Using Instrument-Defined Health State Transitions to Estimate Minimally Important Differences for Four Preference-Based Health-Related Quality of Life Instruments

Luo, Nan; Johnson, Jeffrey; Coons, Stephen Joel

doi:10.1097/mlr.0b013e3181c162a2

Cited by 159 publications

(191 citation statements)

References 24 publications

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“…Questions remain as to whether the impact is clinically significant. Although there is no consensus on what is the minimal clinically important difference (MCID) for the US preference-based EQ-5D index score, previous research claimed different values, ranging from 0.033 to 0.07 [26,31]. The quantified impact from our study is near the upper limit of the range for the EQ-5D index score.…”

Section: Discussionmentioning

confidence: 53%

Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States

Qiu

Radican

et al. 2010

Qual Life Res

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Section: Discussionmentioning

confidence: 53%

Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States

Qiu

Radican

et al. 2010

Qual Life Res

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“…EQ‐5D™ scores characterized each assessment after baseline as improved or deteriorated if the score changed by at least 0·05 points, and stable if it changed by less than 0·05 points21, 22, 23.…”

Section: Methodsmentioning

confidence: 99%

Multicentre observational study of quality of life after surgical palliation of malignant gastric outlet obstruction for gastric cancer

Fujitani¹,

Ando

Sakamaki

et al. 2017

BJS Open

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BackgroundQuality of life (QoL) is a key component in decision‐making for surgical palliation, but QoL data in association with surgical palliation in advanced gastric cancer are scarce. The aim of this multicentre observational study was to examine the impact of surgical palliation on QoL in advanced gastric cancer.MethodsThe study included patients with gastric outlet obstruction caused by incurable advanced primary gastric cancer who had no oral intake or liquid intake only. Patients underwent palliative distal/total gastrectomy or bypass surgery at the physician's discretion. The primary endpoint was change in QoL assessed at baseline, 14 days, 1 month and 3 months following surgical palliation by means of the EuroQoL Five Dimensions (EQ‐5D™) questionnaire and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire gastric cancer module (QLQ‐STO22). Secondary endpoints were postoperative improvement in oral intake and surgical complications.ResultsSome 104 patients (23 distal gastrectomy, 9 total gastrectomy, 70 gastrojejunostomy, 2 exploratory laparotomy) were enrolled from 35 institutions. The mean EQ‐5D™ utility index scores remained consistent, with a baseline score of 0·74 and the change from baseline within ± 0·05. Gastric‐specific symptoms showed statistically significant improvement from baseline. The majority of patients were able to eat solid food 2 weeks after surgery and tolerated it thereafter. The rate of overall morbidity of grade III or more according to the Clavien–Dindo classification was 9·6 per cent (10 patients) and the 30‐day postoperative mortality rate was 1·9 per cent (2 patients).ConclusionIn patients with gastric outlet obstruction caused by advanced gastric cancer, surgical palliation maintained QoL while improving solid food intake, with acceptable morbidity for at least the first 3 months after surgery. Registration number 000023494 (UMIN Clinical Trials Registry).

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“…For each health-state transition (pre-op to post-op, post-op to follow-up, and pre-op to follow-up) the percentage of patients with a mean change greater than the MID was calculated. Estimates of the MID for SF6D, HUI2, and HUI3 were taken from a previous publication (38). In the case of the five-level version of the EQ5D, one-half of the standard deviation at pretreatment (0.5 · SD T1 ) was considered as threshold for MID (39).…”

Section: Statistical Analysesmentioning

confidence: 99%

Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma

Lubitz

Gregorio

Fingeret

et al. 2017

Thyroid

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Background: Thyroid cancer incidence is increasing. The effect of diagnosis and treatment on health-related quality of life (HRQoL) is an essential variable in the absence of a change in life span for the majority of patients. HRQoL instruments, with data useful for between-disease comparisons, are being increasingly used for health policy and outcomes evaluation. Variation exits among the instruments based on the impact of a specific disease. We assessed which of four well-validated, preference-based surveys detect changes in health and clinical intervention in patients diagnosed with papillary thyroid cancer (PTC). Methods: Four commonly used HRQoL questionnaires (Short Form-12v2Ò [SF6D], EuroQol-5D [EQ5D], and Health Utilities Index Mark 2 and 3 [HUI2, HUI3]) were administered to patients with the diagnosis of PTC at three perioperative time points during the first year of treatment. Clinicopathological and treatment course data were assessed for HRQoL impact including complications from surgery, re-operation for persistence/early recurrence, and adjuvant radioactive iodine treatment. We compared standard metrics, including ceiling effect, intraclass correlation coefficient, effect sizes, and quality-adjusted life-years between the four instruments. Results: Of 117 patients, 27% had a preoperative diagnosis of anxiety or depression, 41% had regional lymph node metastases, three had distant metastases and 49% underwent adjuvant radioactive iodine treatment. The ceiling effect (i.e., proportion with a perfect score) was greatest with EQ5D and least with SF6D. Index scores ranged from 0.77 (SF6D) to 0.90 (EQ5D). All scores declined at two weeks postoperatively and returned to pretreatment levels at six months. The SF6D was the only instrument to exceed the conventional minimally important difference between all three time points. Quality-adjusted life-years were as follows: SF6D, 0.79; EQ5D, 0.90; HUI2, 0.88; and HUI3, 0.86. Conclusions: Our results reflect the general good health of PTC patients. The effect on quality of life is primarily related to emotional and social impacts of treatment. The results support the measurement of a similar underlying construct, although variation in detecting changes in health exists between the instruments. Of the instruments assessed, the SF6D is the most responsive to treatment effects and should be utilized in future economic analyses in this patient population.

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Using Instrument-Defined Health State Transitions to Estimate Minimally Important Differences for Four Preference-Based Health-Related Quality of Life Instruments

Abstract: It is possible to use health transitions defined by the MAHC system to estimate the MIDs for preference-based health index scores. This study provides new information regarding MID estimates for the 4 health indices examined.

Cited by 159 publications

References 24 publications

Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States

Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States

Multicentre observational study of quality of life after surgical palliation of malignant gastric outlet obstruction for gastric cancer

Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma

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