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Ren Z, Xu X, Yue R. Preferences and Adherence of People with Prediabetes for Disease Management and Treatment: A Systematic Review. Patient Prefer Adherence 2023; 17:2981-2989. [PMID: 38027075 PMCID: PMC10657754 DOI: 10.2147/ppa.s437267] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To comprehensively summarize the evaluation, preference, and expectations of people with prediabetes regarding the management and treatment of pre-diabetes. Methods Search PubMed, Embase, Web of Science, Cochrane Library and CNKI for articles about prediabetes, preferences, and expectations from inception of the database to June 2023. Results A total of 18 studies involving 17,240 participants with prediabetes were included. Although the preferences and views of people with prediabetes vary widely, there are certain trends: 1) Compared with drug therapy, people with prediabetes prefer exercise and nutrition therapies. 2) People with prediabetes expect intensive lifestyle interventions guided by professionals. 3) Effective communication between doctors and people with prediabetes is crucial for promoting the development and implementation of treatment plans. Conclusion The results of this systematic review showed that people with prediabetes prefer intensive lifestyle interventions due to concerns about drug side effects, dependency, and other factors. In addition, drug acceptance and lifestyle interventions options differed among different populations, which emphasized the significance of individualized therapy.
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Affiliation(s)
- Zonghao Ren
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Xianpeng Xu
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Rensong Yue
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
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Khanna D, Khadka J, Mpundu-Kaambwa C, Lay K, Russo R, Ratcliffe J. Are We Agreed? Self- Versus Proxy-Reporting of Paediatric Health-Related Quality of Life (HRQoL) Using Generic Preference-Based Measures: A Systematic Review and Meta-Analysis. PHARMACOECONOMICS 2022; 40:1043-1067. [PMID: 35997957 PMCID: PMC9550745 DOI: 10.1007/s40273-022-01177-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The aim of this study was to examine the level of agreement between self- and proxy-reporting of health-related quality of life (HRQoL) in children (under 18 years of age) using generic preference-based measures. METHODS A systematic review of primary studies that reported agreement statistics for self and proxy assessments of overall and/or dimension-level paediatric HRQoL using generic preference-based measures was conducted. Where available, data on intraclass correlation coefficients (ICCs) were extracted to summarise overall agreement levels, and Cohen's kappa was used to describe agreement across domains. A meta-analysis was also performed to synthesise studies and estimate the level of agreement between self- and proxy-reported paediatric overall and domain-level HRQoL. RESULTS Of the 30 studies included, 25 reported inter-rater agreement for overall utilities, while 17 reported domain-specific agreement. Seven generic preference-based measures were identified as having been applied: Health Utilities Index (HUI) Mark 2 and 3, EQ-5D measures, Child Health Utility 9 Dimensions (CHU9D), and the Quality of Well-Being (QWB) scale. A total of 45 dyad samples were included, with a total pooled sample of 3084 children and 3300 proxies. Most of the identified studies reported a poor inter-rater agreement for the overall HRQoL using ICCs. In contrast to more observable HRQoL domains relating to physical health and functioning, the inter-rater agreement was low for psychosocial-related domains, e.g., 'emotion' and 'cognition' attributes of both HUI2 and HUI3, and 'feeling worried, sad, or unhappy' and 'having pain or discomfort' domains of the EQ-5D. Parents demonstrated a higher level of agreement with children relative to health professionals. Child self- and proxy-reports of HRQoL showed lower agreement in cancer-related studies than in non-cancer-related studies. The overall ICC from the meta-analysis was estimated to be 0.49 (95% confidence interval 0.34-0.61) with poor inter-rater agreement. CONCLUSION This study provides evidence from a systematic review of studies reporting dyad assessments to demonstrate the discrepancies in inter-rater agreement between child and proxy reporting of overall and domain-level paediatric HRQoL using generic preference-based measures. Further research to drive the inclusion of children in self-reporting their own HRQoL wherever possible and limiting the reliance on proxy reporting of children's HRQoL is warranted.
