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Lewin AM, Cashman K, Harries D, Ackerman IN, Naylor JM, Harris IA. First knee for pain and function versus second knee for quality of life. Bone Jt Open 2024; 5:202-209. [PMID: 38461859 PMCID: PMC10924693 DOI: 10.1302/2633-1462.53.bjo-2023-0035.r1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
Aims The aim of this study was to describe and compare joint-specific and generic health-related quality of life outcomes of the first versus second knee in patients undergoing staged bilateral total knee arthroplasty (BTKA) for osteoarthritis. Methods This retrospective cohort study used Australian national arthroplasty registry data from January 2013 to January 2021 to identify participants who underwent elective staged BTKA with six to 24 months between procedures. The primary outcome was Oxford Knee Score (OKS) at six months postoperatively for the first TKA compared to the second TKA, adjusted for age and sex. Secondary outcomes compared six-month EuroQol five-dimension five-level (EQ-5D-5L) domain scores, EQ-5D index scores, and the EQ visual analogue scale (EQ-VAS) between knees at six months postoperatively. Results The cohort included 635 participants (1,270 primary procedures). Preoperative scores were worse in the first knee compared to the second for all instruments; however, comparing the first knee at six months postoperatively with the second knee at six months postoperatively, the mean between-knee difference was minimal for OKS (-0.8 points; 95% confidence interval (CI) -1.4 to -0.2), EQ-VAS (3.3; 95% CI 1.9 to 4.7), and EQ-5D index (0.09 points; 95% CI 0.07 to 0.12). Outcomes for the EQ-5D-5L domains 'mobility', 'usual activities', and 'pain/discomfort' were better following the second TKA. Conclusion At six months postoperatively, there were no clinically meaningful differences between the first and second TKA in either the joint-specific or overall generic health-related quality of life outcomes. However, individual domain scores assessing mobility, pain, and usual activities were notably higher after the second TKA, likely reflecting the cumulative improvement in quality of life after both knees have been replaced.
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Affiliation(s)
- Adriane M. Lewin
- South West Clinical Campuses, School of Clinical Medicine, UNSW Medicine & Health, Liverpool, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Kara Cashman
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Dylan Harries
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Ilana N. Ackerman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Justine M. Naylor
- South West Clinical Campuses, School of Clinical Medicine, UNSW Medicine & Health, Liverpool, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia
- South West Sydney Local Health District, NSW Health, Sydney, Australia
| | - Ian A. Harris
- South West Clinical Campuses, School of Clinical Medicine, UNSW Medicine & Health, Liverpool, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Liverpool, Australia
- South West Sydney Local Health District, NSW Health, Sydney, Australia
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, Australia
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Graf D, Gschwenter S, Kuzdas-Sallaberger M, Reiger G, Edlmayer A, Felder D, Klausberger H, Wagner K, Skoumal M. Effects of an inpatient rehabilitation programme on functional capacity, quality of life and psychological distress in patients with post covid-19 condition: an observational study. J Rehabil Med 2023; 55:jrm12437. [PMID: 37953513 PMCID: PMC10647930 DOI: 10.2340/jrm.v55.12437] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/05/2023] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVES To examine changes in functional capacity, health-related quality of life and psychological distress in patients with post-COVID-19 condition following a multidisciplinary rehabilitation programme. In addition, to explore whether additional respiratory muscle training for more impaired patients might support their recovery process. DESIGN Retrospective observational cohort study. PATIENTS A total of 779 patients with post-COVID-19 condition (47.9% female, mean age 56.6 years). METHODS Measures assessed were: 6-minute walk test (6MWT), 5-level EQ-5D (EQ-5D-5L) including EQ Visual Analogue Scale (EQ-VAS) and Patient Health Questionnaire-4 (PHQ-4). Data were provided pre- and post-rehabilitation from 2 cohorts: (i) patients participating in a regular multidisciplinary rehabilitation programme; and (ii) patients receiving additional respiratory muscle training due to an initially greater level of impairment. Dependent t-tests and general linear mixed models were used for data analysis. RESULTS A series of dependent t-tests revealed mean overall improvement for both groups in 6-minute walk test distance (6MWD), EQ-5D-5L index, EQ-VAS and PHQ-4 following the rehabilitation programme. General linear mixed models showed significant interaction effects between groups and time for the EQ-5D-5L index and 6MWD. CONCLUSION A multidisciplinary rehabilitation programme appears to have a beneficial impact on the recovery process of patients with post-COVID-19 condition.
