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Assessing quality of life in a clinical study on heart rehabilitation patients: how well do value sets based on given or experienced health states reflect patients' valuations?

https://arctichealth.org/en/permalink/ahliterature276518
Source
Health Qual Life Outcomes. 2016;14:48
Publication Type
Article
Date
2016
Author
Reiner Leidl
Bernd Schweikert
Harry Hahmann
Juergen M Steinacker
Peter Reitmeir
Source
Health Qual Life Outcomes. 2016;14:48
Date
2016
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - psychology - rehabilitation
Adult
Aged
Aged, 80 and over
Female
Humans
Inpatients - psychology
Male
Middle Aged
Outpatients - psychology
Patient satisfaction
Quality of Life - psychology
Regression Analysis
Self Report
Surveys and Questionnaires
Sweden
Abstract
Quality of life as an endpoint in a clinical study may be sensitive to the value set used to derive a single score. Focusing on patients' actual valuations in a clinical study, we compare different value sets for the EQ-5D-3L and assess how well they reproduce patients' reported results.
A clinical study comparing inpatient (n = 98) and outpatient (n = 47) rehabilitation of patients after an acute coronary event is re-analyzed. Value sets include: 1. Given health states and time-trade-off valuation (GHS-TTO) rendering economic utilities; 2. Experienced health states and valuation by visual analog scale (EHS-VAS). Valuations are compared with patient-reported VAS rating. Accuracy is assessed by mean absolute error (MAE) and by Pearson's correlation ?. External validity is tested by correlation with established MacNew global scores. Drivers of differences between value sets and VAS are analyzed using repeated measures regression.
EHS-VAS had smaller MAEs and higher ? in all patients and in the inpatient group, and correlated best with MacNew global score. Quality-adjusted survival was more accurately reflected by EHS-VAS. Younger, better educated patients reported lower VAS at admission than the EHS-based value set. EHS-based estimates were mostly able to reproduce patient-reported valuation. Economic utility measurement is conceptually different, produced results less strongly related to patients' reports, and resulted in about 20 % longer quality-adjusted survival.
Decision makers should take into account the impact of choosing value sets on effectiveness results. For transferring the results of heart rehabilitation patients from another country or from another valuation method, the EHS-based value set offers a promising estimation option for those decision makers who prioritize patient-reported valuation. Yet, EHS-based estimates may not fully reflect patient-reported VAS in all situations.
Notes
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PubMed ID
27005466 View in PubMed
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Effectiveness of person-centred care after acute coronary syndrome in relation to educational level: Subgroup analysis of a two-armed randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature286177
Source
Int J Cardiol. 2016 Oct 15;221:957-62
Publication Type
Article
Date
Oct-15-2016
Author
Andreas Fors
Hanna Gyllensten
Karl Swedberg
Inger Ekman
Source
Int J Cardiol. 2016 Oct 15;221:957-62
Date
Oct-15-2016
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - psychology - rehabilitation - therapy
Aftercare - methods
Aged
Diagnostic Self Evaluation
Educational Status
Female
Humans
Interdisciplinary Communication
Male
Outcome and Process Assessment (Health Care)
Patient Care Planning
Patient-Centered Care - methods
Quality of Life
Sweden
Abstract
The aim of this study was to evaluate the effects of person-centred care (PCC) after acute coronary syndrome (ACS) in relation to educational level of participants.
199 Patients
PubMed ID
27441475 View in PubMed
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