Julie Ratcliffe1, Thomas Flint2, Tiffany Easton3, Maggie Killington3, Ian Cameron4, Owen Davies3, Craig Whitehead3, Susan Kurrle4, Michelle Miller5, Enwu Liu3, Maria Crotty3. 1. Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, SA, Australia. julie.ratcliffe@flinders.edu.au. 2. Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, SA, Australia. 3. Department of Rehabilitation and Aged Care, School of Health Sciences, Flinders University, Adelaide, Australia. 4. John Walsh Centre for Rehabilitation Research, Kolling Institute, University of Sydney, Sydney, Australia. 5. Department of Nutrition and Dietetics, School of Health Sciences, Flinders University, Adelaide, Australia.
Abstract
OBJECTIVE: To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. METHODS: A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures. RESULTS: There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks' follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period. CONCLUSIONS: This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.
OBJECTIVE: To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. METHODS: A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures. RESULTS: There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks' follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period. CONCLUSIONS: This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.
Authors: Philippa A Logan; Jane C Horne; Frances Allen; Sarah J Armstrong; Allan B Clark; Simon Conroy; Janet Darby; Chris Fox; John Rf Gladman; Maureen Godfrey; Adam L Gordon; Lisa Irvine; Paul Leighton; Karen McCartney; Gail Mountain; Kate Robertson; Katie Robinson; Tracey H Sach; Susan Stirling; Edward Cf Wilson; Erika J Sims Journal: Health Technol Assess Date: 2022-01 Impact factor: 4.014
Authors: Elizaveta Sopina; Lynn Chenoweth; Tim Luckett; Meera Agar; Georgina M Luscombe; Patricia M Davidson; Constance D Pond; Jane Phillips; Stephen Goodall Journal: Qual Life Res Date: 2018-09-05 Impact factor: 4.147