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Worku WZ, Azale T, Ayele TA, Mekonnen DK. Women's voices: the lived experience of HIV-positive women in the postpartum period at the University of Gondar comprehensive specialized referral hospital, Ethiopia: a phenomenological study. BMC Womens Health 2023; 23:325. [PMID: 37344854 DOI: 10.1186/s12905-023-02470-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Pregnancy and the postpartum period are incredibly challenging for women living with the Human Immune Deficiency Virus (HIV) due to the multidimensional influence of HIV infection. These women experience the challenges of navigating pregnancy and motherhood while living with HIV. It is poorly understood how women living with HIV (WLWH) experience pregnancy and postpartum. Therefore, the current study aimed to explore the lived experience of pregnancy and postpartum among women living with HIV. METHODS A phenomenological qualitative study design was employed. A semi-structured, interview guide was used to conduct in-depth interviews with HIV-positive postpartum women from April to May 2022. All interviews were recorded using a voice recorder and note was taken. The collected data were transcribed and translated into English for analysis. Inductive thematic analysis was applied to analyze the data. RESULTS Six main themes about the lived experience of women living with HIV were identified: (1) Fear and distress related to maternal and child Health, (2) HIV status self-disclosure dilemma, (3) Courage and commitment of HIV-positive women to prevent HIV, (4) Challenges faced and coping mechanisms used by HIV-positive women, (5) Health care providers and HIV-positive women interaction, and (6) Solution from their voices. CONCLUSION HIV infection also has a multidimensional impact on women's life during pregnancy and postpartum. The findings of this study improve our understanding of the lived experience of HIV-positive women while pregnant and in the postpartum period. These women's descriptions showed that they have been experiencing various challenges that are not often addressed in antenatal clinics, such as distress and uncertainties related to vertical transmission of HIV. These women need specialized support and all-encompassing care to have a healthy pregnancy and postpartum period. Moreover, it is essential to understand the circumstances of women's lives, their relationships with others, and their decision-making processes. Healthcare professionals and other responsible bodies working with women living with HIV should encourage and support these mothers to appraise and maintain their commitment to protecting their children from acquiring HIV infection and maintaining their Health to the maximum to raise their children.
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Affiliation(s)
- Workie Zemene Worku
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Telake Azale
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dawit Kassahun Mekonnen
- Department of Gynaecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Regan AK, Swathi PA, Nosek M, Gu NY. Measurement of Health-Related Quality of Life from Conception to Postpartum Using the EQ-5D-5L Among a National Sample of US Pregnant and Postpartum Adults. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:523-532. [PMID: 36964853 PMCID: PMC10039326 DOI: 10.1007/s40258-023-00798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND During pregnancy, physiological changes occur from conception to birth. We assessed the health-related quality of life (HRQoL) throughout pregnancy and postpartum using the EQ-5D-5L. METHODS Between May and July 2021 (wave 1) and December 2021 and April 2022 (wave 2), we conducted a series of cross-sectional, national online surveys of 5250 pregnant and postpartum United States (US) adults. The survey included the EQ-5D-5L, EQ visual analog scale (EQ VAS), items measuring respondents' sociodemographic and health information, last menstrual period, estimated date of delivery, and date of pregnancy end (if postpartum). We examined monthly EQ-5D-5L items, utility values, and EQ VAS scores during pregnancy and postpartum. We used quantile regression adjusted for calendar month of last menstrual period to estimate changes in HRQoL at different time points of pregnancy and postpartum. RESULTS There was a steady increase in the frequency of respondents reporting health-related problems and a decline in EQ-5D-5L utility values from early pregnancy until the ninth month of pregnancy (β = - 0.21; standard error [SE] 0.02; P < 0.001), followed by a 0.10 (SE 0.02; P < 0.001) unit increase in values during the first postpartum month and a stabilization during the remainder of the postpartum period (β = 0.02; SE 0.02; P = 0.214). The median EQ-5D-5L utility value was lowest during the ninth month of pregnancy (median 0.78 [interquartile range 0.30]). CONCLUSIONS HRQoL as measured by EQ-5D-5L varies across pregnancy, indicating progressive declines throughout pregnancy and a return to first trimester values during the first month postpartum. Studies involving HRQoL measurement in pregnant people should account for the stage of pregnancy in their estimates.
