Mapping the Modified Rankin Scale (mRS) Measurement into the Generic EuroQol (EQ-5D) Health Outcome

Rivero‐Arias, Oliver; Ouellet, Mélissa; Gray, Alastair; Wolstenholme, Jane; Rothwell, Peter M.; Luengo-Fernández, Ramón

doi:10.1177/0272989x09349961

Cited by 134 publications

(128 citation statements)

References 23 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…130 Despite the difficulties, 131 a mapping of the OHS into the EQ-5D QALY suggests that each point in the OHS is worth 0.0222 of a QALY. 132 A change of 20 points in the OHS, the mean value in the PROMs 2008-12 data set, would then correspond to 0.444 of a QALY (compare the actual QALY change of 0.411).…”

Section: Prioritising Patients For Elective Surgery: the Efficiency Omentioning

confidence: 99%

Elective hospital admissions: secondary data analysis and modelling with an emphasis on policies to moderate growth

Chalkley

McCormick

Anderson

et al. 2017

Health Serv Deliv Res

View full text Add to dashboard Cite

BackgroundThe English NHS faces financial pressures that may render the growth rates of elective admissions seen between 2001/2 and 2011/12 unsustainable. A better understanding of admissions growth, and the influence of policy, are needed to minimise the impact on health gain for patients.ObjectivesThis project had several objectives: (1) to better understand the determinants of elective activity and policy to moderate growth at minimum health loss for patients; (2) to build a rich data set integrating health, practice and local area data to study general practitioner (GP) referrals and resulting admissions; (3) to predict patients whose treatment is unlikely to be cost-effective using patient-reported outcomes and to examine variation in provider performance; and (4) to study how policies that aim to reduce elective admissions may change demand for emergency care. The main drivers of elective admissions growth have increased either supply of or demand for care, and could include, for example, technical innovations or increased awareness of treatment benefits. Of the factors studied, neither system reform nor population ageing appears to be a key driver. The introduction of the prospective payment tariff ‘Payment by Results’ appears to have led to primary care trusts (PCTs) having increasingly similar lengths of stay. In deprived areas, increasing GP supply appears to moderate elective admissions. Reducing the incidence of single-handed practices tends to reduce referrals and admissions. Policies to reduce referrals are likely to reduce admissions but treatments may be particularly reduced in the lowest referring practices, in which resulting health loss may be greatest. In this model, per full-time equivalent, female and highly experienced GPs identify more patients admitted by specialists.ResultsIt appears from our studies that some patient characteristics are associated with not achieving sufficient patient gain to warrant cost-effective treatment. The introduction of independent sector treatment centres is estimated to have caused an increase in emergency activity rates at local PCTs. The explanations offered for increasing elective admissions indicate that they are manageable by health policy.ConclusionsFurther work is required to understand some of the results identified, such as whether or not high-volume Clinical Commissioning Groups are fulfilling unmet need; why some practices refer at low rates relative to admissions; why the period effect, which results from factors that equally affect all in the study at a point in time, dominates in the age–period–cohort analysis; and exactly how the emergency and elective sections of hospital treatment interact. This project relies on the analysis of secondary data. This type of research does not easily facilitate the important input of clinical experts or service users. It would be beneficial if other methods, including surveys and consultation with key stakeholders, could be incorporated into future research now that we have uncovered important questions.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Section: Prioritising Patients For Elective Surgery: the Efficiency Omentioning

confidence: 99%

Elective hospital admissions: secondary data analysis and modelling with an emphasis on policies to moderate growth

Chalkley

McCormick

Anderson

et al. 2017

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…The cost of asthma exacerbations represented a mixture of the estimated cost of an accident and emergency (A&E) attendance and NHS reference cost of inpatient attendance, with the ratio of A&E to inpatient admissions estimate taken from Hoskins et al 84 Costs for stroke were taken from a recent National Institute for Health Research (NIHR) commissioned technology assessment report, 98 and incorporates the one-off and ongoing costs of stroke in addition to the reported difference in costs and prevalence of dependent and independent patient states following a stroke incident. 99 All costs have been adjusted for inflation to 2010/11 prices. 100 Uncertainty around cost estimates were incorporated into the probabilistic analysis.…”

Section: Costsmentioning

confidence: 99%

What is the clinical effectiveness and cost-effectiveness of cytisine compared with varenicline for smoking cessation? A systematic review and economic evaluation

Leaviss

Sullivan

Ren

et al. 2014

Health Technology Assessment

View full text Add to dashboard Cite

“…The outcome following a stroke is estimated using a two-stage process, using data from Rivero-Arias et al 154 This paper 154 reported that, of 1283 patients who had a stroke within the Oxford Vascular Study (OXVASC) cohort, 24.8% (319/1283) were dead within 24 months. Of those who survived, the degree of disability following the stroke was graded according to the modified Rankin Scale (mRS) 24 months after the event in 425 patients.…”

Section: Determining the Category Of Strokementioning

confidence: 99%

“…154 Utility multipliers following a stroke were estimated from data that presented EuroQOL Five Dimension (EQ-5D) mapped utility estimates for the utility associated with each of the six mRS scores. As the mildest of these categories (mRS 0) is a full recovery, this is assumed to represent baseline patient utility.…”

Section: Determining the Category Of Strokementioning

confidence: 99%

“…This allowed us to map utility values on to each GOS state using data from the same patient group that was used to inform the stroke utilities. 154 The methods used to derive the utility multipliers for each GOS state are very similar to those used to estimate utility multipliers following stroke, and also make the assumption that the distribution of the mRS states that the GOS states map on to is that reported at 24 months within the Rivero-Arias paper. 154 The assumed mapping between GOS scores and mRS scores, together with the estimated utility multipliers with 95% CrIs, are presented in Table 40.…”

Section: Utility Multipliers Following An Intracranial Haemorrhagementioning

confidence: 99%

See 1 more Smart Citation

Echocardiography in newly diagnosed atrial fibrillation patients: a systematic review and economic evaluation

Simpson

Stevenson²,

Scope³

et al. 2013

Health Technol Assess

View full text Add to dashboard Cite

Mapping the Modified Rankin Scale (mRS) Measurement into the Generic EuroQol (EQ-5D) Health Outcome

Cited by 134 publications

References 23 publications

Elective hospital admissions: secondary data analysis and modelling with an emphasis on policies to moderate growth

Elective hospital admissions: secondary data analysis and modelling with an emphasis on policies to moderate growth

What is the clinical effectiveness and cost-effectiveness of cytisine compared with varenicline for smoking cessation? A systematic review and economic evaluation

Echocardiography in newly diagnosed atrial fibrillation patients: a systematic review and economic evaluation

Contact Info

Product

Resources

About