Development of Clinical Vignettes to Describe Alzheimer's Disease Health States: A Qualitative Study

Abstract

AimsTo develop clinical descriptions (vignettes) of life with Alzheimer’s disease (AD), we conducted focus groups of persons with AD (n = 14), family caregivers of persons with AD (n = 20), and clinicians who see persons with AD in their practices (n = 5).MethodsGroup participants read existing descriptions of AD and commented on the realism and comprehensibility of the descriptions. We used thematic framework analysis to code the comments into themes and develop three new vignettes to describe mild, moderate, and severe AD.ResultsThemes included the types of symptoms to mention in the new vignettes, plus the manner in which the vignettes should be written. Since the vignette descriptions were based on focus group participants’ first-hand knowledge of AD, the descriptions can be said to demonstrate content validity.ConclusionMembers of the general public can read the vignettes and estimate their health-related quality-of-life (HRQoL) as if they had AD based on the vignette descriptions. This is especially important for economic evaluations of new AD medications, which require HRQoL to be assessed in a manner that persons with AD often find difficult to undertake. The vignettes will allow the general public to serve as a proxy and provide HRQoL estimates in place of persons with AD.

Cost-effectiveness of pharmacological therapies for people with Alzheimer’s disease and other dementias: a systematic review and meta-analysis

“…This may be explained by the health utility scales used to calibrate QALYs differing from those reported in the original study [ 30 , 32 ]. The selection of self-rating or proxy-rating scales could also influence the value of health utility and QALYs [ 14 , 38 ], which was also reflected in our sensitivity analysis.…”

Using Video Vignettes to Understand Perceptions of Leaders

“…The multidimensional aspect of vignettes allows for adaptability to a range of disciplines and approaches. Vignettes have been used to instruct and improve training-or program-related outcomes, such as improving educational leadership [4,5] and medical acceptability [6,7]. Vignettes are particularly effective in gauging perceptions and thoughts that are otherwise difficult to understand.…”

Vignettes: a data collection technique to handle the differential operation of items in surveys

“…In spite of the use of vignettes in surveys, such as in the health area (CHRISTEN, HILTON et al, 2016, OREMUS, XIE, GAEBEL, 2016, SILVA et al, 2015, WINSOR, MCLEAN, 2016, in Sociology (CHRISTEN et al, 2016;GANONG;JAMISON;Chapman, 2015) and empirical research in marketing (COVA; PARANQUE, 2016;ZHANG;SIMON, 2016), the recommendations for its establishment are limited in the literature (WASON; POLONSKY; HYMAN, 2002). Thus, this study aims to review and describe criteria presented in the literature for robust textualization of vignettes.…”