitivity and responsiveness for assessing congestive heart failure as a generic measure than the SF-36 and WHOQOL-BREF. The ChQOL is considered suitable as an outcome measure for clinical trials in patients with congestive heart failure.
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Affiliation(s)
- Li Zhao
- School of Chinese Medicine, The Chinese University of Hong Kong, Department of Occupational Therapy, Queen Elizabeth Hospital, Hong Kong, China.
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Denegar CR, Vela LI, Evans TA. Evidence-based sports medicine: outcomes instruments for active populations. Clin Sports Med 2008; 27:339-51, vii. [PMID: 18503871 DOI: 10.1016/j.csm.2008.02.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Clear and directed outcomes assessment is an integral part of clinical decision making. For sports medicine clinicians, it is crucial to choose appropriate instruments that are grounded in disablement theory, designed to measure the ability of a physically active population, and have established psychometric properties. Although there is no instrument ideal for every situation in sports medicine, there are important guidelines that a clinician can follow that will allow for the selection of an appropriate instrument. The purposes of this article are to (1) introduce the reader to self-report instruments available, with particular attention to those most appropriate for athletic populations, (2) describe the relationship between disablement paradigms and health-related self-report instruments, and (3) describe the process of instrument development.
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Affiliation(s)
- Craig R Denegar
- Department of Physical Therapy, Neag School of Education, University of Connecticut, Koons Hall-101A, 358 Mansfield Road, U-2101, Storrs, CT 06269-2064, USA.
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Pickard AS, Wilke C, Jung E, Patel S, Stavem K, Lee TA. Use of a preference-based measure of health (EQ-5D) in COPD and asthma. Respir Med 2008; 102:519-36. [PMID: 18180151 DOI: 10.1016/j.rmed.2007.11.016] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 11/26/2007] [Accepted: 11/27/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND EQ-5D is a generic preference-based measure of health that can help to understand the impact of asthma and chronic obstructive pulmonary disease (COPD). The purpose of this paper was to synthesize literature on the validity and reliability of EQ-5D use in studies of asthma and COPD, and estimate EQ-5D utility scores associated with stage of disease. METHODS A structured search was conducted in EMBASE and MEDLINE (1988-2007) using keywords relevant to respiratory disease and EQ-5D. Original research studies in asthma or COPD that reported EQ-5D results and/or psychometric properties were included. RESULTS Studies that reported psychometric properties supported the construct validity, test-retest reliability, and responsiveness of EQ-5D in asthma (seven studies) and COPD (nine studies), although some evidence of ceiling effects were observed in asthma studies. In asthma studies that reported summary scores (n=11), EQ-5D index-based scores ranged from 0.42 (SD 0.30) to 0.93 (SD not reported). In COPD studies (n=8), scores ranged from 0.52 (SD 0.16) to 0.84 (SD 0.15). While few asthma studies reported scores by severity level, sufficient studies in COPD were available to calculate pooled mean utility scores according to GOLD stage: stage I=0.74 (0.62-0.87), stage II=0.74 (0.66-0.83), stage III=0.69 (0.60-0.78) and stage IV=0.61 (0.44-0.77) (most severe). CONCLUSIONS Evidence generally supported the validity and reliability of EQ-5D in asthma and COPD. Utility scores associated with COPD stage may be useful for modeling health outcomes in economic evaluations of treatments for COPD.
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Affiliation(s)
- A Simon Pickard
- Center for Pharmacoeconomic Research, Department of Pharmacy Practice and Pharmacy Administration, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Valero A, Alonso J, Antépara I, Baró E, Colás C, del Cuvillo A, Ferrer M, Herdman M, Marti-Guadaño E, Monclús L, Navarro-Pulido AM, Sastre J, Izquierdo I, Mullol J. Health-related quality of life in allergic rhinitis: comparing the short form ESPRINT-15 and MiniRQLQ questionnaires. Allergy 2007; 62:1372-8. [PMID: 17983372 DOI: 10.1111/j.1398-9995.2007.01552.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND We compared the psychometric properties of the ESPRINT-15, the short form of a new Spanish instrument to measure health-related quality of life in allergic rhinitis (AR) patients, with those of the Mini-Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). METHODS The questionnaires were compared in Spanish patients with intermittent allergic rhinitis (IAR) or persistent AR in a prospective, observational study. Floor and ceiling effects, internal consistency (Cronbach's alpha), test-retest reliability (intraclass correlation coefficient; ICC), convergent and known groups validity, and sensitivity to change (standardized response means; SRMs) were compared. RESULTS In terms of content, while the MiniRQLQ has a dimension covering practical problems and places more emphasis on symptoms, the ESPRINT-15 has two dimensions (Sleep and Psychological impact) which are not included in the MiniRQLQ. In the validation study, 400 patients were included and 59% of the sample had persistent AR. There were no significant floor or ceiling effects on any dimension on either questionnaire. Cronbach's alpha values for the ESPRINT-15 and MiniRQLQ overall scores were 0.92 and 0.90, respectively. In 48 clinically stable patients, ICCs were 0.80 and 0.77, respectively. Both instruments discriminated between patients with IAR and persistent AR. Correlations with symptom scores and generic measures were moderate to strong. SRMs for overall scores and individual dimensions on the two questionnaires in the 197 patients reporting a change in health status ranged from 0.7 to 1.3. CONCLUSIONS Both questionnaires performed well in psychometric terms. The ESPRINT-15 is particularly recommended for use in Spanish-speaking populations.