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Affiliation(s)
- Daniel Graf
- Department for Research, Innovation and Medical Service Development – Applied Rehabilitation Research, Pension Insurance Institution, Vienna, Austria; University of Turku, Turku, Finland
| | - Stefan Gschwenter
- Department for Research, Innovation and Medical Service Development – Applied Rehabilitation Research, Pension Insurance Institution, Vienna, Austria.
| | - Marina Kuzdas-Sallaberger
- Department for Research, Innovation and Medical Service Development – Applied Rehabilitation Research, Pension Insurance Institution, Vienna, Austria
| | - Gabriele Reiger
- Rehabilitation Clinic Weyer, Pension Insurance Institution, Weyer, Austria
| | - Alexandra Edlmayer
- Department for Research, Innovation and Medical Service Development – Applied Rehabilitation Research, Pension Insurance Institution, Vienna, Austria
| | - David Felder
- Department for Research, Innovation and Medical Service Development – Applied Rehabilitation Research, Pension Insurance Institution, Vienna, Austria
| | | | - Katharina Wagner
- Rehabilitation Clinic Weyer, Pension Insurance Institution, Weyer, Austria
| | - Martin Skoumal
- Main Office, Pension Insurance Institution, Vienna, Austria
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Langenberger B, Schrednitzki D, Halder AM, Busse R, Pross CM. Predicting whether patients will achieve minimal clinically important differences following hip or knee arthroplasty. Bone Joint Res 2023; 12:512-521. [PMID: 37652447 PMCID: PMC10471446 DOI: 10.1302/2046-3758.129.bjr-2023-0070.r2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
Aims A substantial fraction of patients undergoing knee arthroplasty (KA) or hip arthroplasty (HA) do not achieve an improvement as high as the minimal clinically important difference (MCID), i.e. do not achieve a meaningful improvement. Using three patient-reported outcome measures (PROMs), our aim was: 1) to assess machine learning (ML), the simple pre-surgery PROM score, and logistic-regression (LR)-derived performance in their prediction of whether patients undergoing HA or KA achieve an improvement as high or higher than a calculated MCID; and 2) to test whether ML is able to outperform LR or pre-surgery PROM scores in predictive performance. Methods MCIDs were derived using the change difference method in a sample of 1,843 HA and 1,546 KA patients. An artificial neural network, a gradient boosting machine, least absolute shrinkage and selection operator (LASSO) regression, ridge regression, elastic net, random forest, LR, and pre-surgery PROM scores were applied to predict MCID for the following PROMs: EuroQol five-dimension, five-level questionnaire (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), Hip disability and Osteoarthritis Outcome Score-Physical Function Short-form (HOOS-PS), and Knee injury and Osteoarthritis Outcome Score-Physical Function Short-form (KOOS-PS). Results Predictive performance of the best models per outcome ranged from 0.71 for HOOS-PS to 0.84 for EQ-VAS (HA sample). ML statistically significantly outperformed LR and pre-surgery PROM scores in two out of six cases. Conclusion MCIDs can be predicted with reasonable performance. ML was able to outperform traditional methods, although only in a minority of cases.