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Affiliation(s)
- Annette K Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA.
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
| | - Pallavi Aytha Swathi
- School of Medicine, University of Colorado, Denver, CO, USA
- College Arts and Sciences, University of San Francisco, San Francisco, CA, USA
| | - Marcianna Nosek
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
| | - Ning Yan Gu
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
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Wang X, Luo H, Yao E, Tang R, Dong W, Liu F, Liang J, Xiao M, Zhang Z, Niu J, Song L, Fu L, Li X, Qian S, Guo Q, Song Z. Health utility measurement for people living with HIV/AIDS under combined antiretroviral therapy: A comparison of EQ-5D-5L and SF-6D. Medicine (Baltimore) 2022; 101:e31666. [PMID: 36397330 PMCID: PMC9666157 DOI: 10.1097/md.0000000000031666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We compared the discriminative validity, agreement and sensitivity of EQ-5D-5L and SF-6D utility scores in people living with HIV/AIDS (PLWHIV). We conducted a cross-sectional survey among PLWHIV aged more than 18 years old in 9 municipalities in Yunnan Province, China. A convenience sample was enrolled. We administered the SF-12 and EQ-5D-5L to measure health-related quality of life. The utility index of the SF-6D was derived from the SF-12. We calculate correlation coefficients to evaluate the relationship and agreement of 2 instruments. To evaluate the homogeneity of the EQ-5D-5L and SF-6D, intraclass correlation coefficients, scatter plots, and Bland-Altman plots were computed and drawn. We also used receiver operating characteristic curves to compare the discriminative properties and sensitivity of the econometric index. A total of 1797 respondents, with a mean age of 45.6 ± 11.7 years, was interviewed. The distribution of EQ-5D-5L scores skewed towards full health with a skewness of -3.316. The overall correlation between EQ-5D-5L and SF-6D index scores was 0.46 (P < .001). The association of the 2 scales appeared stronger at the upper end. An intraclass correlation coefficient of 0.59 between the EQ-5D-5L and SF-6D meant a moderate correlation and indicated general agreement. The Bland-Altman plot displayed the same results as the scatter plot. The receiver operating characteristic curve showed that the AUC for the SF-6D was 0.776 (95% CI: 0.757, 0.796) and that for the EQ-5D-5L was 0.732 (95% CI: 0.712, 0.752) by the PCS-12, and it was 0.782 (95% CI: 0.763, 0.802) for the SF-6D and 0.690 (95% CI: 0.669, 0.711) for the EQ-5D-5L by the MCS-12. Our study demonstrated evidence of the performance of EQ-5D-5L and SF-6D index scores to measure health utility in people living with HIV/AIDS. There were significant differences in their performance. We preferred to apply the SF-6D to measure the health utility of PLWHIV during the combined antiretroviral therapy period. Our study has demonstrated evidence for instrument choice and preference measurements in PLWHIV under combined antiretroviral therapy.
