Agreement About Identifying Patients Who Change Over Time: Cautionary Results in Cataract and Heart Failure Patients
Published Date:2012 Mar-Apr
Source:Med Decis Making. 32(2):273-286.
Keywords:Academic Medical Centers
Activities Of Daily Living
Quality Of Life
Reproducibility Of Results
Surveys And Questionnaires
Pubmed Central ID:PMC3749910
Funding:P30AG021684/AG/NIA NIH HHS/United States
P01 AG020679/AG/NIA NIH HHS/United States
U48 DP000056/DP/NCCDPHP CDC HHS/United States
1 P01 AG020679-01A2/AG/NIA NIH HHS/United States
U48 DP000056-04/DP/NCCDPHP CDC HHS/United States
5P30AG028748/AG/NIA NIH HHS/United States
P20 MD000182/MD/NIMHD NIH HHS/United States
P01AG020679/AG/NIA NIH HHS/United States
P20MD000182/MD/NIMHD NIH HHS/United States
P30 AG021684/AG/NIA NIH HHS/United States
P20 MD000148/MD/NIMHD NIH HHS/United States
P30 AG028748/AG/NIA NIH HHS/United States
P20MD000148/MD/NIMHD NIH HHS/United States
Preference-based measures of health-related quality of life all use the same dead = 0.00 to perfect health = 1.00 scale, but there are substantial differences among measures.
The objective is to examine agreement in classifying patients as better, stable, or worse.
The EQ-5D, Health Utilities Index Mark 2 and Mark 3, Quality of Well-Being – Self-Administered, Short-Form 36 (Short-Form 6D), and disease-targeted measures were administered prospectively in two clinical cohorts.
The study was conducted at academic medical centers: University of California, Los Angeles; University of California, San Diego; University of Wisconsin-Madison; and University of Southern California.
Patients undergoing cataract extraction surgery with lens replacement completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Patients newly refereed to congestive heart failure specialty clinics completed the Minnesota Living with Heart Failure Questionnaire (MLHF).
In both cohorts subjects completed surveys at baseline, one and six months. The NEI-VFQ-25 and MLHF were used as gold standards to assign patients to categories of change. Agreement was assessed using kappa.
376 cataract patients were recruited. Complete data for baseline and the one-month follow-up were available on all measures for 210 cases. Using criteria specified by Altman, agreement was poor for six of nine pairs of comparisons and fair for three pairs. 160 heart failure patients were recruited. Complete data for baseline and the six-month follow-up were available for 86 cases. Agreement was negligible for five pairs and fair for one.
The study was conducted on selected patients at a few academic medical centers.
The results underscore the lack of interchangeability among different preference-based measures.
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