Outcome measures for adult critical care: a systematic review.

Abstract

et al. Outcome measures for adult critical care: a systematic review. Health Technol Assess 2000;4(24). Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA website (see overleaf). NHS R&D HTA Programme T he overall aim of the NHS R&D Health Technology Assessment (HTA) programme is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and work in the NHS. Research is undertaken in those areas where the evidence will lead to the greatest benefits to patients, either through improved patient outcomes or the most efficient use of NHS resources. The Standing Group on Health Technology advises on national priorities for health technology assessment. Six advisory panels assist the Standing Group in identifying and prioritising projects. These priorities are then considered by the HTA Commissioning Board supported by the National Coordinating Centre for HTA (NCCHTA). This report is one of a series covering acute care, diagnostics and imaging, methodology, pharmaceuticals, population screening, and primary and community care. It was identified as a priority by the Acute Sector Panel and funded as project number 95/55/03. The views expressed in this publication are those of the authors and not necessarily those of the Standing Group, the Commissioning Board, the Panel members or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for the recommendations for policy contained herein. In particular, policy options in the area of screening will be considered by the National Screening Committee. This Committee, chaired by the Chief Medical Officer, will take into account the views expressed here, further available evidence and other relevant considerations. 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. Criteria for inclusion in the HTA monograph series Reports are published in the HTA monograph series if (1) they have resulted from work either prioritised by the Standing Group on Health Technology, or otherwise commissioned for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.

Six-year mortality and quality of life in critically ill patients with chronic obstructive pulmonary disease

“…In fact, our group used this instrument in the validation of our own QOL questionnaire (14). The wide assessment and testing of the GOS is documented in the reviews of both Hayes et al (36) and Teasdale et al (37). A high interobserver reproducibility between research psychologists and research nurses has been reported, with an agreement of 92% (kappa, 0.89) (38).…”

“…Although the responsiveness or capacity to detect changes of the GOS is inferior to that of instruments that evaluate multiple QOL dimensions, its application requires less time and effort. The GOS has been widely used in the clinical setting, not only in head-injury patients but also in neurologic patients and in critical care patients in general, as shown in the exhaustive review by Hayes et al (36). In fact, our group used this instrument in the validation of our own QOL questionnaire (14).…”

“…A good agreement was found between information obtained from family members and that obtained directly from the patient (r ϭ .79, p ϭ .001) (39), by either personal or telephone interview (40), with absolute agreement in 90% of cases (kappa, 0.85). Multiple studies (36,37) have assessed the GOS and reported its relationship with age and impairment measures (evoked potentials, Glasgow Coma Scale, intracranial diagnosis, neuropsychological function status).…”

Combining nutrition and exercise to optimize survival and recovery from critical illness: Conceptual and methodological issues

“…Activities of daily living and instrumental activities of daily living [88,89] Can obtain from multiple sources with some evidence of patient-proxy agreement in ICU patients [95] Return to work/prior activity Commonly used measure Patient-centered Lacks standardized definition but used in many studies [132] Living location Same as above Suggested measures to assess impact of nutrition and exercise interventions on participant restriction at home or usual care setting after discharge from acute care hospital. [110] Has established population norms/utilities [111] Requires licensing fee EQ-5D (3-level or 5-level)…”

Lebensqualität nach Intensivmedizin

“…Für die wissenschaftliche und vergleichende Analyse der Lebensqualität ist es wichtig, standardisierte Instrumente zu haben, mit denen man die HRQL messen kann[9]. In den vergangenen Jahren wurden deswegen verschiedene standardisierte und validierte Fragebögen eingesetzt, um die Lebensqualität ehemaliger Intensivpatienten zu studieren[10]. Die 4 wichtigsten dieser Fragebögen sind:…”