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Rasmussen MS, Andelic N, Selj JN, Danielsen VM, Løvstad M, Howe EI, Hellstrøm T, Soberg HL, Brunborg C, Aas E, Moksnes H, Sveen U, Gaarder C, Næss PA, Helseth E, Røise O, Aarhus M, Øra HP, Bjørneboe JA, Fure S, Røe C, Schäfer C, Perrin PB, Lu J, Elf M, Dahl HM, Jones F, Ponsford J, Narvestad L, Hauger SL. Self-management support program delivered in the sub-acute phase after traumatic injury-study protocol for a pragmatic randomized controlled trial. Trials 2024; 25:639. [PMID: 39350137 PMCID: PMC11441131 DOI: 10.1186/s13063-024-08492-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 09/20/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Traumatic injuries, defined as physical injuries with sudden onset, are a major cause of distress and disability, with far-reaching societal consequences. A significant proportion of trauma survivors report persistent symptoms and difficulties after the injury, and studies show unmet health care needs. Self-management programs delivered in the sub-acute phase after traumatic injuries are scarcely evaluated. The aim of the present study is to evaluate the effectiveness of a self-management program (SEMPO), delivered 3-4 months after moderate-to-severe traumatic injury. METHODS This study protocol describes a pragmatic randomized controlled trial (RCT) with two classical RCT arms (intervention and control) and an explorative self-selection arm. 220 patients will be recruited from Oslo University Hospital, the largest Trauma Referral Centre in Norway. Patients aged 18-72 years residing in the south-east region of Norway, admitted to the Trauma Centre directly or within 72 h after having sustained a moderate to severe traumatic injury, defined as a New Injury Severity Score > 9, having at least 2 days hospital stay, and reporting injury-related symptoms and impairment at discharge from the acute hospital will be included. Patients will be randomly assigned to either a classical RCT randomization arm (intervention or control arm) or to a self-selection arm. In the randomization arm, participants are further randomized into intervention or control group. Participants allocated to the self-selection arm will choose to partake either in the intervention or control arm. The primary outcome is the level of self-efficacy in trauma coping assessed 6 months after completion of the intervention, with a similar time point for the control group. Secondary outcomes include symptom burden, physical functioning and disability, return to work and health care utilization, health-related quality of life, and communication competency. In addition, patients will be asked to nominate one domain-related measurement as their preferred outcome measure. DISCUSSION This RCT will determine the effect of a self-management program tailored to patients with moderate to severe physical trauma, and the self-selection arm incorporates the potential influence of patient treatment preferences on intervention results. If the intervention proves effective, cost-effectiveness and cost-utility analyses will be performed and thereby provide important information for clinicians and policy makers. TRIAL REGISTRATION The study is registered in Clinical Trials with the identifier: NCT06305819. Registered on March 05, 2004.
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Affiliation(s)
- Mari S Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Joanna Nordhagen Selj
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vilde Marie Danielsen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Research and Innovation, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Research and Innovation, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Emilie Isager Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Helene L Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Eline Aas
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Håkon Moksnes
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Christine Gaarder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Traumatology, Oslo University Hospital, Oslo, Norway
| | - Pål Aksel Næss
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Traumatology, Oslo University Hospital, Oslo, Norway
| | - Eirik Helseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Olav Røise
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Orthopaedic Surgery, Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Mads Aarhus
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Hege Prag Øra
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research and Innovation, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - John Andreas Bjørneboe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Silje Fure
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christoph Schäfer
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, University Hospital of North Norway, Faculty of Health Sciences, Tromsø, Norway
| | - Paul B Perrin
- Departments of Psychology and Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Juan Lu
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Marie Elf
- Department of Nursing 2, School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Hilde Margrethe Dahl
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Neurosciences for Children, Section for Child Neurology, Oslo University Hospital, Oslo, Norway
| | - Fiona Jones
- Population Health Research Institute, St George's, University of London, London, England, UK
- Bridges Self-Management, London, England, UK
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Linda Narvestad
- Department of Subjects and Development, Oslo Municipality, Oslo, Norway
| | - Solveig L Hauger
- Department of Research and Innovation, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.