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Affiliation(s)
| | | | | | - Reinhard Busse
- Health Care Management, Technische Universität Berlin, Berlin, Germany
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Tin BT, Tat Bang H, Thu TTA, Anh NTM, Vu VH, Tap NV. Quality of Life in Patients With Unstable Angina Before and After Percutaneous Coronary Intervention: A Single-Center Pilot Study Using the European Quality of Life 5-Dimension 5-Level ( EQ-5D-5L) Questionnaire. Cureus 2023; 15:e45886. [PMID: 37885559 PMCID: PMC10599217 DOI: 10.7759/cureus.45886] [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] [Accepted: 09/23/2023] [Indexed: 10/28/2023] Open
Abstract
Background Unstable angina (UA) has a negative impact on patients' quality of life. Percutaneous coronary intervention (PCI) is a commonly recommended treatment that exhibits positive therapeutic effects and enhances quality of life. This study aimed to compare the alterations in quality of life and related factors before and after PCI in UA patients. Methods A longitudinal follow-up study was conducted on 48 patients with UA before and one month after undergoing PCI. The European Quality of Life (EuroQol) 5-Dimension 5-Level (EQ-5D-5L) scale was utilized to measure the quality of life of patients. Results The study revealed a significant improvement in the quality of life score after one month of coronary artery intervention compared to the pre-intervention stage: the quality of life score before the intervention was 0.73 ± 0.32, whereas it increased to 0.89 ± 0.20 after one month (p<0.001). Sex, occupation, and troponin T were associated with changes in quality of life one month after the coronary artery intervention. Conclusion The pilot study demonstrated a notable enhancement in the quality of life among patients with UA following coronary intervention. Additionally, sex, occupation, and troponin T were identified as factors associated with this improvement.
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Affiliation(s)
- Bui Thanh Tin
- Preventive Medicine Department, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
| | - Ho Tat Bang
- Thoracic and Vascular Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
- Health Organization and Management Department, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
| | - Tran Thi Anh Thu
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
- Health Communication Department, Medical Center of Binh Thanh District, Ho Chi Minh City, VNM
| | - Nguyen Thi My Anh
- Faculty of Nursing - Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
| | - Vu Hoang Vu
- Interventional Cardiology Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
- Internal Medicine Department, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM
| | - Nguyen Van Tap
- Faculty of Medical Management, Nguyen Tat Thanh University, Ho Chi Minh City, VNM
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Ghosh CK, Islam S, Tabassum N, Mohiuddin SA, Hossain MM, Sarkar A, Bari A. Quality of Life of Patients With Inflammatory Bowel Disease in Bangladesh. Cureus 2023; 15:e39929. [PMID: 37283595 PMCID: PMC10239544 DOI: 10.7759/cureus.39929] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 06/08/2023] Open
Abstract
Introduction The importance of maintaining quality of life in managing inflammatory bowel disease (IBD) has increased in recent years. However, there is a lack of studies examining the health-related quality of life (HRQoL) of IBD patients in Bangladesh. Methodology This cross-sectional study was carried out in the IBD clinic, Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2020 to 2022. Data were collected from both ulcerative colitis (UC) and Crohn's disease (CD) patients. HRQoL was recorded on the EuroQol 5 Dimension 5 Level (EQ-5D-5L) questionnaire. Statistical analysis was done by Statistical Analysis Software (SAS, SAS Institute, Cary, NC). Results The mean age was 36.3 years. The majority of the patients were male and had low incomes. People with more monthly income, more frequent relapse, extraintestinal involvement, and moderate to severe disease had lower utility index (p = 0.01, 0.01, 0.0004, and <0.0001, respectively). Among the five individual components, only usual activity was lower in UC patients (p = 0.03); all the other components and consequently the overall utility index did not vary between UC and CD. The visual analog scale (VAS) score seemed to be comparable in UC and CD patients. Conclusion In more severe and frequently relapsing cases of IBD, the utility index representing HRQoL was found to be lower. Comparatively, the HRQoL was mostly similar between patients with UC and CD. Additionally, the mean utility score in IBD patients was higher than that observed in patients with type 2 diabetes mellitus in Bangladesh.