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Affiliation(s)
- Xiaowen Wang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Hongbing Luo
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Enlong Yao
- Honghe Municipal Center for Disease Control and Prevention, Honghe, China
| | - Renhai Tang
- Dehong Municipal Center for Disease Control and Prevention, Dehong, China
| | - Wenbing Dong
- Yuxi Municipal Center for Disease Control and Prevention, Yuxi, China
| | - Fuyong Liu
- Zhaotong Municipal Center for Disease Control and Prevention, Zhaotong, China
| | - Jun Liang
- Kunming Municipal Center for Disease Control and Prevention, Kunming, China
| | - Minyang Xiao
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Zuyang Zhang
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Jin Niu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Lijun Song
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Liru Fu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Xuehua Li
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Shicong Qian
- Wenshan Municipal Center for Disease Control and Prevention, Wenshan, China
| | - Qing Guo
- Lincang Municipal Center for Disease Control and Prevention, Lincang, China
| | - Zhizhong Song
- Yunnan Center for Disease Control and Prevention, Kunming, China
- * Correspondence: Zhizhong Song, Yunnan center for disease control and prevention, No.158, Dongsi street, Xishan municipal, Kunming, Yunnan province, China (e-mail: )
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Sun LF, Huang S, Li YF, Yang ZQ, Yang XJ, Zou JY, Wang XW, Nie JY. Health-related quality of life measured by EQ-5D-3L for the spouses of breast cancer patients. Front Oncol 2022; 12:983704. [DOI: 10.3389/fonc.2022.983704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
To explore factors influencing the health-related quality of life of spouses of breast cancer patients and the suitable questionnaires for this purpose. A cross-sectional study was conducted in the Third Affiliated Hospital of Kunming Medical University. The spouses of breast cancer patients were included and evaluated via face-to-face interviews. Self-designed demographic characteristics and disease-related questionnaires, the 12-item health survey questionnaire (SF-12), the three-level European five-dimensional health status scale (EQ-5D-3L), and the Social Support Rate Scale (SSRS) were used. The internal consistency reliability measure Cronbach’s coefficient, criterion-related validity, construct validity, and sensitivity were used to evaluate the applicability of the EQ-5D-3L. Univariate and multivariate analyses were performed to analyze the factors associated with the health-related quality of life of spouses of breast cancer patients. We investigated a total of 100 spouses of breast cancer patients. Cronbach’s α, the internal consistency reliability coefficient, was 0.502. The EQ-5D-3L health utility score was moderately correlated with PCS-12 (r=0.46, p=0.0001) and weakly correlated with MCS-12 (r=0.35, p=0.0001). The EQ-5D-3L health utility score for the spouses of breast cancer patients was 0.870, and the EQ-VAS was 78.3. In multivariate analysis, social support and cognition of the treatment effect were factors that influenced the EQ-5D-3L health utility score. The EQ-5D-3L has good reliability, validity, and sensitivity for measuring the physiological aspects of the health-related quality of life of spouses of BC patients. EQ-5D-3L was considered suitable for this study.
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Qu S, Wang A, Wang X, Yang Y, Pan X, Zhang T. Health-Related Quality of Life of HIV-Positive and HIV-Negative Pregnant Women in an Impoverished Area: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e29906. [PMID: 35380543 PMCID: PMC9019641 DOI: 10.2196/29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background Liangshan prefecture of Sichuan province was an impoverished mountainous area in China, where the annual number of HIV-positive pregnant women accounted for approximately 10% of China’s total population in the decades before 2020. In general, pregnant women living here are likely to be physically and mentally different from those in other places. Objective This study aims to explore the health-related quality of life (HRQoL) of pregnant women living with HIV in an impoverished area. Methods From December 2018 to January 2019, HIV-positive and HIV-negative parturients within 18 months after delivery were recruited in Liangshan Prefecture, Sichuan Province. Questionnaires were designed to collect their demographic data, while the EuroQol 5-Dimension, 3-Level questionnaire was used to measure their HRQoL when they were in the second trimester from 4 to 6 months of pregnancy, and their quantitative health scores were converted to corresponding healthy utility values by using the Chinese Utility Value Integral System (time trade-off coefficient). Results A total of 250 pregnant women (133 HIV-positive and 117 HIV-negative) were enrolled in the study. Among them, 55 (41.35%) and 75 (64.10%) of HIV-positive and HIV-negative pregnant women self-reported full health (healthy state 11111), respectively. The median health utility value of the 250 pregnant women was 0.961 (IQR –0.046 to 0.961), and those of the HIV-positive and HIV-negative pregnant women were 0.875 (0.424-0.961) and 0.961 (IQR –0.046 to 0.961), respectively. We observed a significant difference only in the dimension of anxiety or depression between the two groups (P=.002) and no significant difference in the distribution of health utility indices between the two groups in terms of maternal age, education level, occupation, annual household income, prenatal care visits, family size, and medical insurance category. Multivariate ordinal logistic regression analysis showed that age (odds ratio [OR] 0.62, P<.05) and prenatal care visit (OR 0.29, P<.01) were independent risk factors for health status. Conclusions Most pregnant women self-reported satisfactory HRQoL in this impoverished mountainous area. HIV-negative pregnant women had an edge over HIV-positive pregnant women, and there were significant differences in anxiety or depression dimensions between the two groups.