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Affiliation(s)
- Diana Khanna
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Jyoti Khadka
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
- Registry of Senior Australians, Healthy Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Kiri Lay
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Remo Russo
- Department of Paediatric Rehabilitation, Women’s and Children’s Hospital, Adelaide, SA Australia
- Faculty of Health Sciences, School of Medicine, Flinders University, Adelaide, SA Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
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Bailey C, Howell M, Raghunandan R, Salisbury A, Chen G, Coast J, Craig JC, Devlin NJ, Huynh E, Lancsar E, Mulhern BJ, Norman R, Petrou S, Ratcliffe J, Street DJ, Howard K, Viney R. Preference Elicitation Techniques Used in Valuing Children's Health-Related Quality-of-Life: A Systematic Review. PHARMACOECONOMICS 2022; 40:663-698. [PMID: 35619044 PMCID: PMC9270310 DOI: 10.1007/s40273-022-01149-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Valuing children's health states for use in economic evaluations is globally relevant and is of particular relevance in jurisdictions where a cost-utility analysis is the preferred form of analysis for decision making. Despite this, the challenges with valuing child health mean that there are many remaining questions for debate about the approach to elicitation of values. The aim of this paper was to identify and describe the methods used to value children's health states and the specific issues that arise in the use of these methods. METHODS We conducted a systematic search of electronic databases to identify studies published in English since 1990 that used preference elicitation methods to value child and adolescent (under 18 years of age) health states. Eligibility criteria comprised valuation studies concerning both child-specific patient-reported outcome measures and child health states defined in other ways, and methodological studies of valuation approaches that may or may not have yielded a value set algorithm. RESULTS A total of 77 eligible studies were identified from which data on country setting, aims, condition (general population or clinically specific), sample size, age of respondents, the perspective that participants were asked to adopt, source of values (respondents who completed the preference elicitation tasks) and methods questions asked were extracted. Extracted data were classified and evaluated using narrative synthesis methods. The studies were classified into three groups: (1) studies comparing elicitation methods (n = 30); (2) studies comparing perspectives (n = 23); and (3) studies where no comparisons were presented (n = 26); selected studies could fall into more than one group. Overall, the studies varied considerably both in methods used and in reporting. The preference elicitation tasks included time trade-off, standard gamble, visual analogue scaling, rating/ranking, discrete choice experiments, best-worst scaling and willingness to pay elicited through a contingent valuation. Perspectives included adults' considering the health states from their own perspective, adults taking the perspective of a child (own, other, hypothetical) and a child/adolescent taking their own or the perspective of another child. There was some evidence that children gave lower values for comparable health states than did adults that adopted their own perspective or adult/parents that adopted the perspective of children. CONCLUSIONS Differences in reporting limited the conclusions that can be formed about which methods are most suitable for eliciting preferences for children's health and the influence of differing perspectives and values. Difficulties encountered in drawing conclusions from the data (such as lack of consensus and poor reporting making it difficult for users to choose and interpret available values) suggest that reporting guidelines are required to improve the consistency and quality of reporting of studies that value children's health using preference-based techniques.
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Affiliation(s)
- Cate Bailey
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne, VIC, Australia.
