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L'Heureux J, McTaggart-Cowan H, Johns G, Chen L, Steiner T, Tocher P, Sun H, Zhang W. How to present work productivity loss results from clinical trials for patients and caregivers? A mixed methods approach. Soc Sci Med 2023; 328:115999. [PMID: 37276772 DOI: 10.1016/j.socscimed.2023.115999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES From the perspectives of patients and caregivers, the objectives were: identifying which result presentations, describing work productivity loss (WPL) outcomes, are most understandable; measuring which presentations are important to report; and investigating which WPL outcomes are viewed as important alongside clinical trials results. METHODS We used a four phased, sequential mixed methods design, guided by patient-oriented research engaging one patient partner. We conducted think-aloud interviews, in British Columbia/Canada, to review WPL results and our survey measuring the understandability and importance of the results, and importance of each WPL outcome. We surveyed a sample representing working Canadians. The findings were summarized and analyzed using linear and logistic regression. We conducted sub-group analyses; one was gender based. All regressions were conducted using generalized estimating equations. RESULTS In our qualitative phases, 20 patients and caregivers were interviewed. Participants recommended for the results to be brief, simple, and represented visually. Then, 118 patients and 120 caregivers were surveyed. The results presented in days or cost yielded the highest understandability and importance to report. All WPL outcomes were identified as important to somewhat important to report by most. The associations indicated that the more understandable the result presentation was, the more likely it was to be rated as important. Age was the only factor significantly associated with selecting days or cost as the most important result. CONCLUSION Presenting WPL results in days and cost, using lay terms and visual supports, were viewed as easiest to understand and most important to report in clinical trials by patients and caregivers. Our findings are supportive of clinical trials standardizing the measurement of WPL to include all of its outcomes (absenteeism, presenteeism, employment status changes and total work productivity loss), in addition to tools assessing the comprehensiveness of WPL results to be provided to patients and caregivers.
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Affiliation(s)
- Jacynthe L'Heureux
- School of Population and Public Health, University of British Columbia; 2206 E Mall, Vancouver, British Columbia, V6T 1Z3, Canada.
| | - Helen McTaggart-Cowan
- Faculty of Health Sciences, Simon Fraser University; Blusson Hall, Room, 11300, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada; British Columbia Cancer Research Centre, 675 W 10th Avenue; Vancouver, British Columbia, V5Z 1L3, Canada.
| | - Gary Johns
- Sauder School of Business, University of British Columbia; 2053 Main Mall, Vancouver, British Columbia, V6T 1Z2, Canada; John Molson School of Business, Concordia University, 1450 Guy Street, Montreal, Quebec, H3H 0A1, Canada.
| | - Lin Chen
- Patient Voices Network, 201-750 Pender Street, Vancouver, British Columbia, V6C 2T8, Canada
| | - Theodore Steiner
- Division of Infectious Diseases, Vancouver General Hospital, 2733 Heather Street, Rm C328 HP East, Vancouver, British Columbia, V5Z 3J5, Canada.
| | - Paige Tocher
- Centre for Health Evaluation and Outcome Sciences, 570-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, 570-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
| | - Wei Zhang
- School of Population and Public Health, University of British Columbia; 2206 E Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Centre for Health Evaluation and Outcome Sciences, 570-1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia; 2405 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada.
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Zhang W, Tocher P, L'Heureux J, Sou J, Sun H. Measuring, Analyzing, and Presenting Work Productivity Loss in Randomized Controlled Trials: A Scoping Review. Value Health 2023; 26:123-137. [PMID: 35961865 DOI: 10.1016/j.jval.2022.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 05/14/2022] [Accepted: 06/08/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to conduct a scoping review of randomized controlled trials (RCTs) and investigate which work productivity loss outcomes were measured in these RCTs, how each outcome was measured and analyzed, and how the results for each outcome were presented. METHODS A systematic search was conducted from January 2010 to April 2020 from 2 databases: PubMed and Cochrane Central Register of Controlled Trials. Data on country, study population, disease focus, sample size, work productivity loss outcomes measured (absenteeism, presenteeism, employment status changes), and methods used to measure, report, and analyze each work productivity loss outcome were extracted and analyzed. RESULTS We found 435 studies measuring absenteeism or presenteeism, of which 155 studies (35.6%) measured both absenteeism and presenteeism and were included in our final review. Only 9 studies also measured employment status changes. The most used questionnaire was the Work Productivity and Activity Impairment Questionnaire. The analysis of absenteeism and presenteeism data was mostly done using regression models (n = 98, n = 98, respectively) for which a normal distribution was assumed (n = 77, n = 89, respectively). Absenteeism results were most often presented in time whereas presenteeism was commonly presented using a percent scale or score. CONCLUSIONS There is a lack of consensus on how to measure, analyze, and present work productivity loss outcomes in RCTs published in the past 10 years. The diversity of measurement, analysis, and presentation methods used in RCTs may make comparability challenging. There is a need for guidelines providing recommendations to standardize the comprehensiveness and the appropriateness of methods used to measure, analyze, and report work productivity loss in RCTs.
