scholarly journals Concordance among Swedish, German, Danish, and UK EQ-5D-3L Value Sets: Analyses of Patient-Reported Outcomes in the Swedish Hip Arthroplasty Register

2021 ◽  
Vol 10 (18) ◽  
pp. 4205
Author(s):  
Fitsum Sebsibe Teni ◽  
Ola Rolfson ◽  
Jenny Berg ◽  
Reiner Leidl ◽  
Kristina Burström
Keyword(s):  
Hip Arthroplasty ◽  
Arthroplasty Register ◽  
Patient Reported ◽  
Before And After ◽  
Value Sets ◽  
Using Data ◽  
Mean Differences ◽  
The Uk ◽  
Eq Vas

Background: Application of different value sets to health-related quality of life (HRQoL) measured with the EQ-5D-3L may lead to different results due to differences in methods, perspectives, and countries used. Focusing on concordance, this study aimed at understanding the implications of applying EQ-5D-3L value sets from Sweden, Germany, Denmark, and the UK to evaluate HRQoL of patients undergoing total hip replacement (THR) in Sweden before and after surgery. Methods: We performed a longitudinal study of patients in the Swedish Hip Arthroplasty Register from preoperative stage to 1-year follow-up (n = 73,523) using data collected from 2008 to 2016. Eight EQ-5D-3L value sets from the four countries were compared based on a valuation method (visual analogue scale (VAS) or time trade-off (TTO)), perspective (experience-based or hypothetical), and country. Concordance among the value sets with patient-reported EQ VAS score was also assessed. Longitudinal changes in EQ-5D-3L index over the 1-year follow-up were compared across value sets by method, perspective, and country. Results: Value sets based on the same method and perspective showed higher concordance in EQ-5D-3L index at both measurement time points than other comparisons. In the comparisons by perspective, VAS value sets showed higher concordance than TTO value sets. The Swedish VAS and the Danish TTO value sets showed the highest levels of concordance with patient-reported EQ VAS scores. Generally, value sets based on the same method and perspective had the smallest mean differences between changes in EQ-5D-3L indices from preoperative to 1-year postoperative follow-up. Conclusion: Among THR patients value sets based on the same method and perspective, a direct transfer of results across countries could be meaningful. In cases of differences in methods and perspectives among value sets, transfer of value sets across settings would have to consider conversion through crosswalk.

Abstract 11: Comparison of Patient Reported Angina with Provider Assigned Canadian Cardiovascular Society Angina Class Before and After Revascularization

2016 ◽  
Vol 9 (suppl_2) ◽  
Author(s):  
Michael E Nassif ◽  
David J Cohen ◽  
Suzanne V Arnold ◽  
Mohammed Qintar ◽  
Michael E Farkouh ◽  
...  
Keyword(s):  
Coronary Disease ◽  
Symptom Burden ◽  
Canadian Cardiovascular Society ◽  
Chi Square ◽  
Critical Determinant ◽  
Patient Reported ◽  
Before And After ◽  
Angina Frequency ◽  
Using Data

Background: The Canadian Cardiovascular Society (CCS) classification system for angina is a critical determinant of revascularization appropriateness. A major limitation of CCS is that it rates patients’ symptoms from the perspective of providers, rather than patients themselves. Accordingly, we sought to evaluate the correlation of physician-assigned CCS class with patient-reported Seattle Angina Questionnaire (SAQ), before and after revascularization. Methods: Using data from the FREEDOM trial, which randomized 1900 patients from over 160 international sites to either PCI or CABG, CCS was reported by physicians and the SAQ was completed by patients prior to randomization and 1 year later. SAQ angina frequency (SAQ AF) scores were considered to correspond to CCS class per the following: SAF AF: 100=CCS 0, 61-99=CCS I, 31-60=CCS II, 0-30=CCS III/IV. Agreement between physician- and patient-reported angina categories was compared using chi square tests. Results: Among 1640 patients who had CCS and SAQ data at both baseline and 1-year, the mean age was 63.1 years, 71% were male, and 83% had 3-vessel coronary disease. Before revascularization, physicians correctly reported the burden of angina in 25.5% of patients and overestimated the burden of angina in 62.1%. Among 1194 patients who reported monthly or no angina, 229 (19.2%) were classified by their physicians as having CCS III/IV. In contrast, at follow-up, 71.2% of patients had their angina correctly estimated by their physicians and only 0.6% among the 1568 patients with monthly/no angina were assigned CCS III/IV by their physicians. Among the 28.8% misclassified by CCS at 1 year, 20.8% had less angina than reported by physicians and 8.0% had more (Figure; p=0.01). Findings were similar when the analysis was repeated in patients who were treated with PCI or CABG. Conclusions: In a large cohort of patients with stable coronary disease undergoing revascularization, clinicians often overestimated the amount of angina patients were having prior to revascularization but were significantly more accurate at follow-up. Given that importance placed on CCS for enrollment in clinical trials, or assigning appropriateness of revascularization in clinical practice, using patient-reported symptom burden as a more unbiased measure should be considered.