| | - Martin Howell
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Rakhee Raghunandan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Amber Salisbury
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, VIC, Australia
| | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Nancy J Devlin
- Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia
| | - Elisabeth Huynh
- Department of Health Services and Policy Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Emily Lancsar
- Department of Health Services and Policy Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Brendan J Mulhern
- Centre for Health Economics, Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Deborah J Street
- Centre for Health Economics, Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics, Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia
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Khadka J, Kwon J, Petrou S, Lancsar E, Ratcliffe J. Mind the (inter-rater) gap. An investigation of self-reported versus proxy-reported assessments in the derivation of childhood utility values for economic evaluation: A systematic review. Soc Sci Med 2019; 240:112543. [PMID: 31586777 DOI: 10.1016/j.socscimed.2019.112543] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/24/2019] [Accepted: 09/07/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Evidence surrounding utilities for health states, derived either directly from the application of preference-based valuation methods or indirectly from the application of preference-based quality of life instruments, is increasingly being utilised to inform the cost-effectiveness of child health interventions. Proxy (parent or health professional) assessments are common in this area. This study sought to investigate the degree of convergence in childhood utilities generated directly or indirectly within dyad child and proxy assessments. METHODS A systematic literature review was conducted following PRISMA guidelines. A comprehensive literature search strategy conducted across six search engines (PubMed, Embase, Web of Science, PsychoINFO, EconLit, CINAHL and Cochrane Library). Original peer-reviewed articles that reported utilities derived directly or indirectly using simultaneous dyad child and proxy assessments were extracted. Mean and median utilities, correlation coefficients and levels of agreement were extracted, catalogued and assessed. RESULTS A total of 35 studies that reported utilities for two or more respondent types were identified. Of these, 29 studies reported dyad childhood self-report and proxy utilities whilst six studies reported levels of agreement and/or correlations only without documenting overall utilities. Proxy assessment was most often conducted by parents with the HUI3 representing the most commonly applied instrument across a range of health conditions. The utilities derived from child and parent proxy assessment were bidirectional with parental proxies tending to underestimate and health professional proxies tending to overestimate relative to child self-reports. Inter-rater agreement between child self-reports and parent-proxy reports were poorer for more subjective attributes (cognition, emotion and pain), relative to physical attributes (mobility, self-care, speech, vision) of health-related quality of life. CONCLUSIONS Childhood utilities derived from children or proxies are not interchangeable. The choice of self or proxy assessor may have potentially significant implications for economic evaluations of child health interventions.
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Affiliation(s)
- Jyoti Khadka
- Health and Social Care Economics Group, College of Nursing and Health Science, Flinders University, Bedford Park, South Australia, Australia; Institute for Choice, Business School, University of South Australia, South Australia, Australia; Registry of Senior Australians, Healthy Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
| | - Joseph Kwon
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Stavros Petrou
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Emily Lancsar
- Department of Health Services Research and Policy, School of Population Health, The Australian National University, Canberra, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, College of Nursing and Health Science, Flinders University, Bedford Park, South Australia, Australia
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Crump RT, Beverung LM, Lau R, Sieracki R, Nicholson M. Reliability, Validity, and Feasibility of Direct Elicitation of Children's Preferences for Health States. Med Decis Making 2016; 37:314-326. [PMID: 27694286 DOI: 10.1177/0272989x16671925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Children's preferences for health states represent an important perspective when comparing the value of alternative health care interventions related to pediatric medicine, and are fundamental to comparative effectiveness research. However, there is debate over whether these preference data can be collected and used. PURPOSE The purpose of this study was to establish psychometric properties of eliciting preferences for health states from children using direct methods. DATA SOURCES Ovid Medline, PsycINFO, Scopus, EconLit. STUDY SELECTION English studies, published after 1990, were identified using Medical Subject Headings or keywords. Results were reviewed to confirm that the study was based on: 1) a sample of children, and 2) preferences for health states. DATA EXTRACTION Standardized data collection forms were used to record the preference elicitation method used, and any reported evidence regarding the validity, reliability, or feasibility of the method. DATA SYNTHESIS Twenty-six studies were ultimately included in the analysis. The standard gamble and time tradeoff were the most commonly reported direct preference elicitation methods. Seven studies reported validity, four reported reliability, and nine reported feasibility. Of the validity reports, construct validity was assessed most often. Reliability reports typically involved interclass correlation coefficient. For feasibility, four studies reported completion rates. LIMITATIONS The search was limited to four databases and restricted to English studies published after 1990. Only evidence available in published studies were considered; measurement properties may have been tested in pilot or pre-studies but were not published, and are not included in this review. CONCLUSION The few studies found through this systematic review demonstrate that there is little empirical evidence on which to judge the use of direct preference elicitation methods with children regarding health states.
