Sungwon Chang1, Patricia M Davidson2, Phillip J Newton3, Peter Macdonald4, Melinda J Carrington5, Thomas H Marwick6, John D Horowitz7, Henry Krum8, Christopher M Reid8, Yih Kai Chan5, Paul A Scuffham9, David Sibbritt3, Simon Stewart5. 1. University of Technology, Sydney, Australia. Electronic address: Sungwon.Chang@uts.edu.au. 2. University of Technology, Sydney, Australia; Johns Hopkins University, USA. 3. University of Technology, Sydney, Australia. 4. St Vincent's Hospital and Victor Chang Cardiac Research Institute, Sydney, Australia. 5. Baker IDI Heart and Diabetes Institute, Melbourne, Australia. 6. Menzies Research Institute, University of Tasmania, Australia. 7. The Queen Elizabeth Hospital, Adelaide, Australia. 8. Monash Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Australia. 9. Griffith Health Institute, Griffith University, Logan, Australia.
Abstract
BACKGROUND: A number of composite outcomes have been developed to capture the perspective of the patient, clinician and objective measures of health in assessing heart failure outcomes. To date there has been a limited examination in the composition of these outcomes. METHODS AND RESULTS: Three commonly used scoring systems in heart failure trials: Packer's composite, Patient Journey and the African American Heart Failure Trial (A-HeFT) scores were compared in assessing outcomes from the Which heart failure intervention is most cost-effective & consumer friendly in reducing hospital care (WHICH(?)) Trial. Comparability and interpretability of these outcomes and the influence of each component to the final outcome were examined. Despite all three composite outcomes incorporating mortality, hospitalisation and quality of life (QoL), the contribution of each individual component to the final outcomes differed. The component with the most influence in deteriorating condition for the Packer's composite was hospitalisation (67.7%), while in Patient Journey it was QoL (61.5%) and for A-HeFT composite score it was mortality (45.4%). CONCLUSIONS: The contribution made by each component varied in subtle, but important ways. This study emphasises the importance of understanding the value system of the composite outcomes to enable meaningful interpretation of results.
BACKGROUND: A number of composite outcomes have been developed to capture the perspective of the patient, clinician and objective measures of health in assessing heart failure outcomes. To date there has been a limited examination in the composition of these outcomes. METHODS AND RESULTS: Three commonly used scoring systems in heart failure trials: Packer's composite, Patient Journey and the African American Heart Failure Trial (A-HeFT) scores were compared in assessing outcomes from the Which heart failure intervention is most cost-effective & consumer friendly in reducing hospital care (WHICH(?)) Trial. Comparability and interpretability of these outcomes and the influence of each component to the final outcome were examined. Despite all three composite outcomes incorporating mortality, hospitalisation and quality of life (QoL), the contribution of each individual component to the final outcomes differed. The component with the most influence in deteriorating condition for the Packer's composite was hospitalisation (67.7%), while in Patient Journey it was QoL (61.5%) and for A-HeFT composite score it was mortality (45.4%). CONCLUSIONS: The contribution made by each component varied in subtle, but important ways. This study emphasises the importance of understanding the value system of the composite outcomes to enable meaningful interpretation of results.
Authors: Antonio López-Villegas; Daniel Catalán-Matamoros; Emilio Robles-Musso; Salvador Peiró Journal: Clin Res Cardiol Date: 2015-09-30 Impact factor: 5.460
Authors: Remedios López-Liria; Antonio López-Villegas; César Leal-Costa; Salvador Peiró; Emilio Robles-Musso; Rafael Bautista-Mesa; Patricia Rocamora-Pérez; Knut Tore Lappegård; Daniel Catalán-Matamoros Journal: Int J Environ Res Public Health Date: 2020-02-23 Impact factor: 3.390
Authors: Rafael Jesus Bautista-Mesa; Antonio Lopez-Villegas; Salvador Peiro; Daniel Catalan-Matamoros; Emilio Robles-Musso; Remedios Lopez-Liria; Cesar Leal-Costa Journal: BMC Geriatr Date: 2020-11-16 Impact factor: 3.921