scholarly journals Variations in Patients’ Overall Assessment of Their Health Across and Within Disease Groups Using the EQ-5D Questionnaire: Protocol for a Longitudinal Study in the Swedish National Quality Registers

10.2196/27669 ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. e27669
Author(s):  
Fitsum Sebsibe Teni ◽  
Ola Rolfson ◽  
Nancy Devlin ◽  
David Parkin ◽  
Emma Nauclér ◽  
...  
Keyword(s):  
General Population ◽  
Data Retrieval ◽  
Health State ◽  
Health States ◽  
National Quality ◽  
Patient Reported ◽  
Patient Groups ◽  
Value Sets ◽  
Eq Vas

Background EQ-5D is one of the most commonly used questionnaires to measure health-related quality of life. It is included in many of the Swedish National Quality Registers (NQRs). EQ-5D health states are usually summarized using “values” obtained from members of the general public, a majority of whom are healthy. However, an alternative, which remains to be studied in detail, is the potential to use patients’ self-reported overall health on the visual analog scale (VAS) as a means of capturing experience-based perspective. Objective The aim of this study is to assess EQ VAS as a valuation method with an experience-based perspective through comparison of its performance across and within patient groups, and with that of the general population in Sweden. Methods Data on nearly 700,000 patients from 12 NQRs covering a variety of diseases/conditions and nearly 50,000 individuals from the general population will be analyzed. The EQ-5D-3L data from the 12 registers and EQ-5D-5L data from 2 registers will be used in the analyses. Longitudinal studies of patient-reported outcomes among different patient groups will be conducted in the period from baseline to 1-year follow-up. Descriptive statistics and analyses comparing EQ-5D dimensions and observed self-assessed EQ VAS values across and within patient groups will be performed. Comparisons of the change in health state and observed EQ VAS values at 1-year follow-up will also be undertaken. Regression models will be used to assess whether EQ-5D dimensions predict observed EQ VAS values to investigate patient value sets in each patient group. These will be compared across the patient groups and with the existing Swedish experience-based VAS and time trade-off value sets obtained from the general population. Results Data retrieval started in May 2019 and data of patients in the 12 NQRs and from the survey conducted among the general population have been retrieved. Data analysis is ongoing on the retrieved data. Conclusions This research project will provide information on the differences across and within patient groups in terms of self-reported health status through EQ VAS and comparison with the general population. The findings of the study will contribute to the literature by exploring the potential of self-assessed EQ VAS values to develop value sets using an experience-based perspective. Trial Registration ClinicalTrials.gov NCT04359628; https://clinicaltrials.gov/ct2/show/NCT04359628. International Registered Report Identifier (IRRID) DERR1-10.2196/27669

scholarly journals Variations in Patients’ Overall Assessment of Their Health Across and Within Disease Groups Using the EQ-5D Questionnaire: Protocol for a Longitudinal Study in the Swedish National Quality Registers (Preprint)

2021 ◽  
Author(s):  
Fitsum Sebsibe Teni ◽  
Ola Rolfson ◽  
Nancy Devlin ◽  
David Parkin ◽  
Emma Nauclér ◽  
...  
Keyword(s):  
General Population ◽  
Data Retrieval ◽  
Health State ◽  
Health States ◽  
National Quality ◽  
Patient Reported ◽  
Patient Groups ◽  
Value Sets ◽  
Eq Vas