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Affiliation(s)
- R Trafford Crump
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (RTC, LMB, RL, RS, MN)
| | - Lauren M Beverung
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (RTC, LMB, RL, RS, MN)
| | - Ryan Lau
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (RTC, LMB, RL, RS, MN)
| | - Rita Sieracki
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (RTC, LMB, RL, RS, MN)
| | - Mateo Nicholson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI (RTC, LMB, RL, RS, MN)
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Gómez-Campos R, David Langer R, de Fátima Guimarães R, Contiero San Martini M, Cossio-Bolaños M, de Arruda M, Guerra-Júnior G, Moreira Gonçalves E. Accuracy of Body Mass Index Cutoffs for Classifying Obesity in Chilean Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050472. [PMID: 27164119 PMCID: PMC4881097 DOI: 10.3390/ijerph13050472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 03/13/2016] [Accepted: 03/28/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the accuracy of two international Body Mass Index (BMI) cut-offs for classifying obesity compared to the percentage of fat mass (%FM) assessed by Dual-Energy X-ray Absorptiometry (DXA) in a Chilean sample of children and adolescents; MATERIAL AND METHODS The subjects studied included 280 children and adolescents (125 girls and 155 boys) aged 8 to 17 years. Weight and height were measured. The BMI was calculated. Two international references (IOFT and WHO) were used as cut-off points. The %FM was assessed by DXA. The receiver operating characteristic (ROC) curve was used to assess the performance of BMI in detecting obesity on the basis of %FM; RESULTS A high correlation was observed between the %FM measured by the DXA and the Z-scores of IOTF and WHO scores in the Chilean adolescents separated by sex (r = 0.78-0.80). Differences occurred in both references (IOFT and WHO) in relation to the criteria (p < 0.001). Both references demonstrated a good ability to predict sensitivity (between 84% and 93%) and specificity (between 83% and 88%) in both sexes of children and adolescents; CONCLUSIONS A high correlation was observed between the Z-score of the BMI with the percentage of fat determined by the DXA. Despite this, the classifications using the different BMI cut-off points showed discrepancies. This suggests that the cut-off points selected to predict obesity in this sample should be viewed with caution.
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Affiliation(s)
- Rossana Gómez-Campos
- Instituto de Actividad Física y Salud, Universidad Autonoma de Chile, 5 Poniente 1670, Talca, Chile.
- Faculty of Physical Education, State University of Campinas, Avenida Érico Veríssimo, 701, Cidade Universitária Zeferino Vaz, Barão Geraldo, CEP 13083-851, Campinas, Brazil.
- Department of Research, Universidad Científica del Sur, Panamericana Sur Km 19 Villa, Lima, Perú.
| | - Raquel David Langer
- Growth and Development Lab, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), CEP 13083-887, Campinas-SP, Brazil.
| | - Roseane de Fátima Guimarães
- Growth and Development Lab, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), CEP 13083-887, Campinas-SP, Brazil.
| | - Mariana Contiero San Martini
- Growth and Development Lab, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), CEP 13083-887, Campinas-SP, Brazil.
| | - Marco Cossio-Bolaños
- Faculty of Physical Education, State University of Campinas, Avenida Érico Veríssimo, 701, Cidade Universitária Zeferino Vaz, Barão Geraldo, CEP 13083-851, Campinas, Brazil.
- Department of Physical Activity Sciences, Catholic University of Maule, Av. San Miguel 3605, Talca, Chile.
