Agreement About Identifying Patients Who Change Over Time: Cautionary Results in Cataract and Heart Failure Patients

Feeny, David; Spritzer, Karen; Hays, Ron D; Liu, Honghu; Ganiats, Theodore G.; Kaplan, Robert M.; Palta, Mari; Fryback, Dennis G.

doi:10.1177/0272989X11418671

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Agreement About Identifying Patients Who Change Over Time: Cautionary Results in Cataract and Heart Failure Patients

Published Date:

2012 Mar-Apr

Publisher's site:

http://dx.doi.org/10.1177/0272989X11418671 New Site Icon

Source:

Med Decis Making. 32(2):273-286.

[PDF-297.12 KB]

Details:

Personal Authors:

Feeny, David ; Spritzer, Karen ; Hays, Ron D ; Liu, Honghu ; Ganiats, Theodore G. ; ... More ▼

Keywords:

[+]

Pubmed ID:

22009666

Pubmed Central ID:

PMC3749910

Description:

Background

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.

Objective

The objective is to examine agreement in classifying patients as better, stable, or worse.

Design

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.

Setting

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

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).

Measurements

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.

Results

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.

Limitations

The study was conducted on selected patients at a few academic medical centers.

Conclusions

The results underscore the lack of interchangeability among different preference-based measures.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

Supporting Files:

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