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Karchoud JF, Haagsma J, Karaban I, Hoeboer C, van de Schoot R, Olff M, van Zuiden M. Long-term PTSD prevalence and associated adverse psychological, functional, and economic outcomes: a 12-15 year follow-up of adults with suspected serious injury. Eur J Psychotraumatol 2024; 15:2401285. [PMID: 39297236 PMCID: PMC11414644 DOI: 10.1080/20008066.2024.2401285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 07/26/2024] [Accepted: 08/21/2024] [Indexed: 09/22/2024] Open
Abstract
Background: An increasing number of longitudinal studies investigates long-term PTSD, related outcomes and potential gender differences herein. However, a knowledge gap exists when it comes to studies following individual civilian trauma beyond a decade post-trauma.Objective: To investigate the long-term PTSD prevalence, associated adverse psychological, functional and economic outcomes related to (suspected) serious injury of 12-15 years ago in Dutch adults, as well as potential gender differences herein.Method: N = 194 trauma-exposed adults (34% women) admitted to an emergency department following suspected serious injury completed a follow-up assessment 12-15 years (M = 14.30, SD = 1.00) post-trauma. Participants completed assessments of clinician-rated PTSD symptom severity, as well as self-report questionnaires on psychological, functional and economic outcomes.Results: Nine participants (4.8%) fulfilled the DSM-5 diagnostic criteria for PTSD related to the index trauma of 12-15 years ago. Results showed that PTSD symptom severity (CAPS-5) was significantly associated with more severe symptoms of anxiety (HADS) and depression (QIDS), lower well-being (WHO-5) and (health-related) quality of life (WHOQOL; EQ-5D-5L), but not with alcohol use (AUDIT), productivity loss at work (iPCQ) and health care use (iMCQ). No significant gender differences in the long-term PTSD prevalence nor in its related psychological, functional and economic outcomes were found.Conclusions: Our findings underscore the long-term presence of PTSD and associated adverse psychological and functional outcomes in a proportion of adults who experienced (suspected) serious injury over a decade ago. PTSD is already widely recognized for its substantial impact in the aftermath of a trauma. The current study emphasizes the potential long-term consequences of individual civilian trauma, highlighting the importance of accurate screening and prevention for PTSD.
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Affiliation(s)
- Jeanet F. Karchoud
- Psychiatry, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Irina Karaban
- Psychiatry, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Chris Hoeboer
- Psychiatry, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Rens van de Schoot
- Department of Methods and Statistics, Utrecht University, Utrecht, The Netherlands
| | - Miranda Olff
- Psychiatry, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Mirjam van Zuiden
- Psychiatry, Amsterdam Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
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Meakes S, Enninghorst N, Weaver N, Hardy BM, Balogh ZJ. Long-term functional outcomes in polytrauma: a fundamentally new approach is needed in prediction. Eur J Trauma Emerg Surg 2024; 50:1439-1452. [PMID: 38358513 PMCID: PMC11458641 DOI: 10.1007/s00068-023-02430-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024]
Abstract
PURPOSE Modern trauma care has reduced mortality but poor long-term outcomes with low follow-up rates are common with limited recommendations for improvements. The aim of this study was to describe the impact of severe injury on the health-related quality of life, specifically characterise the non-responder population and to identify modifiable predictors of poorer outcomes. METHODS Five-year (2012-2016) prospective cohort study was performed at a level 1 trauma centre. Baseline Short-Form Health Survey (SF36) was collected at admission, and at 6 and 12 months postinjury together with demographics, injury mechanism and severity, psychosocial wellbeing, and return to work capacity. RESULTS Of the 306 consecutive patients [age 52 ± 17 years, male 72%, ISS 21 (17, 29), mortality 5%], 195 (64%) completed questionnaires at baseline, and at 12 months. Preinjury physical health scores were above the general population (53.1 vs. 50.3, p < 0.001) and mental health component was consistent with the population norms (51.7 vs. 52.9, p = 0.065). One year following injury, both physical health (13.2, 95% CI 14.8, 11.6) and mental health scores (6.0, 95% CI 8.1, 3.8) were significantly below age- and sex-adjusted preinjury baselines. Non-responders had similar ISS but with a lower admission GCS, and were more likely to be younger, and without comorbidities, employment, or university education. CONCLUSION Contrary to their better than population norm preinjury health status, polytrauma patients remain functionally impaired at least 1 year after injury. The identified high risk for non-responding group needs more focused efforts for follow-up. A fundamentally different approach is required in polytrauma research which identify modifiable predictors of poor long-term outcomes.
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Affiliation(s)
- Simone Meakes
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, 2310, Australia
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Natalie Enninghorst
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Natasha Weaver
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Benjamin M Hardy
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, 2310, Australia
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia
- University of Newcastle, Newcastle, NSW, Australia
| | - Zsolt J Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, 2310, Australia.
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, Australia.
- University of Newcastle, Newcastle, NSW, Australia.