BACKGROUND EQ-5D is one of the most commonly used questionnaires to measure health-related quality of life. It is included in many of the Swedish National Quality Registers (NQRs). EQ-5D health states are usually summarized using “values” obtained from members of the general public, a majority of whom are healthy. However, an alternative, which remains to be studied in detail, is the potential to use patients’ self-reported overall health on the visual analog scale (VAS) as a means of capturing experience-based perspective. OBJECTIVE The aim of this study is to assess EQ VAS as a valuation method with an experience-based perspective through comparison of its performance across and within patient groups, and with that of the general population in Sweden. METHODS Data on nearly 700,000 patients from 12 NQRs covering a variety of diseases/conditions and nearly 50,000 individuals from the general population will be analyzed. The EQ-5D-3L data from the 12 registers and EQ-5D-5L data from 2 registers will be used in the analyses. Longitudinal studies of patient-reported outcomes among different patient groups will be conducted in the period from baseline to 1-year follow-up. Descriptive statistics and analyses comparing EQ-5D dimensions and observed self-assessed EQ VAS values across and within patient groups will be performed. Comparisons of the change in health state and observed EQ VAS values at 1-year follow-up will also be undertaken. Regression models will be used to assess whether EQ-5D dimensions predict observed EQ VAS values to investigate patient value sets in each patient group. These will be compared across the patient groups and with the existing Swedish experience-based VAS and time trade-off value sets obtained from the general population. RESULTS Data retrieval started in May 2019 and data of patients in the 12 NQRs and from the survey conducted among the general population have been retrieved. Data analysis is ongoing on the retrieved data. CONCLUSIONS This research project will provide information on the differences across and within patient groups in terms of self-reported health status through EQ VAS and comparison with the general population. The findings of the study will contribute to the literature by exploring the potential of self-assessed EQ VAS values to develop value sets using an experience-based perspective. CLINICALTRIAL ClinicalTrials.gov NCT04359628; https://clinicaltrials.gov/ct2/show/NCT04359628. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/27669

scholarly journals Total Hip Arthroplasty: Minimal Clinically Important Difference and Patient Acceptable Symptom State for the Forgotten Joint Score 12

2021 ◽  
Vol 18 (5) ◽  
pp. 2267
Author(s):  
Umile Giuseppe Longo ◽  
Sergio De Salvatore ◽  
Ilaria Piergentili ◽  
Anna Indiveri ◽  
Calogero Di Naro ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Validity And Reliability ◽  
Total Hip ◽  
Forgotten Joint Score ◽  
Post Surgery ◽  
Clinically Important Difference ◽  
Patient Reported ◽  
Patient Acceptable Symptom State

The Forgotten Joint Score-12 (FJS-12) is a valid patient-reported outcome measures (PROMs) used to assess prosthesis awareness during daily activities after total hip arthroplasty (THA). The minimum clinically important difference (MCID) can be defined as the smallest change or difference that is evaluated as beneficial and could change the patient’s clinical management. The patient acceptable symptom state (PASS) is considered the minimum PROMs cut-off value that corresponds to a patient’s satisfactory state of health. Despite the validity and reliability of the FJS-12 having been already demonstrated, the MCID and the PASS of this score have not previously been defined. Patients undergoing THA from January 2019 to October 2019 were assessed pre-operatively and six months post-surgery using the FJS-12, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Hip Score (OHS). Pre-operative and follow-up questionnaires were completed by 50 patients. Both distribution-based approaches and anchor approaches were used to estimate MCID. The aim of this paper was to assess the MCID and PASS values of FJS-12 after total hip replacement. The FJS-12 MCID from baseline to 6 months post-operative follow-up was 17.5. The PASS calculated ranged from 69.8 to 91.7.

scholarly journals SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  
Keyword(s):  
Wound Healing ◽  
Local Anaesthetic ◽  
Surrogate Endpoints ◽  
Incision And Drainage ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After ◽  
The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p < 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

Does improved radiographic alignment truly enhance dynamic functional balance?

2021 ◽  
Author(s):  
R Haddas ◽  
S Kisinde ◽  
D Mar ◽  
I Lieberman
Keyword(s):  
Patient Reported Outcomes ◽  
Added Value ◽  
Functional Balance ◽  
Radiographic Measurements ◽  
Patient Reported ◽  
Before And After ◽  
Gait Abnormalities ◽  
The Relationship ◽  
Radiographic Alignment