- Research Network on Human Biological Development, Urb. Amauta C-6, Jose Luis Bustamante y Rivero, Arequipa, Peru.
| | - Miguel de Arruda
- Faculty of Physical Education, State University of Campinas, Avenida Érico Veríssimo, 701, Cidade Universitária Zeferino Vaz, Barão Geraldo, CEP 13083-851, Campinas, Brazil.
| | - Gil Guerra-Júnior
- Growth and Development Lab, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), CEP 13083-887, Campinas-SP, Brazil.
| | - Ezequiel Moreira Gonçalves
- Growth and Development Lab, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), CEP 13083-887, Campinas-SP, Brazil.
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Bobanga ID, Vogt BA, Woodside KJ, Cote DR, Dell KM, Cunningham RJ, Noon KA, Barksdale EM, Humphreville VR, Sanchez EQ, Schulak JA. Outcome differences between young children and adolescents undergoing kidney transplantation. J Pediatr Surg 2015; 50:996-9. [PMID: 25805006 DOI: 10.1016/j.jpedsurg.2015.03.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND/PURPOSE Although graft loss remains the biggest challenge for all pediatric kidney transplant (KT) recipients, unique challenges exist within different age groups. We aim to evaluate the different characteristics and graft survival outcomes of young children and adolescents undergoing KT. METHODS Children who underwent isolated KT between 2000 and 2013 at our institution were included in this retrospective analysis. Patient characteristics and outcomes were compared using student's t-test, chi-square test, Kaplan-Meier curve and Cox proportional hazards model. RESULTS Of 73 children who underwent KT, 31 were <12 (young children), and 42 were ≥ 12 years old (adolescents). Overall patient survival was 100%. The younger group had superior 5-year (100% vs. 75.5%) and 10-year (94.4% vs. 43.8%) graft survival (p=0.008). Factors predictive of poor graft survival on multivariate analysis were older age at transplantation (HR 1.2, CI 1-1.4, p=0.047), female gender (HR 9.0, CI 1.9-43, p=0.006), and acute rejection episodes (HR 13, CI 2-90, p=0.008). The most common causes of graft loss were acute and chronic rejection episodes and immunosuppression nonadherence. CONCLUSION Adolescents undergoing KT have inferior graft survival compared to younger children. In adjusted modeling, children with older age, female gender, and acute rejection episodes have inferior graft survival.
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Affiliation(s)
- Iuliana D Bobanga
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Beth A Vogt
- Departments of Pediatrics, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Kenneth J Woodside
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH.
| | - Devan R Cote
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Katherine M Dell
- Departments of Pediatrics, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Robert J Cunningham
- Departments of Pediatrics, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Kelly A Noon
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Edward M Barksdale
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Vanessa R Humphreville
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - Edmund Q Sanchez
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
| | - James A Schulak
- Department of Surgery, Case Western Reserve University & University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH
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Ebrahim S, Parshuram C. Comparison of utility scores from the Visual Analog Scale and Health Utilities Index 3 in children following pediatric intensive care unit admission. J Child Health Care 2015; 19:53-62. [PMID: 23939724 DOI: 10.1177/1367493513496909] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Indirect and direct health-related quality of life (HRQoL) measures are intended to assess the same underlying constructs. There is evidence that the two types of assessments can show important differences. We assessed the agreement between the utilities of direct and indirect HRQoL measurements in children following pediatric intensive care unit (PICU) admission. We collected Health Utilities Index 3 (HUI-3) and Visual Analog Scale (VAS) ratings of children who were urgently admitted to the PICU of a university-affiliated pediatric hospital at ICU admission (baseline) and one month post-ICU admission. The mean (SD) VAS converted standard gamble and HUI-3 utilities were 0.82 (±0.19) and 0.70 (±0.39), respectively, at baseline (n = 51), and 0.81 (±0.15) and 0.58 (±0.39) at one month (n = 36). The VAS utilities were significantly greater than the HUI-3 utilities (p = 0.009). At baseline, the intraclass coefficient (95% confidence interval) was 0.49 (0.25-0.68), representing moderate agreement, and at one month, was 0.18 (-0.87 to 0.45), representing negligible agreement. There were significant differences between indirect and direct measures, and inconsistent agreement between utilities derived from the two measures. These data illustrate the potential impact of HRQoL assessment techniques on economic analyses used to inform health policy decision-making for pediatric critical care.