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Cole E, Crouch R, Baxter M, Wang C, Sivapathasuntharam D, Peck G, Jennings C, Jarman H. Investigating the effects of frailty on six-month outcomes in older trauma patients admitted to UK major trauma centres: a multi-centre follow up study. Scand J Trauma Resusc Emerg Med 2024; 32:1. [PMID: 38178162 PMCID: PMC10768225 DOI: 10.1186/s13049-023-01169-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Pre-injury frailty is associated with adverse in-hospital outcomes in older trauma patients, but the association with longer term survival and recovery is unclear. We aimed to investigate post discharge survival and health-related quality of life (HRQoL) in older frail patients at six months after Major Trauma Centre (MTC) admission. METHODS This was a multi-centre study of patients aged ≥ 65 years admitted to five MTCs. Data were collected via questionnaire at hospital discharge and six months later. The primary outcome was patient-reported HRQoL at follow up using Euroqol EQ5D-5 L visual analogue scale (VAS). Secondary outcomes included health status according to EQ5D dimensions and care requirements at follow up. Multivariable linear regression analysis was conducted to evaluate the association between predictor variables and EQ-5D-5 L VAS at follow up. RESULTS Fifty-four patients died in the follow up period, of which two-third (64%) had been categorised as frail pre-injury, compared to 21 (16%) of the 133 survivors. There was no difference in self-reported HRQoL between frail and not-frail patients at discharge (Mean EQ-VAS: Frail 55.8 vs. Not-frail 64.1, p = 0.137) however at follow-up HRQoL had improved for the not-frail group but deteriorated for frail patients (Mean EQ-VAS: Frail: 50.0 vs. Not-frail: 65.8, p = 0.009). There was a two-fold increase in poor quality of life at six months (VAS ≤ 50) for frail patients (Frail: 65% vs. Not-frail: 30% p < 0.009). Frailty (β-13.741 [95% CI -25.377, 2.105], p = 0.02), increased age (β -1.064 [95% CI [-1.705, -0.423] p = 0.00) and non-home discharge (β -12.017 [95% CI [118.403, 207.203], p = 0.04) were associated with worse HRQoL at follow up. Requirements for professional carers increased five-fold in frail patients at follow-up (Frail: 25% vs. Not-frail: 4%, p = 0.01). CONCLUSIONS Frailty is associated with increased mortality post trauma discharge and frail older trauma survivors had worse HRQoL and increased care needs at six months post-discharge. Pre-injury frailty is a predictor of poor longer-term HRQoL after trauma and recognition should enable early specialist pathways and discharge planning.
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Affiliation(s)
- Elaine Cole
- Centre for Trauma Sciences, Queen Mary University, London, England.
| | - Robert Crouch
- University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Mark Baxter
- University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Chao Wang
- Kingston University, Kingston, England
| | | | - George Peck
- Imperial College Healthcare NHS Trust, London, England
| | - Cara Jennings
- King's College Hospital NHS Foundation, Kingston, England
| | - Heather Jarman
- St George's University Hospital NHS Foundation Trust, London, England
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Dodwad SJM, Isbell KD, Mueck KM, Klugh JM, Meyer DE, Wade CE, Kao LS, Harvin JA. Patient-Reported Outcomes Following Severe Abdominal Trauma: A Secondary Analysis of the Damage Control Laparotomy Trial. J Surg Res 2024; 293:57-63. [PMID: 37716101 PMCID: PMC10841256 DOI: 10.1016/j.jss.2023.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/21/2023] [Accepted: 06/13/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION Little is known about patient-reported outcomes (PROs) following abdominal trauma. We hypothesized that patients undergoing definitive laparotomy (DEF) would have better PROs compared to those treated with damage control laparotomy (DCL). METHODS The DCL Trial randomized DEF versus DCL in abdominal trauma. PROs were measured using the European Quality of Life-5 Dimensions-5 Levels (EQ-5D) questionnaire at discharge and six months postdischarge (1 = perfect health, 0 = death, and <0 = worse than death) and Posttraumatic Stress Disorder (PTSD) Checklist-Civilian. Unadjusted Bayesian analysis with a neutral prior was used to assess the posterior probability of achieving minimal clinically important difference. RESULTS Of 39 randomized patients (21 DEF versus 18 DCL), 8 patients died (7 DEF versus 1 DCL). Of those who survived, 28 completed the EQ-5D at discharge (12 DEF versus 16 DCL) and 25 at 6 mo (12 DEF versus 13 DCL). Most patients were male (79%) with a median age of 30 (interquartile range (IQR) 21-42), suffered blunt injury (56%), and were severely injured (median injury severity score 33, IQR 21 - 42). Median EQ-5D value at discharge was 0.20 (IQR 0.06 - 0.52) DEF versus 0.31 (IQR -0.03 - 0.43) DCL, and at six months 0.51 (IQR 0.30 - 0.74) DEF versus 0.50 (IQR 0.28 - 0.84) DCL. The posterior probability of minimal clinically important difference DEF versus DCL at discharge and six months was 16% and 23%, respectively. CONCLUSIONS Functional deficits for trauma patients persist beyond the acute setting regardless of laparotomy status. These deficits warrant longitudinal studies to better inform patients on recovery expectations.
