A Multiattribute Approach to Health-Status Measurement and Clinical Management Illustrated by an Application to Brain-Tumors in Childhood

Barr, RD; Pai, Mkr; Weitzman, Sheila; Feeny, David; Furlong, William; Rosenbaum, Peter; Torrance, G. W.

doi:10.3892/ijo.4.3.639

Cited by 60 publications

(50 citation statements)

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“…Die Dimensionalität der Lebensqualität ist in Untersuchungen an Erwachsenen in einer Reihe qualitativer und quantitativer Studien sowohl im nationalen als auch im internationalen Bereich erhärtet worden [19,20]. Fraglich ist allerdings, inwieweit Kinder vergleichbare Dimensionen zur Beschreibung ihrer gesundheitsbezogenen Lebensqualität wählen würden.…”

Section: Spezifische Probleme Der Lq-erfassung Bei Kindernunclassified

Verfahren zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen

Ravens‐Sieberer¹

2000

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschu

126

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Section: Spezifische Probleme Der Lq-erfassung Bei Kindernunclassified

Verfahren zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen

Ravens‐Sieberer¹

2000

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschu

126

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“…However, the inherent subjectivity of QoL belies some unique challenges to its measurement. Limited evidence suggests that parental reports may be more accurate than those of health professionals, 203 but empirical investigations of the level of agreement between parent and child appraisals yields mixed results. 204 Difficulties arise in establishing the levels of agreement between two parents, 205,206 the potential for bias within parental ratings and the potential differences in the life priorities of parents and children.…”

Section: Review Strengths and Limitationsmentioning

confidence: 99%

Self-care support for children and adolescents with long-term conditions: the REfOCUS evidence synthesis

Bee

Pedley

Rithalia

et al. 2018

Health Serv Deliv Res

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BackgroundSelf-care support (e.g. education, training, peer/professional support) is intended to enhance the self-care capacities of children and young people, while simultaneously reducing the financial burden facing health-care systems.ObjectivesTo determine which models of self-care support for long-term conditions (LTCs) are associated with significant reductions in health utilisation and costs without compromising outcomes for children and young people.DesignSystematic review with meta-analysis.PopulationChildren and young people aged 0–18 years with a long-term physical or mental health condition (e.g. asthma, depression).InterventionSelf-care support in health, social care, educational or community settings.ComparatorUsual care.OutcomesGeneric/health-related quality of life (QoL)/subjective health symptoms and health service utilisation/costs.DesignRandomised/non-randomised trials, controlled before-and-after studies, and interrupted time series designs.Data sourcesMEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Science, NHS Economic Evaluation Database, The Cochrane Library, Health Technology Assessment database, Paediatric Economic Database Evaluation, IDEAS, reference scanning, targeted author searches and forward citation searching. All databases were searched from inception to March 2015.MethodsWe conducted meta-analyses, simultaneously plotting QoL and health utilisation effects. We conducted subgroup analyses for evidence quality, age, LTC and intervention (setting, target, delivery format, intensity).ResultsNinety-seven studies reporting 114 interventions were included. Thirty-seven studies reported adequate allocation concealment. Fourteen were UK studies. The vast majority of included studies recruited children and young people with asthma (n = 66, 68%). Four per cent of studies evaluated ‘pure’ self-care support (delivered through health technology without additional contact), 23% evaluated facilitated self-care support (≤ 2 hours’/four sessions’ contact), 65% were intensively facilitated (≥ 2 hours’/four sessions’ contact) and 8% were case management (≥ 2 hours’ support with multidisciplinary input). Self-care support was associated with statistically significant, minimal benefits for QoL [effect size (ES) –0.17, 95% confidence interval (CI) –0.23 to –0.11], but lacked clear benefit for hospital admissions (ES –0.05, 95% CI –0.12 to 0.03). This finding endured across intervention intensities and LTCs. Statistically significant, minimal reductions in emergency use were observed (ES –0.11, 95% CI –0.17 to –0.04). The total cost analysis was limited by the small number of data. Subgroup analyses revealed statistically significant, minimal reductions in emergency use for children aged ≤ 13 years (ES –0.10, 95% CI –0.17 to –0.04), children and young people with asthma (ES –0.12, 95% CI –0.18 to –0.06) and children and young people receiving ≥ 2 hours per four sessions of support (ES –0.10, 95% CI –0.17 to –0.03). Preliminary evidence suggested that interventions that include the child or young person, and deliver some content individually, may optimise QoL effects. Face-to-face delivery may help to maximise emergency department effects. Caution is required in interpreting these findings.LimitationsIdentification of optimal models of self-care support is challenged by the size and nature of evidence available. The emphasis on meta-analysis meant that a minority of studies with incomplete but potentially relevant data were excluded.ConclusionsSelf-care support is associated with positive but minimal effects on children and young people’s QoL, and minimal, but potentially important, reductions in emergency use. On current evidence, we cannot reliably conclude that self-care support significantly reduces health-care costs.Future workResearch is needed to explore the short- and longer-term effects of self-care support across a wider range of LTCs.Study registrationThis study is registered as PROSPERO CRD42014015452.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…The validity of these proxy measures is not well established. Limited evidence suggests that parental reports may be more accurate than those of health professionals, 94 but empirical investigations of the level of agreement between parent and child appraisals yields mixed results. 89 Ultimately, greater agreement may be observed for ratings of children's physical well-being than for assessments of emotional or social function.…”

Section: Challenges In Measuring Children's Quality Of Lifementioning

confidence: 99%

The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review

Bee

Bower

Byford

et al. 2014

Health Technology Assessment

107

150

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This report should be referenced as follows:Bee P, Bower P, Byford S, Churchill R, Calam R, Stallard P, et al. The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review. Health Technol Assess 2014;18(8). This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). Health Technology Assessment is indexed and abstracted inEditorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.ukCriteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: www.hta.ac.uk/ This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 09/117/02. The contractual start date was in November 2010. The draft report began editorial review in June 2012 and was accepted for publication in November 2012. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not nec...

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A Multiattribute Approach to Health-Status Measurement and Clinical Management Illustrated by an Application to Brain-Tumors in Childhood

Cited by 60 publications

References 0 publications

Verfahren zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen

Verfahren zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen

Self-care support for children and adolescents with long-term conditions: the REfOCUS evidence synthesis

The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review

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