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Affiliation(s)
- Wei Zhang
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada; Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada.
| | - Paige Tocher
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Jacynthe L'Heureux
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Julie Sou
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
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Zhang W, Sun H, L'Heureux J. Substitutes or complements between informal and formal home care in the Canadian longitudinal study on aging: Functional impairment as an effect modifier. Health Policy 2021; 125:1267-1275. [PMID: 34301407 DOI: 10.1016/j.healthpol.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/26/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022]
Abstract
In Canada and around the world, policy makers are struggling with funding between informal care and formal home care. Understanding the relationship between the two types of care is helpful to inform funding allocations. In this study, we examined the relationship between informal care and formal home care and assessed whether this relationship varies across levels of functional impairment using the Canadian Longitudinal Survey of Aging (CLSA). Our study population was baseline CLSA participants between 2011 and 2015 who were functionally impaired. We used self-reported measures of total hours of informal and formal home care received over 12 months and evaluated their relationship using a two-part model and an instrumental variable method. Our results emphasized the importance of accounting for the potential endogeneity of informal care. We consistently found that there was a negative relationship between informal care hours and the probability of receiving formal home care among middle-aged and older adults and a negative coefficient of the interaction term between informal care hours and functional impairment level. The results suggest that there is a substitution relationship between informal care and formal home care and that this substitution relationship is stronger for highly impaired middle-aged and older individuals. Our findings will help policy makers understand the complexity of the relationship between informal and formal home care and implement policies accordingly.
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Affiliation(s)
- Wei Zhang
- School of Population and Public Health, the University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.
| | - Huiying Sun
- Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.
| | - Jacynthe L'Heureux
- School of Population and Public Health, the University of British Columbia, Vancouver, British Columbia, Canada.
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El Amil Z, Tuncer H, Al-Malki M, L'Heureux J, Welch P, Roy T, Al-Homsi A. EBV-Positive Lymphoplasmacytic Lymphoma: A Highly Aggressive Post Transplant Lymphoproliferative Disorder with Multiorgan Involvement. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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El Amil Z, L'Heureux J, Welch P, Roy T, Tuncer H, Al-Homsi A. Double Cord Blood Transplantation: Pre-Engraftment or Recessive Cord Rejection Syndrome? Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Osoegawa K, Vessere GM, Utami KH, Mansilla MA, Johnson MK, Riley BM, L'Heureux J, Pfundt R, Staaf J, van der Vliet WA, Lidral AC, Schoenmakers EFPM, Borg A, Schutte BC, Lammer EJ, Murray JC, de Jong PJ. Identification of novel candidate genes associated with cleft lip and palate using array comparative genomic hybridisation. J Med Genet 2007; 45:81-6. [PMID: 17873121 PMCID: PMC3732463 DOI: 10.1136/jmg.2007.052191] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM AND METHOD We analysed DNA samples isolated from individuals born with cleft lip and cleft palate to identify deletions and duplications of candidate gene loci using array comparative genomic hybridisation (array-CGH). RESULTS Of 83 syndromic cases analysed we identified one subject with a previously unknown 2.7 Mb deletion at 22q11.21 coinciding with the DiGeorge syndrome region. Eighteen of the syndromic cases had clinical features of Van der Woude syndrome and deletions were identified in five of these, all of which encompassed the interferon regulatory factor 6 (IRF6) gene. In a series of 104 non-syndromic cases we found one subject with a 3.2 Mb deletion at chromosome 6q25.1-25.2 and another with a 2.2 Mb deletion at 10q26.11-26.13. Analyses of parental DNA demonstrated that the two deletion cases at 22q11.21 and 6q25.1-25.2 were de novo, while the deletion of 10q26.11-26.13 was inherited from the mother, who also has a cleft lip. These deletions appear likely to be causally associated with the phenotypes of the subjects. Estrogen receptor 1 (ESR1) and fibroblast growth factor receptor 2 (FGFR2) genes from the 6q25.1-25.2 and 10q26.11-26.13, respectively, were identified as likely causative genes using a gene prioritization software. CONCLUSION We have shown that array-CGH analysis of DNA samples derived from cleft lip and palate subjects is an efficient and productive method for identifying candidate chromosomal loci and genes, complementing traditional genetic mapping strategies.
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Affiliation(s)
- K Osoegawa
- Center for Genetics, Children's Hospital Oakland Research Institute (CHORI), 5700 Martin Luther King Jr. Way Oakland, CA 94609, USA.
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Abstract
The research indicating the incidence rates and specific risks for suicide in the gay, lesbian, bisexual, and questioning (GLBQ) adolescent population is reviewed. An ecological model of suicide risk assessment for GLBQ youth is presented based on Bronfenbrenner's model of human development. The model argues for individual, micro, and macro levels of assessment to increase clinical judgement and accuracy in determining high risk GLBQ adolescents. The model also delineates both primary and secondary intervention strategies which could be utilized to prevent GLBQ youth suicide.
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Affiliation(s)
- L L Morrison
- Department of Social and Behavioral Sciences, The University of New England, Biddeford, ME 04005, USA.
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Swordy SP, Grunsfeld J, L'Heureux J, Meyer P, Müller D, Tang KK. Observation of transition radiation from relativistic heavy nuclei. Phys Rev D Part Fields 1990; 42:3197-3206. [PMID: 10013202 DOI: 10.1103/physrevd.42.3197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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