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Affiliation(s)
- Shah-Jahan M Dodwad
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas.
| | - Kayla D Isbell
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas
| | - Krislynn M Mueck
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Red Duke Trauma Institute, Memorial Hermann Hospital - Texas Medical Center, Houston, Texas
| | - James M Klugh
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas
| | - David E Meyer
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Red Duke Trauma Institute, Memorial Hermann Hospital - Texas Medical Center, Houston, Texas
| | - Charles E Wade
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Red Duke Trauma Institute, Memorial Hermann Hospital - Texas Medical Center, Houston, Texas
| | - Lillian S Kao
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Red Duke Trauma Institute, Memorial Hermann Hospital - Texas Medical Center, Houston, Texas
| | - John A Harvin
- Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Surgical Trials and Evidence-based Practice, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas; Red Duke Trauma Institute, Memorial Hermann Hospital - Texas Medical Center, Houston, Texas
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Aarø LE, Ohm E, Skogen JC, Nilsen T, Knapstad M, Vedaa Ø, Nes RB, Clarsen B, Klepp KI. A cross-sectional study of the relationship between injuries and quality of life, psychological distress, sleeping problems, and global subjective health in adults from three Norwegian counties. Health Qual Life Outcomes 2023; 21:120. [PMID: 37919801 PMCID: PMC10623734 DOI: 10.1186/s12955-023-02191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/13/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Studies examining associations between injuries and outcomes like quality of life and psychological distress are important to understand a broader range of possible consequences of injuries for population health. AIMS The aim of this study was to examine associations between self-reported injury and quality of life, psychological distress, sleeping problems, and global subjective health. METHODS The sample was drawn from the Norwegian National Population Register. Data were collected among the general adult populations in three Norwegian counties in 2019-2020 (response rate 45.3%, n = 74,030). Exposure variables were being injured during the last 12 months, cause of injury (if more than one, the most serious one), and functional impairment due to injuries. Outcome variables included measures of total quality of life, global quality of life, positive affect, negative affect, positive social relations, social capital (trust, belongingness, feeling safe), psychological distress, sleep problems, loneliness, and global subjective health. Data were analysed with General Linear Modelling in SPSS Complex. RESULTS Reporting to have been injured once during the last 12 months was associated with slightly elevated levels of psychological distress, sleeping problems, and loneliness, and lower mean scores on quality-of-life indicators and global subjective health. Reporting being injured twice or more showed more pronounced contrasts to the reference group on the same outcomes, with Cohen's d-values (absolute numbers) ranging from 0.17 to 0.54. For having been victim to violence, d-values ranged from 0.30 to 1.01. Moderate functional impairment due to injuries was associated with less favourable scores on all outcomes (d ranging from 0.15 to 0.71). For strong functional impairment d-values ranged from 0.35 to 1.17. CONCLUSIONS Elevated levels of distress and reduced levels of quality of life are particularly associated with multiple injuries, being victim to violence, and functional impairment due to injuries. Prospective, longitudinal studies with high quality instruments and large samples, allowing adjustment for baseline values of outcome variables, and utilization of state-of-the-art statistical techniques, would bring this research closer to examining causality.
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Affiliation(s)
- Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgt. 7, NO-5015, Bergen, Norway.