Prospective, concurrent-cohort study. To establish the relationship between radiographic alignment parameters and functional CoE measurements at one week before and at three months after realignment surgery in ADS patients. Adult degenerative scoliosis (ADS) represents a significant healthcare burden with exceedingly high and increasing prevalence, particularly among the elderly. Radiographic alignment measures and patient-reported outcomes currently serve as the standard means to assess spinal alignment, deformity, and stability. Neurological examinations have served as qualitative measures for indicating muscle strength, motor deficits, and gait abnormalities. Three-Dimensional motion analysis is increasingly being used to identify and measure gait and balance instability. Recently, techniques have been established to quantify balance characteristics described by Dubousset as the “cone of economy” (CoE). The relationship between radiographic alignment parameters and CoE balance measures of ADS patients before and after realignment surgery is currently unknown. 29 ADS patients treated with realignment surgery. Patients were evaluated at one week before realignment surgery and at their three-month follow-up examination. During each evaluation, patients completed self-reported outcomes (visual analog scales for pain, Oswestry Disability Index, SRS22r) and a functional balance test. Mean changes in dependent measures from before to after surgery were compared using paired t-tests. Pearson correlations were used to test for significant correlations between changes in radiographic and CoE measures. Significant improvements were found for all patient-reported outcomes, in several radiographic measures, and in CoE measures. Improvements of scoliosis Cobb angle, coronal pelvic tilt, lumbar lordosis, and thoracic kyphosis showed significant correlations with CoE sway and total distance measures at both the center of mass and center of the head. Improved radiographic alignment measures significantly correlated with improved CoE balance measures among ADS patients treated with realignment surgery at their three-month follow-up. These findings indicate that functional balance evaluations when used in conjunction with radiographic measurements, may provide a more robust and improved patient-specific sensitivity for postoperative assessments. CoE balance may represent a new measure of added value for surgical intervention of ADS.

scholarly journals Feasibility of Collecting Multiple Patient-Reported Outcome Measures Alongside the Dutch Arthroplasty Register

2019 ◽  
Vol 7 (4) ◽  
pp. 484-492
Author(s):  
Claire Tilbury ◽  
Claudia S Leichtenberg ◽  
Bart L Kaptein ◽  
Lennard A Koster ◽  
Suzan H M Verdegaal ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Short Form ◽  
Response Rates ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Participation Rates ◽  
Arthroplasty Register ◽  
Patient Reported ◽  
Lost To Follow Up

Background: Compliance rates with patient-reported outcome measures (PROMs) collected alongside arthroplasty registries vary in the literature. We described the feasibility of a routinely collected set PROMs alongside the Dutch Arthroplasty Register. Methods: The longitudinal Leiden Orthopaedics Outcomes of OsteoArthritis Study is a multicenter (7 hospitals), observational study including patients undergoing total hip or total knee arthroplasty (THA or TKA). A set of PROMs: Short Form-12, EuroQol 5 Dimensions, Hip/Knee injury and Osteoarthritis Outcome Score, Oxford Hip/Knee Score was collected preoperatively and at 6, 12, 24 months, and every 2 years thereafter. Participation rates and response rates were recorded. Results: Between June 2012 and December 2014, 1796 THA and 1636 TKA patients were invited, of whom 1043 THA (58%; mean age 68 years [standard deviation, SD: 10]) and 970 TKA patients (59%; mean age 71 years [SD 9.5]) participated in the study. At 6 months, 35 THA/38 TKA patients were lost to follow-up. Response rates were 90% for THA (898/1000) and 89% for TKA (827/932) participants. At 1 and 2 years, 8 and 18 THA and 17 and 11 TKA patients were lost to follow-up, respectively. The response rates among those eligible were 87% (866/992) and 84% (812/972) for THA and 84% (771/917) and 83% (756/906) for TKA patients, respectively. The 2-year questionnaire was completed by 78.5% of the included THA patients and by 77.9% of the included TKA patients. Conclusions: About 60% of patients undergoing THA or TKA complete PROMs preoperatively, with more than 80% returning follow-up PROMs. To increase the participation rates, more efforts concerning the initial recruitment of patients are needed.

Importance of Retaining Sufficient Acetabular Depth: Successful 2-Year Outcomes of Hip Arthroscopy for Patients With Pincer Morphology as Compared With Matched Controls

2020 ◽  
Vol 48 (10) ◽  
pp. 2471-2480 ◽  
Author(s):  
Claudia R. Brick ◽  
Catherine J. Bacon ◽  
Matthew J. Brick
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoroacetabular Impingement ◽  
Hip Arthroplasty ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Control Group ◽  
Total Hip ◽  
Patient Reported ◽  
Acetabular Overcoverage