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Affiliation(s)
- Chanchal Kumar Ghosh
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Sumona Islam
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Nowrin Tabassum
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Syed Arafat Mohiuddin
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Md Mosarrof Hossain
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Aditi Sarkar
- Department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Amit Bari
- Department of Nephrology, Kidney Foundation Hospital and Research Institute, Dhaka, BGD
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Chatzinikolaou A, Tzikas S, Lavdaniti M. Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires. Cureus 2021; 13:e17982. [PMID: 34667665 PMCID: PMC8517455 DOI: 10.7759/cureus.17982] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/05/2022] Open
Abstract
Background Cardiovascular disease (CVD) is responsible for 18 million annual deaths worldwide. CVD affects patients' Quality of Life (QoL) mainly in physical, emotional and social dimension. Aim To assess the QoL of patients with CVD in Northern Greece, using three different instruments. Methods The study was conducted in one large hospital located in a major Greek city. A convenience sample of 80 patients participated. A questionnaire including Short Form-36 Health Survey (SF-36), EuroQoL 5-dimensions 5-levels (EQ-5D-5L), MacNew, demographic, and clinical characteristics was used to collect data. Results The mean age of the patients was 63.31±14.07. Analysis revealed statistically significant main effects of age on the physical limitations, emotional limitations, social functioning, and pain. Also, the analysis showed significant main effects of education on the MacNew Physical, MacNew Social, and the EQ-5D-5L index (p< 0.05). Participants who had graduated primary school had significantly lower quality of life scores than higher education graduates in the MacNew physical (p< 0.02). Furthermore, in the SF-36 pain subscale, the heart failure group had a significantly lower quality of life than the other heart diseases (p= 0.03). Conclusion Quality of life is affected by factors such as age, type of heart disease, therapy, and comorbidities. Health care providers should be knowledgeable of the factors that affect the quality of life sectors (physical, emotional, and social life) of patients with CVD in order to meet their needs and have the most suitable treatment.
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Affiliation(s)
| | - Stergios Tzikas
- Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Maria Lavdaniti
- Nursing Department, International Hellenic University, Thessaloniki, GRC
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Huang W, Yang J, Liu Y, Liu C, Zhang X, Fu W, Shi L, Liu G. Assessing health-related quality of life of patients with colorectal cancer using EQ-5D-5L: a cross-sectional study in Heilongjiang of China. BMJ Open 2018; 8:e022711. [PMID: 30530472 PMCID: PMC6286482 DOI: 10.1136/bmjopen-2018-022711] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
AIM This study aimed to assess the health-related quality of life (HRQoL) of patients with colorectal cancer (CRC) and its determinants. METHODS A cross-sectional questionnaire survey was conducted on 300 newly diagnosed patients with CRC in China's Heilongjiang province, measuring HRQoL using the EuroQol five-dimension five-level (EQ-5D-5L). Kruskal-Wallis analyses were performed to identify the independent variables associated with the EQ-5D-5L utility scores. Predictors of the utility scores were confirmed using a Tobit regression model. RESULTS The respondents had a mean EQ-5D-5L utility score of 0.617 (SD=0.371) and a median of 0.740 (range: -0.348 to 1.000). Pain/discomfort and anxiety/depression were major concerns of the respondents, with a prevalence of over 60% (all levels inclusive). The Kruskal-Wallis analyses found lower utility scores in those who were not married, worked as a farmer, enrolled with the new rural cooperative medical scheme and had lower household income (p<0.05). Those who were at a later stage of CRC, underwent surgical only therapy and had a stoma also had lower EQ-5D-5L scores than others (p<0.05). The Tobit regression model confirmed these predictors, except for occupation and marital status. CONCLUSION Patients with CRC have poor HRQoL, with pain/discomfort and depression/anxiety as the most frequently reported problems. The poor HRQoL is associated with the seriousness of the disease condition, as well as the low socioeconomic status of the patients.
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Affiliation(s)
- Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Jinjin Yang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yang Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Xin Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Wenqi Fu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Limei Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guoxiang Liu
- School of Health Management, Harbin Medical University, Harbin, China
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Zhao Y, Li SP, Liu L, Zhang JL, Chen G. Does the choice of tariff matter?: A comparison of EQ-5D-5L utility scores using Chinese, UK, and Japanese tariffs on patients with psoriasis vulgaris in Central South China. Medicine (Baltimore) 2017; 96:e7840. [PMID: 28834893 PMCID: PMC5572015 DOI: 10.1097/md.0000000000007840] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China.A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland-Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis.In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland-Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China.