| | - Eyvind Ohm
- Department of Health and Inequality, Norwegian Institute of Public Health, Marcus Thranes Gate 6, NO-0473, Oslo, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgt. 7, NO-5015, Bergen, Norway
- Centre for Alcohol & Drug Research, Stavanger University Hospital, Lagårdsveien 78, NO-4068, Stavanger, Norway
| | - Thomas Nilsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Sandakerveien 24C, NO-0473, Oslo, Norway
| | - Marit Knapstad
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgt. 7, NO-5015, Bergen, Norway
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgt. 7, NO-5015, Bergen, Norway
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Sandakerveien 24C, NO-0473, Oslo, Norway
| | - Benjamin Clarsen
- Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaesgt. 7, NO-5015, Bergen, Norway
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Marcus Thranes Gate 6, NO-0473, Oslo, Norway
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7
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Gohy B, Opava CH, von Schreeb J, Van den Bergh R, Brus A, Fouda Mbarga N, Ouamba JP, Mafuko JM, Mulombwe Musambi I, Rougeon D, Côté Grenier E, Gaspar Fernandes L, Van Hulse J, Weerts E, Brodin N. Assessing independence in mobility activities in trauma care: Validity and reliability of the Activity Independence Measure-Trauma (AIM-T) in humanitarian settings. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001723. [PMID: 37695762 PMCID: PMC10495016 DOI: 10.1371/journal.pgph.0001723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
The importance of measuring outcomes after injury beyond mortality and morbidity is increasingly recognized, though underreported in humanitarian settings. To address shortcomings of existing outcome measures in humanitarian settings, the Activity Independence Measure-Trauma (AIM-T) was developed, and is structured in three subscales (i.e., core, lower limb, and upper limb). This study aimed to assess the AIM-T construct validity (structural validity and hypothesis testing) and reliability (internal consistency, inter-rater reliability and measurement error) in four humanitarian settings (Burundi, Iraq, Cameroon and Central African Republic). Patients with acute injury (n = 195) were assessed using the AIM-T, the Barthel Index (BI), and two pain scores. Structural validity was assessed through confirmatory factor analysis. Hypotheses were tested regarding correlations with BI and pain scores using Pearson correlation coefficient (PCC) and differences in AIM-T scores between patients' subgroups, using standardized effect size Cohen's d (d). Internal consistency was assessed with Cronbach's alpha (α). AIM-T was reassessed by a second rater in 77 participants to test inter-rater reliability using intraclass correlation coefficient (ICC). The results showed that the AIM-T structure in three subscales had an acceptable fit. The AIM-T showed an inverse weak to moderate correlation with both pain scores (PCC<0.7, p≤0.05), positive strong correlation with BI (PCC≥0.7, p≤0.05), and differed between all subgroups (d≥0.5, p≤0.05). The inter-rater reliability in the (sub)scales was good to excellent (ICC 0.86-0.91) and the three subscales' internal consistency was adequate (α≥0.7). In conclusion, this study supports the AIM-T validity in measuring independence in mobility activities and its reliability in humanitarian settings, as well as it informs on its interpretability. Thus, the AIM-T could be a valuable measure to assess outcomes after injury in humanitarian settings.
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Affiliation(s)
- Bérangère Gohy
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Humanity & Inclusion, Rehabilitation Technical Direction, Brussels, Belgium
| | - Christina H. Opava
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Johan von Schreeb
- Department of Global Public Health, Karolinska Institutet, Stockholm Sweden
| | | | - Aude Brus
- Humanity & Inclusion, Innovation, Impact & Information Division, Brussels, Belgium
| | - Nicole Fouda Mbarga
- Médecins Sans Frontières, Operational Center Geneva, YaoundeYaounde, Cameroon
| | - Jean Patrick Ouamba
- Médecins Sans Frontières, Operational Center Geneva, YaoundeYaounde, Cameroon
| | - Jean-Marie Mafuko
- Médecins Sans Frontières, Operational Center Brussels, Bujumbura, Burundi
| | - Irene Mulombwe Musambi
- Médecins Sans Frontières, Operational Center Paris, Bangui, Central African Republic, Baghdad, Iraq
| | - Delphine Rougeon
- Médecins Sans Frontières, Operational Center Paris, Bangui, Central African Republic, Baghdad, Iraq
| | | | | | | | - Eric Weerts
- Humanity & Inclusion, Rehabilitation Technical Direction, Brussels, Belgium
| | - The AIM-T Study Group
- Médecins Sans Frontières, Operational Center Brussels, Brussels, Belgium
- Médecins Sans Frontières, Operational Center Geneva, YaoundeYaounde, Cameroon
- Médecins Sans Frontières, Operational Center Brussels, Bujumbura, Burundi
- Médecins Sans Frontières, Operational Center Paris, Bangui, Central African Republic, Baghdad, Iraq
- Médecins Sans Frontières, Operational Center Paris, Baghdad, Iraq
- Médecins Sans Frontières, Operational Center Paris, France
| | - Nina Brodin
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopaedics, Danderyd Hospital Corp., Division of Physiotherapy, Danderyd, Sweden
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8
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Maclennan B, Derrett S, Wyeth E. Health-related quality of life 12 years after injury: prevalence and predictors of outcomes in a cohort of injured Māori. Qual Life Res 2023:10.1007/s11136-023-03419-9. [PMID: 37055711 PMCID: PMC10393854 DOI: 10.1007/s11136-023-03419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE Studies have found that many people who sustain an injury can experience adverse outcomes for a considerable time thereafter. Māori, the Indigenous peoples of Aotearoa me Te Waipounamu (New Zealand; NZ), are no exception. The Prospective Outcomes of Injury Study (POIS) found that almost three-quarters of Māori participants were experiencing at least one of a range of poor outcomes at two years post-injury. The aim of this paper was to estimate the prevalence, and identify predictors, of adverse health-related quality of life (HRQoL) outcomes in the POIS-10 Māori cohort, 12 years after participants sustained an injury. METHODS Interviewers reached 354 individuals who were eligible to participate in a POIS-10 Māori interview, to be conducted a decade after the last phase of POIS interviews (held 24 months post-injury). The outcomes of interest were responses to each of the five EQ-5D-5L dimensions at 12 years post-injury. Potential predictors (i.e., pre-injury sociodemographic and health measures; injury-related factors) were collected from earlier POIS interviews. Additional injury-related information was collected from administrative datasets proximate to the injury event 12 years prior. RESULTS Predictors of 12-year HRQoL outcomes varied by EQ-5D-5L dimension. The most common predictors across dimensions were pre-injury chronic conditions and pre-injury living arrangements. CONCLUSION An approach to rehabilitation where health services proactively enquire about, and consider the broader aspects of, patient health and wellbeing throughout the injury recovery process, and effectively coordinate their patients' care with other health and social services where necessary, may help improve long-term HRQoL outcomes for injured Māori.
