Literature DB >> 9504591

Frequency and methodologic rigor of quality-of-life assessments in the critical care literature.

D K Heyland1, G Guyatt, D J Cook, M Meade, E Juniper, L Cronin, A Gafni.   

Abstract

OBJECTIVES: To present a framework for describing/measuring quality of life (QOL) and health-related quality of life (HRQL), and to assess the frequency and methodologic rigor of QOL studies in the adult critical care literature. DATA SOURCES: Computerized bibliographic search of published research, manual search of key intensive care unit (ICU) journals, and citation review of relevant articles. STUDY SELECTION: We manually searched Critical Care Medicine, American Journal of Respiratory and Critical Care Medicine, and Intensive Care Medicine for the period January 1992 to July 1995 to assess the frequency of published QOL studies. Combined with a computerized bibliographic search, we found 64 studies that met our criteria that reported on patient-related outcomes (other than mortality) after hospital discharge. DATA EXTRACTION: We abstracted data on the nature of each study, the instruments used to measure QOL, and the methodologic rigor of the QOL assessments. We evaluated each study using criteria we developed to assess the validity of HRQL measurements.
MEASUREMENTS AND MAIN RESULTS: In our manual search, we found 1,073 articles relevant to the practice of adult critical care. Of these, 19 (1.7%)/1073 included QOL measurements. Combined with our comprehensive search strategy, we found 64 papers that evaluated QOL in ICU patients. These papers dealt primarily with issues of: prognosis (32 [50%]), resource allocation (23 [36%]), and clinical prediction (9 [14%]). We found no randomized trials that included post-ICU QOL as an outcome. With respect to the validity of the HRQL assessments, 63/64 (98%) studies evaluated aspects of patients' lives that we considered important. Thirty-three (52%) studies were limited in scope to specific aspects of HRQL, and 31 (48%) studies covered broad areas of HRQL. In these 64 studies, there were 108 different instruments used. The reliability and validity of the instruments used were reported in 7 (6%) and 15 (14%) cases, respectively. For 81 (75%) instruments, the investigators either explained the results or used informative, qualitative descriptors whose interpretation was self-evident. Overall, three (5%) of the included studies met all four methodologic criteria to assess the validity of HRQL assessments.
CONCLUSIONS: QOL assessments occur infrequently in the ICU literature and are of limited methodologic quality. More studies using valid and reliable instruments are necessary to document the long-term QOL of critically ill patients, especially those at risk of a "poor" outcome.

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Year:  1998        PMID: 9504591     DOI: 10.1097/00003246-199803000-00037

Source DB:  PubMed          Journal:  Crit Care Med        ISSN: 0090-3493            Impact factor:   7.598


  24 in total

1.  Survival and functional outcome after prolonged intensive care unit stay.

Authors:  P A Lipsett; S M Swoboda; J Dickerson; M Ylitalo; T Gordon; M Breslow; K Campbell; T Dorman; P Pronovost; B Rosenfeld
Journal:  Ann Surg       Date:  2000-02       Impact factor: 12.969

2.  Quality of life following critical care: moving beyond survival.

Authors:  D K Heyland; D J Kutsogiannis
Journal:  Intensive Care Med       Date:  2000-09       Impact factor: 17.440

3.  Surviving intensive care: a report from the 2002 Brussels Roundtable.

Authors:  Derek C Angus; Jean Carlet
Journal:  Intensive Care Med       Date:  2003-01-21       Impact factor: 17.440

Review 4.  Quality of life in adult survivors of critical illness: a systematic review of the literature.

Authors:  David W Dowdy; Mark P Eid; Artyom Sedrakyan; Pedro A Mendez-Tellez; Peter J Pronovost; Margaret S Herridge; Dale M Needham
Journal:  Intensive Care Med       Date:  2005-04-01       Impact factor: 17.440

Review 5.  Studying outcomes of intensive care unit survivors: measuring exposures and outcomes.

Authors:  Dale M Needham; David W Dowdy; Pedro A Mendez-Tellez; Margaret S Herridge; Peter J Pronovost
Journal:  Intensive Care Med       Date:  2005-05-21       Impact factor: 17.440

6.  Health-related quality of life after fast-track treatment results from a randomized controlled clinical equivalence trial.

Authors:  Ghislaine A P G van Mastrigt; Manuela A Joore; Fred H M Nieman; Johan L Severens; Jos G Maessen
Journal:  Qual Life Res       Date:  2010-03-26       Impact factor: 4.147

7.  Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients.

Authors:  Anne Kaarlola; Ville Pettilä; Pertti Kekki
Journal:  Intensive Care Med       Date:  2004-11-03       Impact factor: 17.440

8.  Quality of life after complicated elective surgery requiring intensive care.

Authors:  Christian Lamer; Marc Harboun; Lyes Knani; David Moreau; Laurent Tric; Jean-Luc LeGuillou; Isabelle Gasquet; Thierry Moreau
Journal:  Intensive Care Med       Date:  2004-04-15       Impact factor: 17.440

9.  Long-term outcome in ICU patients: what about quality of life?

Authors:  Francisca García Lizana; Daliana Peres Bota; Michael De Cubber; Jean-Louis Vincent
Journal:  Intensive Care Med       Date:  2003-07-08       Impact factor: 17.440

10.  Quality of life in the five years after intensive care: a cohort study.

Authors:  Brian H Cuthbertson; Siân Roughton; David Jenkinson; Graeme Maclennan; Luke Vale
Journal:  Crit Care       Date:  2010-01-20       Impact factor: 9.097

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