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Affiliation(s)
- Yue Zhao
- Department of Dermatology, Heping Hospital, Changzhi Medical College, Changzhi, Shanxi
| | - Shun-Ping Li
- School of Health Care Management, Shandong University
- Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan
| | - Liu Liu
- School of Health Care Management, Shandong University
- Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan
| | - Jiang-Lin Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Clayton, Australia
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Lin FJ, Pickard AS, Krishnan JA, Joo MJ, Au DH, Carson SS, Gillespie S, Henderson AG, Lindenauer PK, McBurnie MA, Mularski RA, Naureckas ET, Vollmer WM, Lee TA. Measuring health-related quality of life in chronic obstructive pulmonary disease: properties of the EQ-5D-5L and PROMIS-43 short form. BMC Med Res Methodol 2014; 14:78. [PMID: 24934150 PMCID: PMC4072614 DOI: 10.1186/1471-2288-14-78] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/06/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Patient Reported Outcomes Measurement Information System 43-item short form (PROMIS-43) and the five-level EQ-5D (EQ-5D-5L) are recently developed measures of health-related quality of life (HRQL) that have potentially broad application in evaluating treatments and capturing burden of respiratory-related diseases. The aims of this study were: (1) to examine their psychometric properties in patients with chronic obstructive pulmonary disease (COPD), and (2) to identify dimensions of HRQL that differ and do not differ by lung function. METHODS We conducted a multi-center, cross-sectional study ("COPD Outcomes-based Network for Clinical Effectiveness & Research Translation" [CONCERT]). We analyzed patients who met spirometric criteria for COPD, and completed EQ-5D-5L and PROMIS questionnaires. Disease severity was graded based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. Pulmonary function test, PROMIS-43, EQ-5D (index score and EQ-Visual Analog Scale [EQ-VAS]), six minute walk test (6MWT), and three dyspnea scales (mMRC, Borg, FACIT-Dyspnea) were administered. Validity and reliability of EQ-5D-5L and PROMIS-43 were examined, and differences in HRQL by GOLD grade were assessed. RESULTS Data from 670 patients with COPD were analyzed (mean age 68.5 years; 58% male). More severe COPD was associated with more problems with mobility, self-care and usual activities (all p-values <0.01) according to EQ-5D-5L. Related domains on EQ-5D-5L, PROMIS and clinical measures were moderately (r = 0.30-0.49) to strongly (r ≥ 0.50) correlated. A statistically significant trend of decreasing HRQL with more severe lung functions was observed for EQ-5D-5L index scores, EQ-VAS scores, and PROMIS physical function and social roles. CONCLUSIONS Results supported the validity of EQ-5D-5L and PROMIS-43 in COPD patients, and indicate that physical function and social activities decrease with level of lung function by GOLD grade, but not pain, mental health, sleep or fatigue as reported by patients.
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Affiliation(s)
- Fang-Ju Lin
- University of Illinois at Chicago, Chicago, IL, USA
| | - A Simon Pickard
- University of Illinois at Chicago, Chicago, IL, USA
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, 833 South Wood St., M/C 886, Chicago, IL 60612, USA
| | - Jerry A Krishnan
- University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - Min J Joo
- University of Illinois Hospital & Health Sciences System, Chicago, IL, USA
| | - David H Au
- VA Puget Sound Health Care System and University of Washington, Seattle, WA, USA
| | | | - Suzanne Gillespie
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | | | - Peter K Lindenauer
- Baystate Medical Center, Springfield, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Mary Ann McBurnie
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | - Richard A Mularski
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | | | - William M Vollmer
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | - Todd A Lee
- University of Illinois at Chicago, Chicago, IL, USA
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11
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Ramos-Goñi JM, Rivero-Arias O, Errea M, Stolk EA, Herdman M, Cabasés JM. Dealing with the health state 'dead' when using discrete choice experiments to obtain values for EQ-5D-5L heath states. Eur J Health Econ 2013; 14 Suppl 1:S33-42. [PMID: 23900663 PMCID: PMC3728441 DOI: 10.1007/s10198-013-0511-2] [Citation(s) in RCA: 11] [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] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate two different methods to obtain a dead (0)--full health (1) scale for EQ-5D-5L valuation studies when using discrete choice (DC) modeling. METHOD The study was carried out among 400 respondents from Barcelona who were representative of the Spanish population in terms of age, sex, and level of education. The DC design included 50 pairs of health states in five blocks. Participants were forced to choose between two EQ-5D-5L states (A and B). Two extra questions concerned whether A and B were considered worse than dead. Each participant performed ten choice exercises. In addition, values were collected using lead-time trade-off (lead-time TTO), for which 100 states in ten blocks were selected. Each participant performed five lead-time TTO exercises. These consisted of DC models offering the health state 'dead' as one of the choices--for which all participants' responses were used (DCdead)--and a model that included only the responses of participants who chose at least one state as worse than dead (WTD) (DCWTD). The study also estimated DC models rescaled with lead-time TTO data and a lead-time TTO linear model. RESULTS The DC(dead) and DCWTD models produced relatively similar results, although the coefficients in the DCdead model were slightly lower. The DC model rescaled with lead-time TTO data produced higher utility decrements. Lead-time TTO produced the highest utility decrements. CONCLUSIONS The incorporation of the state 'dead' in the DC models produces results in concordance with DC models that do not include 'dead'.