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Affiliation(s)
- Brett Maclennan
- Division of Health Sciences, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Sarah Derrett
- Division of Health Sciences, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Emma Wyeth
- Division of Health Sciences, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
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9
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Sumaedi S, Sumardjo S, Saleh A, Syukri AF. A model of health-related quality of life during COVID-19 pandemic: the role of food customer loyalty and affordability. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2023. [DOI: 10.1108/ijqrm-04-2021-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
PurposeThis research aims to test the simultaneous effects of the perceived threat of COVID-19, e-health literacy, e-health access barrier, loyalty toward healthy foods in general, loyalty toward functional foods, the affordability of healthy foods in general and the affordability of functional foods on health-related quality of life (HrQoL) during the COVID-19 pandemic.Design/methodology/approachA survey with 400 respondents in Banten, Indonesia, was performed. The data were analyzed using multiple regression analysis.FindingsThe results of the research showed that HrQoL during the COVID-19 pandemic was positively affected by e-health literacy and the affordability of healthy foods in general while negatively affected by the e-health access barrier, the perceived threat of COVID-19 and loyalty toward healthy foods in general. Furthermore, HrQoL was not influenced by loyalty toward and affordability of functional foods.Research limitations/implicationsThis research was conducted in Banten. Due to the operational limitations during the COVID-19 pandemic, this research used a purposive sampling technique. Therefore, the next research should retest the model in different contexts and locations.Practical implicationsTo improve HrQoL during the COVID-19 pandemic, citizens need to be educated on finding and utilizing credible online health information during the COVID-19 pandemic. Governments and health service providers should also strive to offer ease of access to credible online health information. Furthermore, the affordability of healthy foods, in general, should be managed well.Originality/valueA few studies on HrQoL during COVID-19 pandemic were performed. However, there is a lack of paper that examines the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic. To the best of the authors’ knowledge, this paper is the first that involved and tested the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic.
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10
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Harbertson J, MacGregor AJ, McCabe CT, Eskridge SL, Jurick SM, Watrous JR, Galarneau MR. Differences in quality-of-life scores across injury categories by mental health status among injured U.S. military service members and veterans. Qual Life Res 2023; 32:461-472. [PMID: 36301403 DOI: 10.1007/s11136-022-03263-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Posttraumatic stress disorder (PTSD) and depression are strong predictors of poor health-related quality of life (HRQOL) among injured U.S. military service members (SMs). Patterns of HRQOL between injury categories and injury categories stratified by mental health (MH) symptoms have not been examined. Among deployment-injured SMs and veterans (n = 4353), we examined HRQOL and screening data for PTSD and/or depression within specific injury categories. METHODS Participants included those enrolled in the Wounded Warrior Recovery Project with complete data for HRQOL (SF-36) from June 2017 to May 2020. Injuries were categorized using the Barell Injury Diagnosis Matrix (Barell Matrix). Mean physical component summary (PCS) and mental component summary (MCS) scores were calculated for each injury category and stratified by the presence or absence of probable PTSD and/or depression. RESULTS The average follow-up time that participants were surveyed after injury was 10.7 years. Most participants were male, non-Hispanic White, served in the Army, and enlisted rank. Mechanism of injury for 77% was blast-related. Mean PCS and MCS scores across the entire sample were 43.6 (SD = 10.3) and 39.5 (SD = 13.3), respectively; 50% screened positive for depression and/or PTSD. PCS and MCS scores were significantly lower within each injury category among individuals with probable PTSD and/or depression than those without. CONCLUSION Among deployment-injured SMs, those with probable PTSD and/or depression reported significantly lower HRQOL within injury categories and HRQOL component (i.e., physical or mental) than those without. Findings are consistent with prior reports showing mental health symptoms to be strongly associated with lower HRQOL and suggest integration of mental health treatment into standard care practices to improve long-term HRQOL.