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Affiliation(s)
- Shuiling Qu
- Chinese Center for Disease Control and Prevention, Beijing, China.,National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoyan Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yehuan Yang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoping Pan
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tong Zhang
- Capital Institute of Pediatrics, Beijing, China
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Xiao J, Xiao J, Liu Y, Li B, Zhang L, Han J, Zhao H. Efficacy and safety of Efavirenz 400 mg-based regimens switching from 600 mg-based regimens in people living with HIV with virological suppression in China: a randomized, open-label, non-inferiority study. Int J Infect Dis 2022; 117:48-55. [DOI: 10.1016/j.ijid.2022.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/20/2022] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
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Wang X, Luo H, Yao E, Tang R, Dong W, Liu F, Liang J, Li H, Xiao M, Zhang Z, Niu J, Song L, Fu L, Li X, Qian S, Guo Q, Song Z. The role of personality, social economic and prevention strategy effects on health-related quality of life among people living with HIV/AIDS. Infect Dis Poverty 2021; 10:104. [PMID: 34344462 PMCID: PMC8336408 DOI: 10.1186/s40249-021-00890-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND HIV/AIDS has transformed into a chronic controllable but not yet curable infectious disease as other chronic diseases to some extent. The additional of so called fourth 90% that included the improved health-related quality of life (HRQoL) for people living with HIV (PLWHIV) required solutions beyond antiretroviral therapy and viral load suppression. This study will explore the role of personality, social economic and prevention strategy effection on HRQoL among people living with HIV/AIDS. METHODS A cross-sectional study was conducted among PLWHIV aged more than 16 years old in the 10 municipalities in Yunnan Province, China from October 2019 to May 2020, enrolling total 1997 participants. Individual-level HRQoL data were measured by 12-item Short Form Health Survey (SF-12) and EuroQol Five Dimensions Questionnaire (EQ-5D-5L). We assembled municipal-level data about social economic from Yunnan Statistical Yearbook in 2020 and strategy practice information from the self-evaluation system. We used the principal component analysis to build the social economic and strategy effect on each area respectively and one-way ANOVA was used to perform univariate analysis to identify the predictors with significant differences. Finally we used multi-level model (MLM) to explore the personality, social economic and strategy effects in health-related quality of life among PLWHIV. RESULTS The global score for quality of life measured using EQ-5D-5L had an estimated mean score (standard deviation, SD) of 0.901 ± 0.146. The HRQoL score measured using PCS-12 had an estimated mean score (SD) of 46.62 ± 8.55. The mean MCS-12 score (SD) was estimated to be 47.80 ± 9.71. The area-level predictors explained a proportion of 13.6-17.2% for the between-area variation of the HRQoL scores, regardless of the total HRQoL, physical component and mental component. The impacts of stigma (P < 0.01), social support (P < 0.001), anxiety (P < 0.001), depression (P < 0.05) and social economic status (P < 0.05) on HRQoL at the individual-level were significantly different. The plots visualized the impact of individual-level factors on a respondent's HRQoL was modified by the area-level characteristics. CONCLUSIONS The study identified the possible strategy determinant of individual HRQoL of PLWHIV and also the area effect on HRQoL. Stigma, social support, anxiety, depression and social economic status were the individual-level determinants on HRQoL. These could be a valuable resource for evaluating the overall health of the areas and help improve local decision making.
