Literature DB >> 20702509

Evidence of disagreement between patient-perceived change and conventional longitudinal evaluation of change in health-related quality of life among older adults.

Steven McPhail1, Tracy Comans, Terry Haines.   

Abstract

OBJECTIVE: To identify agreement levels between conventional longitudinal evaluation of change (post-pre) and patient-perceived change (post-then test) in health-related quality of life.
DESIGN: A prospective cohort investigation with two assessment points (baseline and six-month follow-up) was implemented.
SETTING: Community rehabilitation setting.
SUBJECTS: Frail older adults accessing community-based rehabilitation services. INTERVENTION: Nil as part of this investigation. MAIN MEASURES: Conventional longitudinal change in health-related quality of life was considered the difference between standard EQ-5D assessments completed at baseline and follow-up. To evaluate patient-perceived change a 'then test' was also completed at the follow-up assessment. This required participants to report (from their current perspective) how they believe their health-related quality of life was at baseline (using the EQ-5D). Patient-perceived change was considered the difference between 'then test' and standard follow-up EQ-5D assessments.
RESULTS: The mean (SD) age of participants was 78.8 (7.3). Of the 70 participants 62 (89%) of data sets were complete and included in analysis. Agreement between conventional (post-pre) and patient-perceived (post-then test) change was low to moderate (EQ-5D utility intraclass correlation coefficient (ICC) = 0.41, EQ-5D visual analogue scale (VAS) ICC = 0.21). Neither approach inferred greater change than the other (utility P =0.925, VAS P =0.506). Mean (95% confidence interval (CI)) conventional change in EQ-5D utility and VAS were 0.140 (0.045,0.236) and 8.8 (3.3,14.3) respectively, while patient-perceived change was 0.147 (0.055,0.238) and 6.4 (1.7,11.1) respectively.
CONCLUSIONS: Substantial disagreement exists between conventional longitudinal evaluation of change in health-related quality of life and patient-perceived change in health-related quality of life (as measured using a then test) within individuals.

Entities:  

Mesh:

Year:  2010        PMID: 20702509     DOI: 10.1177/0269215510371422

Source DB:  PubMed          Journal:  Clin Rehabil        ISSN: 0269-2155            Impact factor:   3.477


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