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Affiliation(s)
- Juan Manuel Ramos-Goñi
- HTA Unit of Canary Islands Health Service, Servicio Canario de la Salud, C/Calvario, 271-B, 1 IQZ, 38350, Tacoronte, Santa Cruz de Tenerife, Canary Islands, Spain.
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12
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Abstract
BACKGROUND The effect of lead time in time trade-off (TTO) valuation is not well understood. The purpose of this study was to investigate the effects on health-state valuation of the length of lead time and the way the lead-time TTO task is displayed visually. METHODS Using two general population samples, we compared three lead-time TTO variants: 10 years of lead time in full health preceding 5 years of unhealthy time (standard); 5 years of lead time preceding 5 years of unhealthy time (experimental); and 10 years of lead time and 5 years of unhealthy time, presented with a visual aid to highlight the point where the lead time ends (experimental). Participants were randomized to receive one of the lead-time variants, as administered by a computer software program. RESULTS Health-state values generated by TTO valuation tasks using a longer lead time were slightly lower than those generated by tasks using a shorter lead time. When lead time and unhealthy time were presented with visual aids highlighting the difference between the lead time and unhealthy time, respondents spent more time considering health states with a value close to 0. CONCLUSIONS Different lead-time time trade-off variants should be carefully studied in order to achieve the best measurement of health-state values using this new method.
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Affiliation(s)
- Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Block MD3, Singapore 117597, Singapore.
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13
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Abstract
OBJECTIVES The traditional time trade-off (TTO) method has some problems in the valuation of health states considered worse than dead. The aim of our study is to compare two TTO variants that address this issue: lead-time and lag-time TTO. METHODS Quota sampling was undertaken in June 2011 in Buenos Aires as part of the EQ-5D-5L Multinational Pilot Study. Respondents were randomly assigned to one of the TTO variants with two blocks of five EQ-5D-5L health states. Tasks were administered using a web-based digital aid (EQ-VT) administered in a group interview. RESULTS A total of 387 participants were included [mean age 38.85 (SD: 13.97); 53.14 % females]. The mean observed values ranged from 0.44 (0.59) for state 21111 to 0.02 (0.76) for state 53555 in the lead-time group and between 0.53 (0.52) and 0.08 (0.76) in the lag-time group. There were no statistically significant differences in the values between TTO variants, except for a significant difference of 0.19 for state 33133. In both variants, marked peaks were observed around the value 0 across all states, with a higher percentage of 0 responses in the last state valued, suggesting ordering effects. CONCLUSIONS No important differences were found between TTO variants regarding values for EQ-5D-5L health states, suggesting that they could be equivalent variants. However, differences between the two methods may have been obscured by other aspects of the study design affecting the characteristics of the data.
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Affiliation(s)
- Federico Augustovski
- Institute of Clinical Effectiveness and Health Policy, IECS, Dr Emilio Ravignani 2024, C1414CPV Buenos Aires, Argentina.
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