Assessing responsiveness of generic and specific health related quality of life measures in heart failure

被引:100
作者
Eurich, Dean T.
Johnson, Jeffrey A. [1 ]
Reid, Kimberly J.
Spertus, John A.
机构
[1] Inst Hlth Econ, Edmonton, AB, Canada
[2] Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada
[3] St Lukes Hlth Ctr, Kansas City, MO USA
[4] St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA
[5] Univ Missouri, Kansas City, MO 64110 USA
关键词
D O I
10.1186/1477-7525-4-89
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Responsiveness, or sensitivity to clinical change, is an important consideration in selection of a health-related quality of life (HRQL) measure for trials or clinical applications. Many approaches can be used to assess responsiveness, which may affect the interpretation of study results. We compared the relative responsiveness of generic and heart failure specific HRQL instruments, as measured both by common psychometric indices and by external clinical criteria. Methods: We analyzed data collected at baseline and 6-weeks in 298 subjects with heart failure on the following HRQL measures: EQ-5D (US, UK, and VAS Scoring), Kansas City Cardiomyopathy Questionnaire (KCCQ) (Clinical and Overall Summary Score), and RAND12 (Physical and Mental Component Summaries). Three external indicators of clinical change were used to classify subjects as improved, deteriorated, or unchanged: 6-minute walk test, New York Heart Association (NYHA) class, and physician global rating of change. Four responsiveness statistics (T-test, effect size, Guyatt's responsiveness statistic, and standardized response mean) were used to evaluate the responsiveness of the select measures. The median rank of each HRQL measure across responsiveness indices and clinical criteria was then determined. Results: Average age of subjects was 60 years, 75 percent were male, and had moderate to severe heart failure symptoms. Overall, the KCCQ Summary Scores had the highest relative ranking, irrespective of the responsiveness index or external criterion used. Importantly, we observed that the relative ranking of responsiveness of the generic measures (i.e. EQ-5D, RAND12) was influenced by both the responsive indices and external criterion used. Conclusion: The disease specific KCCQ was the most responsive HRQL measure assessing change over a 6-week period, although generic measures provide information for which the KCCQ is not suitable. The responsiveness of generic HRQL measures may be affected by the index used, as well as the external criterion to classify patients who have clinically change or remained stable.
引用
收藏
页数:14
相关论文
共 28 条
[1]   Quality of life measures in epilepsy - How well can they detect change over time? [J].
Birbeck, GL ;
Kim, S ;
Hays, RD ;
Vickrey, BG .
NEUROLOGY, 2000, 54 (09) :1822-1827
[2]   Health-related quality-of-life assessments and patient-physician communication - A randomized controlled trial [J].
Detmar, SB ;
Muller, MJ ;
Schornagel, JH ;
Wever, LDV ;
Aaronson, NK .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (23) :3027-3034
[3]   REPRODUCIBILITY AND RESPONSIVENESS OF HEALTH-STATUS MEASURES - STATISTICS AND STRATEGIES FOR EVALUATION [J].
DEYO, RA ;
DIEHR, P ;
PATRICK, DL .
CONTROLLED CLINICAL TRIALS, 1991, 12 (04) :S142-S158
[4]   Modeling valuations for EuroQol health states [J].
Dolan, P .
MEDICAL CARE, 1997, 35 (11) :1095-1108
[5]   Effect of domperidone on the health-related quality of life of patients with symptoms of diabetic gastroparesis [J].
Farup, CE ;
Leidy, NK ;
Murray, M ;
Williams, GR ;
Helbers, L ;
Quigley, EMM .
DIABETES CARE, 1998, 21 (10) :1699-1706
[6]   INCORPORATING UTILITY-BASED QUALITY-OF-LIFE ASSESSMENT MEASURES IN CLINICAL-TRIALS - 2 EXAMPLES [J].
FEENY, DH ;
TORRANCE, GW .
MEDICAL CARE, 1989, 27 (03) :S190-S204
[7]   Effects of sustained audit/feedback on self-reported health status of primary care patients [J].
Fihn, SD ;
McDonell, MB ;
Diehr, P ;
Anderson, SM ;
Bradley, KA ;
Au, DH ;
Spertus, JA ;
Burman, M ;
Reiber, GE ;
Kiefe, CI ;
Cody, M ;
Sanders, KM ;
Whooley, MA ;
Rosenfeld, K ;
Baczek, LA ;
Sauvigne, A .
AMERICAN JOURNAL OF MEDICINE, 2004, 116 (04) :241-248
[8]   Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: A new health status measure for heart failure [J].
Green, CP ;
Porter, CB ;
Bresnahan, DR ;
Spertus, JA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 35 (05) :1245-1255
[9]  
GUYATT GH, 1985, CAN MED ASSOC J, V132, P919
[10]   Methods to explain the clinical significance of health status measures [J].
Guyatt, GH ;
Osoba, D ;
Wu, AW ;
Wyrwich, KW ;
Norman, GR .
MAYO CLINIC PROCEEDINGS, 2002, 77 (04) :371-383