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Weernink MGM, Janus SIM, van Til JA, Raisch DW, van Manen JG, IJzerman MJ. A Systematic Review to Identify the Use of Preference Elicitation Methods in Healthcare Decision Making. Pharmaceut Med 2014. [DOI: 10.1007/s40290-014-0059-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rhodes ET, Goran MI, Lieu TA, Lustig RH, Prosser LA, Songer TJ, Weigensberg MJ, Weinstock RS, Gonzalez T, Rawluk K, Zoghbi RM, Ludwig DS, Laffel LM. Health-related quality of life in adolescents with or at risk for type 2 diabetes mellitus. J Pediatr 2012; 160:911-7. [PMID: 22217471 PMCID: PMC4793715 DOI: 10.1016/j.jpeds.2011.11.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 10/04/2011] [Accepted: 11/10/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate how adolescents with or at risk for type 2 diabetes mellitus (T2DM) and their parent/guardians (parents) perceive adolescents' health-related quality of life. STUDY DESIGN We interviewed overweight/obese, 12- to 18-year-old youth with T2DM, prediabetes, or insulin resistance and one parent from 5 US sites. Assessments included Pediatric Quality of Life Inventory (PedsQL), Health Utilities Index, family conflict, and diabetes burden. RESULTS In 108 adolescents, diagnoses included 40.7% with T2DM, 25.0% with prediabetes, and 34.3% with insulin resistance. PedsQL summary score (SS) was higher in adolescents than parents (P=.02). Parents rated physical functioning lower than adolescents (P<.0001), but there were no differences in psychosocial health. Adolescent PedsQL SS did not differ with diagnosis, but was inversely associated with adolescent body mass index z-score (P=.0004) and family conflict (P<.0001) and associated with race/ethnicity (P<.0001). Number of adolescent co-morbidities (P=.007) and burden of diabetes care (P<.05) were inversely associated with parent PedsQL SS. There were no differences in the Health Utilities Index-Mark 3 multi-attribute utility score. CONCLUSIONS Parents perceive their adolescents' physical functioning as more impaired than adolescents themselves. Contextual factors including severity of obesity, race/ethnicity, family conflict, and burden of diabetes care influence health-related quality of life. Family-based approaches to treatment and prevention of T2DM may benefit from increased attention to the biopsychosocial context.
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Affiliation(s)
- Erinn T. Rhodes
- Division of Endocrinology, Children’s Hospital Boston, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Michael I. Goran
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA,Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Tracy A. Lieu
- Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA,Division of General Pediatrics, Children’s Hospital Boston, Boston, MA
| | - Robert H. Lustig
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA
| | - Lisa A. Prosser
- Center for Child Health Care Studies, Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA,Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, MI
| | - Thomas J. Songer
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Marc J. Weigensberg
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ruth S. Weinstock
- Department of Medicine, SUNY Upstate Medical University, Syracuse, NY
| | - Tessa Gonzalez
- Division of Endocrinology, Children’s Hospital Boston, Boston, MA
| | - Kaitlin Rawluk
- Division of Endocrinology, Children’s Hospital Boston, Boston, MA
| | - Roula M. Zoghbi
- Division of Endocrinology, Children’s Hospital Boston, Boston, MA
| | - David S. Ludwig
- Division of Endocrinology, Children’s Hospital Boston, Boston, MA,Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Lori M. Laffel
- Department of Pediatrics, Harvard Medical School, Boston, MA,Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston