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Affiliation(s)
- Xiaowen Wang
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Hongbing Luo
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Enlong Yao
- Honghe Municipal Center for Disease Control and Prevention, Honghe, Yunnan Province China
| | - Renhai Tang
- Dehong Municipal Center for Disease Control and Prevention, Dehong, Yunnan Province China
| | - Wenbin Dong
- Yuxi Municipal Center for Disease Control and Prevention, Yuxi, Yunnan Province China
| | - Fuyong Liu
- Zhaotong Municipal Center for Disease Control and Prevention, Zhaotong, Yunnan Province China
| | - Jun Liang
- Kunming Municipal Center for Disease Control and Prevention, Kunming, Yunnan Province China
| | - Huilan Li
- Puer Municipal Center for Disease Control and Prevention, Puer, Yunnan Province China
| | - Minyang Xiao
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Zuyang Zhang
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Jin Niu
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Lijun Song
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Liru Fu
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Xuehua Li
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
| | - Shicong Qian
- Wenshan Municipal Center for Disease Control and Prevention, Wenshan, Yunnan Province China
| | - Qing Guo
- Lincang Municipal Center for Disease Control and Prevention, Lincang, Yunnan Province China
| | - Zhizhong Song
- Yunnan Center for Disease Control and Prevention, No.158, Dongsi Street, Xishan Municipal, Kunming, Yunnan Province China
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Cheng LJ, Tan RLY, Luo N. Measurement Properties of the EQ VAS Around the Globe: A Systematic Review and Meta-Regression Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1223-1233. [PMID: 34372988 DOI: 10.1016/j.jval.2021.02.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aimed to synthesize and evaluate published evidence on the measurement properties of the EQ VAS, a component of all EQ-5D questionnaires. METHODS This systematic review followed the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Five electronic databases were searched for EQ-5D-3L and EQ-5D-5L validation articles published from January 1, 2009, to November 5, 2019. Evidence for construct validity, test-retest reliability, and responsiveness was extracted from individual studies before being aggregated for evaluation of the populations represented by the studied samples. Multivariable logistic meta-regression was conducted to explore the effects of potential covariates on construct validity. RESULTS A total of 50 articles containing 488 studies, using samples drawn from 12 different populations, were identified. Generally, the quality of evidence was high for construct validity studies (n = 397) but only moderate for both test-retest reliability studies (n = 21) and responsiveness studies (n = 70). "Sufficient" construct validity of EQ VAS was found in 8 of 12 populations, "sufficient" test-retest reliability was found in 3 of 11 populations, and "sufficient" responsiveness was found in 5 of 12 populations. Meta-regression analyses suggested that construct validity studies from the Asian-Pacific region were more likely to show a negative rating compared with studies from Europe and North America. CONCLUSION The EQ VAS exhibits "sufficient" construct validity, "inconsistent" test-retest reliability, and "inconsistent" responsiveness across a broad range of populations. Additional studies are needed to explore the suboptimal validity of the EQ VAS in the Asian-Pacific region, whereas more high-quality validation studies are needed to assess its reliability and responsiveness.