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Affiliation(s)
- Judith Harbertson
- Leidos, Inc., San Diego, CA, USA. .,Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA.
| | - Andrew J MacGregor
- Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA.,Axiom Resource Management, Inc., San Diego, CA, USA
| | - Cameron T McCabe
- Leidos, Inc., San Diego, CA, USA.,Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Susan L Eskridge
- Leidos, Inc., San Diego, CA, USA.,Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Sarah M Jurick
- Leidos, Inc., San Diego, CA, USA.,Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Jessica R Watrous
- Leidos, Inc., San Diego, CA, USA.,Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106-3521, USA
| | - Michael R Galarneau
- Operational Readiness Research Directorate, Naval Health Research Center, San Diego, USA
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11
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Association between sarcopenia and quality of life among adults aged ≥ 65 years from low- and middle-income countries. Aging Clin Exp Res 2022; 34:2779-2787. [PMID: 36121641 DOI: 10.1007/s40520-022-02231-8] [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: 06/18/2022] [Accepted: 08/12/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Sarcopenia has been associated with a lower quality of life (QoL). However, studies on this association from low- and middle-income countries (LMICs) are scarce. AIMS To examine the association between sarcopenia and QoL, in a large nationally representative sample of older adults from six LMICs. METHODS Cross-sectional, community-based data from the WHO study on global ageing and adult health (SAGE) were analysed. Non-severe sarcopenia was defined as having low skeletal muscle mass (SMM) and weak handgrip strength but no slow gait speed, while severe sarcopenia was defined as having low SMM, weak handgrip strength, and slow gait speed. QoL was assessed with the 8-item WHO QoL instrument (range 0-100) with higher scores representing better QoL. Multivariable linear regression analysis was conducted. RESULTS Data on 14,585 people aged ≥ 65 years were analyzed [mean (SD) age 72.6 (11.5) years; 55.0% female]. After adjustment for potential confounders, compared to no sarcopenia, severe sarcopenia was associated with a significant - 3.37 points [95% CI - 5.56, - 1.18] lower QoL score. Non-severe sarcopenia was not significantly associated with lower QoL. DISCUSSION The association between sarcopenia and QoL observed in our study may be explained by factors such as functional impairment and disability related with sarcopenia. CONCLUSIONS In this large representative sample of older adults from multiple LMICs, compared to no sarcopenia, only severe sarcopenia was associated with a significantly lower QoL score. Interventions to prevent or manage sarcopenia among older adults in LMICs may contribute to better QoL in this population.
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12
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Maclennan B, Wyeth E, Samaranayaka A, Derrett S. Predictors of EQ-5D-3L outcomes amongst injured Māori: 1-year post-injury findings from a New Zealand cohort study. Qual Life Res 2022; 31:1689-1701. [PMID: 35076826 PMCID: PMC8787030 DOI: 10.1007/s11136-022-03085-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Māori, the Indigenous population of New Zealand (NZ), are at higher risk of problems with health-related quality of life (HRQoL) 12 months following injury. This paper examines pre-injury sociodemographic and health characteristics and injury-related factors, including healthcare access, and their association with HRQoL outcomes 12 months after injury. METHODS The Prospective Outcomes of Injury Study recruited 2856 injured New Zealanders aged 18-64 years from the entitlement claims register of the country's no-fault injury insurance agency. One-fifth (n = 566) of the cohort were Māori. Information on predictors and outcomes, with the exception of injury and hospitalisation, was obtained directly from participants at approximately 3 and 12 months post-injury. The outcomes of interest were responses to the five dimensions of the EQ-5D-3L and a dichotomous measure obtained by summing scored responses to each question. Modified Poisson regression was used to identify predictors of each outcome at 12 months post-injury. RESULTS Predictors differed by outcome. Being female, experiencing EQ-5D-3L problems pre-injury, having ≥ 2 chronic conditions pre-injury, perceiving one's injury to be a threat of long-term disability, and having trouble accessing health services for injury were common predictors of EQ-5D-3L problems at 12 months post-injury for Māori. CONCLUSION Opportunities exist to improve HRQoL outcomes by identifying individuals in the early stages of injury recovery who may benefit from further treatment and support.