Background: Patients with pincer-type femoroacetabular impingement are commonly treated with arthroscopic reduction of acetabular depth as measured by the lateral center-edge angle (LCEA). The optimal amount of rim reduction has not been established, although large resections may increase contact pressures through the hip. A recent publication demonstrated inferior surgical outcomes in patients with acetabular overcoverage as compared with normal acetabular coverage. Casual observation of our database suggested equivalent improvements, prompting a similar analysis. Purpose: To analyze patient-reported outcomes after hip arthroscopy for femoroacetabular impingement in patients with acetabular overcoverage who were matched with controls with normal coverage, as well as to analyze associations with reduction in LCEA. Study Design: Cohort study; Level of evidence, 3. Methods: Data were collected prospectively from patients with a minimum 2-year follow-up after receiving hip arthroscopy for femoroacetabular impingement by a single surgeon. Cases were reviewed to identify those with pincer-type morphology (LCEA >40°) and matched according to sex, age, chondral damage, and surgery date in a 1:1 ratio with controls with an LCEA of 25° to 40°. The surgical goal was to reduce the LCEA to the upper end of the normal range with minimal rim resection, usually 35° to 37°. Radiographic measurements of coverage, intraoperative findings, procedures, and patient-reported outcomes were recorded, including the 12-Item International Hip Outcome Tool, Non-arthritic Hip Score, Hip Disability and Osteoarthritis Outcome Score, visual analog scale for pain, rates of revision or reoperation, and conversion to total hip arthroplasty. Results: A total of 114 hips (93 patients) for the pincer group were matched 1:1 from 616 hips (541 patients) for the control group. The pincer group (mean ± SD age, 34.5 ± 12.2 years) did not differ in age, body mass index, or follow-up from controls. LCEA was reduced in both groups pre- to postoperatively: the pincer group from 44.0° ± 2.8° to 34.2° ± 3.5° and the controls from 32.9° ± 3.9° to 31.0° ± 3.0°. No differences in improvement were observed: iHOT-12 improved by 35.7 points in both groups ( P = .9 for analysis of variance interaction) and Nonarthritic Hip Score by 22.3 points ( P = .6). From all eligible surgical procedures, 2-year follow up rates were 2.5% and 2.6% for the pincer and control cohorts, respectively, and 1.2% and 0.3% for conversion to total hip arthroplasty. Conclusion: Arthroscopic management of acetabular overcoverage can achieve excellent results, equivalent to arthroscopy for other causes of symptomatic femoroacetabular impingement. A key finding was smaller rim resections producing a mean postoperative LCEA of 34.2° with a small standard deviation.

Effect of marital status on patient-reported outcomes following total hip arthroplasty: a matched analysis with minimum 2-year follow-up

2019 ◽  
pp. 112070001986401
Author(s):  
Ajay C Lall ◽  
Garrett R Schwarzman ◽  
Muriel R Battaglia ◽  
Sarah L Chen ◽  
David R Maldonado ◽  
...  
Keyword(s):  
Marital Status ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Psychosocial Support ◽  
Short Form ◽  
Harris Hip Score ◽  
Never Married ◽  
Total Hip ◽  
Patient Reported

Introduction: Mental health and patient expectation have been identified as key predictors of recovery following THA; however, there is limited literature examining the effects of social support and marital status on patient-reported outcomes (PROs). Methods: Data were prospectively collected and retrospectively reviewed for patients who underwent THA between July 2008 and January 2016. Patients were included if they underwent primary THA during this period and if they had documented preoperative marital status of married, divorced, or never married. Married patients were group matched to non-married patients (divorced or never married) with similar sex, age, body mass index (BMI), gender distribution, and frequency of surgical approach. Results: There were 414 married patients and 98 non-married patients who were eligible and had minimum 2-year follow-up. Mean PROs were significantly worse in the non-married group than the married group for the following measures: modified Harris Hip Score ( p = 0.002), Harris Hip Score ( p = 0.002), Forgotten Joint Score ( p = 0.04), and the physical portions of the Veterans RAND ( p = 0.025) and Short Form ( p = 0.02) surveys. Conclusions: Our study demonstrated inferior absolute PRO scores at latest follow-up for patients who were non-married compared to married following THA. These results show that while total hip replacement may still yield clinical benefit in all patients, non-married patients may ultimately achieve an inferior functional status, and expectations should be adjusted accordingly. Physicians should assess levels of psychosocial support in their patients prior to undergoing hip arthroplasty in order to optimise results.

Sign in / Sign up

Export Citation Format

Share Document