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Affiliation(s)
- Ling Jie Cheng
- Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore; Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rachel Lee-Yin Tan
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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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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Estimating Health Utility in Patients Presenting for Spine Surgery Using Patient-reported Outcomes Measurement Information System (PROMIS) Health Domains. Spine (Phila Pa 1976) 2019; 44:908-914. [PMID: 31205166 DOI: 10.1097/brs.0000000000002977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVE To evaluate whether Patient-Reported Outcomes Measurement Information System (PROMIS) health domains can effectively estimate health utility index values for patients presenting for spine surgery. SUMMARY OF BACKGROUND DATA Stable estimates of health utility are required to determine cost-effectiveness of spine surgery. There are no established methods to estimate health utility using PROMIS. METHODS We enrolled 439 patients with spine disease (mean age, 54 ± 18 yrs) presenting for surgery and assessed their health using the Medical Outcomes Study Short Form-12, version 2 (SF-12v2) and PROMIS domains. Standard health utility values were estimated from the SF-12v2. Participants were randomly assigned to derivation or validation cohort. In the derivation cohort, health utility values were estimated as a function of PROMIS domains using regression models. Model fit statistics determined the most parsimonious health utility estimation equation (HEE). In the validation cohort, values were calculated using the HEE. Estimated health utility values were correlated with SF-12v2-derived health utility values. RESULTS Mean preoperative health utility was 0.492 ± 0.008 and was similar between the two cohorts. All PROMIS health domains were significantly associated with health utility except Anxiety (P = 0.830) and Sleep Disturbance (P = 0.818). The final HEE was:Health Utility (est) = 0.70742 - 0.00471 × Pain + 0.00647 × Physical function - 0.00316 × Fatigue - 0.00214 × Depression + 0.00317 × Satisfaction with Participation in Social Roles.The estimation model accounted for 74% of observed variation in health utility. In the validation sample, mean health utility was 0.5033 ± 0.1684 and estimated health utility was 0.4966 ± 0.1342 (P = 0.401). These measures were strongly correlated (rho = 0.834). CONCLUSION Our results indicate that PROMIS provides a reasonable estimate of health utility in adults presenting for lumbar or cervical spine surgery. LEVEL OF EVIDENCE 1.
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Lee H, Cho SY, Kim JS, Yoon SY, Kim BI, An JM, Kim KB. Difference in health status of Korean farmers according to gender. Ann Occup Environ Med 2019; 31:7. [PMID: 30899524 PMCID: PMC6407243 DOI: 10.1186/s40557-019-0287-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 02/10/2019] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study was to compare differences in lifestyle diseases, musculoskeletal pain, psychosocial stress, and self-health awareness according to gender in Korean farmers. Methods The study population comprised 436 farmers residing in rural areas in Korea. A self-administered questionnaire was used to survey demographic characteristics, health-related behaviors, and musculoskeletal pain. The psychosocial well-being index short form (PWI-SF) was used to survey psychosocial stress, and the 12-item short form health survey (SF-12) was used to survey self-health awareness. In addition, a clinical examination was performed for each participant, and lifestyle diseases were identified through a health checkup. Results Among lifestyle diseases, females showed a significantly higher proportion than males for metabolic syndrome (OR: 4.57 [95% CI, 1.67-12.51]). For musculoskeletal pain, females again showed significantly higher proportion than males for hand pain (OR: 16.79 [95% CI, 3.09-91.30]), and pain in at least one body part (OR: 2.34 [95% CI, 1.16-4.70]). For psychosocial stress, females showed a significantly higher proportion than males for high-risk stress (OR: 3.10 [95% CI, 1.17-8.24]). Among the items in self-health awareness, females showed significantly higher proportion than males for mental component score (MCS) (OR: 3.10 [95% CI, 1.52-6.31]) and total score (OR: 2.34 [95% CI, 1.11-4.90]). Conclusions For all items that showed significant differences, females showed higher proportion than males, which indicates that female farmers tended to have poorer overall health than male farmers. Therefore, specialized programs will have to be developed to improve the health of female farmers.
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Affiliation(s)
- Ho Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
| | - Seong-Yong Cho
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
| | - Jin-Seok Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
| | - Seong-Yong Yoon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
| | - Bu-Il Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
| | - Jong-Min An
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
| | - Ki-Beom Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, 1gongdan-ro, Gumi, Gyeongsangbuk-do Republic of Korea
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