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MESH Headings
- Adult
- Conjunctivitis, Allergic/physiopathology
- Conjunctivitis, Allergic/psychology
- Female
- Health Status
- Humans
- Male
- Psychometrics/instrumentation
- Psychometrics/standards
- Quality of Life/psychology
- Reproducibility of Results
- Rhinitis, Allergic, Perennial/physiopathology
- Rhinitis, Allergic, Perennial/psychology
- Rhinitis, Allergic, Seasonal/physiopathology
- Rhinitis, Allergic, Seasonal/psychology
- Sensitivity and Specificity
- Severity of Illness Index
- Sickness Impact Profile
- Spain
- Surveys and Questionnaires/standards
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Affiliation(s)
- A Valero
- Unidad de Alergia, Servicio de Neumologia y Alergia Respiratoria, Hospital Clinic, Barcelona, Spain
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Oga T, Nishimura K, Tsukino M, Sato S, Hajiro T, Mishima M. Longitudinal deteriorations in patient reported outcomes in patients with COPD. Respir Med 2006; 101:146-53. [PMID: 16713225 DOI: 10.1016/j.rmed.2006.04.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2006] [Revised: 03/26/2006] [Accepted: 04/02/2006] [Indexed: 11/22/2022]
Abstract
Goals of effective management of patients with chronic obstructive pulmonary disease (COPD) include relieving their symptoms and improving their health status. We examined how such patient reported outcomes would change longitudinally in comparison to physiological outcomes in COPD. One hundred thirty-seven male outpatients with stable COPD were recruited for the study. The subjects health status was evaluated using the St. George's Respiratory Questionnaire (SGRQ) and the Chronic Respiratory Disease Questionnaire (CRQ). Their dyspnoea using the modified Medical Research Council (MRC) scale and their psychological status using the Hospital Anxiety and Depression Scale (HADS) were assessed upon entry and every 6 months thereafter over a 5-year period. Pulmonary function and exercise capacity as evaluated by peak oxygen uptake (VO2) on progressive cycle ergometry were also followed over the same time. Using mixed effects models to estimate the slopes for the changes, scores on the SGRQ, the CRQ, the MRC and the HADS worsened in a statistically significant manner over time. However, changes only weakly correlated with changes in forced expiratory volume in 1s (FEV(1)) and peak (VO2). We demonstrated that although changes in pulmonary function and exercise capacity are well known in patients with COPD, patient reported outcomes such as health status, dyspnoea and psychological status also deteriorated significantly over time. In addition, deteriorations in patient reported outcomes only weakly correlated to changes in physiological indices. To capture the overall deterioration of COPD from the subjective viewpoints of the patients, patient reported outcomes should be followed separately from physiological outcomes.
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Affiliation(s)
- Toru Oga
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 53, Kawahara, Shogoin, Kyoto, Japan.
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Arioka H, Kobayashi K, Kudo K, Kabe J. Validation Study of a Disease-specific Module, the Asthma Health Questionnaire (AHQ) Using Japanese Adult Asthmatic Patients. Allergol Int 2005. [DOI: 10.2332/allergolint.54.473] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Gunter MJ, Brixner D, von Worley A, Carter S, Gregory C. Impact of a Seizure Disorder Disease Management Program on Patient-Reported Quality of Life. ACTA ACUST UNITED AC 2004; 7:333-47. [PMID: 15671790 DOI: 10.1089/dis.2004.7.333] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of this study was to evaluate the impact of a comprehensive, multifaceted disease management program on self-reported quality of life (QOL) for adult patients with epilepsy. The study (1996-2000) employed a quasi-experimental research design in which primary care clinics in a southwestern integrated delivery system were assigned to either the intervention or comparison group. The impact evaluation involved a comparison of responses to a validated QOL survey before and after a disease management intervention for adult health plan members with epilepsy. The intervention consisted of both formal provider training and associated tools and reinforcements as well as direct-to-patient interventions, including a comprehensive education booklet, a seizure diary, a patient education class, and a resource list. Pre-post analysis utilizing paired t-tests was conducted to identify any pre-post differences in QOL for both the intervention and comparison group patients, as measured by the seven specific domains of the epilepsy QOL instrument (QOLIE-31). The intervention group patients showed statistically significant positive changes in two QOL domains: Seizure Worry (p < 0.001) and Emotional Well-being (p < 0.05). One other domain, Overall Quality of Life, showed improvement in the intervention group that approached statistical significance (p < 0.06). There were no statistically significant changes for the comparison group. A well-designed, comprehensive disease management program can improve patient empowerment and coordination of care between the patient and provider, which resulted in an improvement in quality of life, one of the most central patient outcomes in this difficult disease.
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