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Rhodes ET, Prosser LA, Hoerger TJ, Lieu T, Ludwig DS, Laffel LM. Estimated morbidity and mortality in adolescents and young adults diagnosed with Type 2 diabetes mellitus. Diabet Med 2012; 29:453-63. [PMID: 22150528 DOI: 10.1111/j.1464-5491.2011.03542.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS To estimate remaining life expectancy (RLE), quality-adjusted life expectancy (QALE), causes of death and lifetime cumulative incidence of microvascular/macrovascular complications of diabetes for youths diagnosed with Type 2 diabetes. METHODS A Markov-like computer model simulated the life course for a hypothetical cohort of adolescents/young adults in the USA, aged 15-24 years, newly diagnosed with Type 2 diabetes following either conventional or intensive treatment based on the UK Prospective Diabetes Study. Outcomes included RLE, discounted QALE in quality-adjusted life years (QALYs), cumulative incidence of microvascular/macrovascular complications and causes of death. RESULTS Compared with a mean RLE of 58.6 years for a 20-year-old in the USA without diabetes, conventional treatment produced an average RLE of 43.09 years and 22.44 discounted QALYs. Intensive treatment afforded an incremental 0.98 years and 0.44 discounted QALYs. Intensive treatment led to lower lifetime cumulative incidence of all microvascular complications and lower mortality from microvascular complications (e.g. end-stage renal disease (ESRD) death 19.4% vs. 25.2%). Approximately 5% with both treatments had ESRD within 25 years. Lifetime cumulative incidence of coronary heart disease (CHD) increased with longer RLE and greater severity of CHD risk factors. Incorporating disutility (loss in health-related quality of life) of intensive treatment resulted in net loss of QALYs. CONCLUSIONS Adolescents/young adults with Type 2 diabetes lose approximately 15 years from average RLE and may experience severe, chronic complications of Type 2 diabetes by their 40s. The net clinical benefit of intensive treatment may be sensitive to preferences for treatment. A comprehensive management plan that includes early and aggressive control of cardiovascular risk factors is likely needed to reduce lifetime risk of CHD.
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Affiliation(s)
- E T Rhodes
- Division of Endocrinology, Children's Hospital Boston, Boston, MA 02115, USA.
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Ethier MC, Regier DA, Tomlinson D, Judd P, Doyle J, Gassas A, Naqvi A, Sung L. Perspectives toward oral mucositis prevention from parents and health care professionals in pediatric cancer. Support Care Cancer 2011; 20:1771-7. [PMID: 21947490 DOI: 10.1007/s00520-011-1274-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 09/13/2011] [Indexed: 11/24/2022]
Abstract
PURPOSE The objectives of this study were: (1) to describe parents and health care professionals (HCPs) perceived importance of oral mucositis prevention in children with cancer; (2) To describe utilities and willingness-to-pay (WTP) to prevent mucositis. METHODS Respondents included parents of children receiving intensive chemotherapy for leukemia/lymphoma or undergoing stem cell transplantation and HCPs caring for children with cancer. Importance of mild and severe oral mucositis was estimated using a visual analogue scale (VAS). Mucositis-associated utilities were elicited using the time trade-off technique (TTO). WTP to avoid mucositis was obtained using contingent valuation. These techniques quantify how much time or money the participant is willing to relinquish in order to prevent mucositis. RESULTS Eighty-two parents and 60 HCPs were included. Parents and HCPs believed mild mucositis to be of similar importance (median VAS 2.5 versus 3.6; P = 0.357) while parents considered severe mucositis less important than HCPs (median VAS 8.3 versus 9.0; P < 0.0001). No differences in parent versus HCP responses were seen with TTO (mild or severe mucositis) and most parents were not willing to trade any survival time to prevent severe mucositis. Parents were willing to pay significantly more than HCPs to prevent mild mucositis (average median WTP $1,371 CAN vs. $684 CAN, P = 0.031). No differences were seen in WTP to prevent severe mucositis. CONCLUSIONS Parents and HCP believe severe mucositis to be important, although it is more important to HCPs. Parents would not be willing to reduce life expectancy to eliminate mucositis.
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Affiliation(s)
- Marie-Chantal Ethier
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada
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