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Affiliation(s)
- Brett Maclennan
- Department of Preventive and Social Medicine, Dunedin School of Medicine, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Emma Wyeth
- Department of Preventive and Social Medicine, Dunedin School of Medicine, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Ari Samaranayaka
- Biostatistics Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Sarah Derrett
- Department of Preventive and Social Medicine, Dunedin School of Medicine, Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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13
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Corbacho B, Keding A, Chuang LH, Ramos-Goni JM, Joshi K, Cockayne S, Torgerson D. Comparison of the EQ-5D-5L and the EQ-5D-3L using individual patient data from the REFORM trial. F1000Res 2021. [DOI: 10.12688/f1000research.54554.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: This study compares the 5-level version of the EQ-5D (5L) with the 3-level version EQ-5D (3L) in older adults using individual patient data from the REFORM (REducing Falls with Orthoses and a Multifaceted podiatry intervention) trial. Methods: EQ-5D-5L and EQ-5D-3L were administered to men and women (n=151) over the age of 65 years alongside the REFORM trial. The two versions of the EQ-5D were assessed in terms of feasibility, level of consistency, ceiling effect and discriminatory power. We also undertook a comparison of the performance of different EQ-5D-3L and EQ-5D-5L value sets. Results: The proportion of participants that returned a complete questionnaire was higher for the 5L (96.7%) than for the 3L (92.7%). Missing values among dimensions were on average 1.59% (5L) and 1.45% (3L). The ceiling effect was reduced from 18.2% (3L) to 6% (5L). On average the proportion of inconsistent responses between both descriptive systems was 3.25%. Redistribution from 3L to 5L showed valid results for the majority of consistent level combinations, with slight inconsistency in the case of Anxiety/Depression. For the 5L, 67 unique health states were observed for the 5L compared to 27 for the 3L. The absolute informatively improved with the new classification system (5.48 for 5L versus 3.91 for 3L) and relative discriminatory power improved slightly on average (0.90 for 5L versus 0.84 for 3L). The mean difference between the EQ-5D-5L and EQ-5D-3L values was 0.091 (range -0.345 to 0.505); whilst the mean difference between the EQ-5D-5L and the crosswalk values was 0.082 (range -0.035 to 0.293). Conclusion: In the REFORM clinical trial involving an elderly population, our study supported the feasibility and convergent validity of both EQ-5D-3L and EQ-5D-5L. Results suggest that the 5L improves the ceiling effect and discriminatory power. The EQ-5D-5L scores were significantly higher than both EQ-5D-3L and crosswalk.
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Derrett S, Wyeth EH, Richardson A, Davie G, Samaranayaka A, Lilley R, Harcombe H. Prospective Outcomes of Injury Study 10 Years on (POIS-10): An Observational Cohort Study. Methods Protoc 2021; 4:mps4020035. [PMID: 34067618 PMCID: PMC8163161 DOI: 10.3390/mps4020035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/12/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Injury is a leading cause of disability and is costly. This prospective cohort study extension aims to improve disability, health, and wellbeing outcomes for injured New Zealanders, including for Māori. We will identify predictors and modifiable risk factors of long-term outcomes (positive and negative), and develop an Injury Early Care Tool (INJECT) to inform the implementation of effective interventions to improve outcomes. In the Prospective Outcomes of Injury Study (POIS), 2856 people participated following an injury (occurring between 2007 and 2009) registered with New Zealand's no-fault accident compensation scheme (ACC). POIS-10 will invite 2121 people (including 358 Māori) who completed a 24-month POIS interview and agreed to follow-up, anticipating 75% participation (n = 1591). Interviews will collect sociodemographic characteristics, life events, comorbidities, and new injuries since participants' 24-month interview, as well as key disability, health, and wellbeing outcomes 12 years post-injury. Injury-related data will be collected from ACC and hospitalisation records 12 years post-injury. Regression models for the main outcomes will examine the direct effects of predictor variables after adjustment for a wide range of confounders. POIS-10 is enhanced by our partnership with ACC, and expert advisors and will benefit injured people, including Māori, through increased understanding of mechanisms and interventions to improve long-term post-injury outcomes.
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Affiliation(s)
- Sarah Derrett
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
- Correspondence:
| | - Emma H. Wyeth
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
| | - Amy Richardson
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
| | - Gabrielle Davie
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
| | - Ari Samaranayaka
- Biostatistics Centre, Division of Health Sciences, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand;
| | - Rebbecca Lilley
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
| | - Helen Harcombe
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand; (A.R.); (G.D.); (R.L.); (H.H.)
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