Measuring the impact of dysphonia on quality of life using health state preferences

2020 ◽  
Vol 130 (4) ◽  
Author(s):  
Matthew R. Naunheim ◽  
Leanne Goldberg ◽  
Jennifer B. Dai ◽  
Benjamin J. Rubinstein ◽  
Mark S. Courey
2020 ◽  
Vol 17 (34) ◽  
pp. 867-873
Author(s):  
Dhfer ALSHAYBAN ◽  
Royes JOSEPH

Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0036
Author(s):  
Christopher G. Neville ◽  
Judith F. Baumhauer ◽  
Jeff Houck

Category: Other Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes in quality of life. Methods: The PROMIS PF scale was available at the start and end of physical therapy treatment for 352 patients with foot and ankle ICD10 codes. PF was chosen as a good outcome measure to assess overall outcome from physical therapy care. Changes from baseline to post-care were examine using Cohen’s d to remove dependence on sample size and was interpreted as d=0.20 as a small effect, d=0.05 as a medium effect, and d=0.80 as a large effect. Using available isotonic regression with linear interpolation functions, health state utility scores were calculated from the PROMIS PF scores. These scores represent a health state between 0, representing ‘being dead’, and 1 being the utility of ‘full health’. This methodology has been shown to be reliable and valid for assessing overall health quality of life from changes in physical function. Repeated measures ANOVA models were used to compare outcomes across time. Results: A significant improvement (p<0.01) in PF scores was seen across the sample following physical therapy (PF t-score; baseline 38.6+-8.8; follow-up 45+-9.1). This change was associated with a moderate to large ES of 0.75. The average ES for those subjects with a starting t-score less than 45 (n=294) was 0.86 (large effect) while for those with a starting t-score of greater than 45 (n=58) was 0.27 (small effect). There was also a significant (p<0.01) improvement in utility scores following physical therapy (utility score; baseline 0.58+-0.2; follow-up 0.72+-0.2). Conclusion: There is a general improvement in reported physical function following physical therapy but the magnitude of this effect depends on baseline function. Lower function is associated with greater changes. Improvement in physical function was associated with an overall improvement in quality of life. The non-linear nature of utility scores suggests some patients may have large increases in quality of life with small changes in physical function.


2016 ◽  
Vol 37 (3) ◽  
pp. 252-261
Author(s):  
Eleanor M. Pullenayegum ◽  
Kelly M. Sunderland ◽  
Jeffrey A. Johnson ◽  
Feng Xie ◽  

Background. Health state preferences vary among countries, and country-specific value sets are important in health care reimbursement decisions. When decisions are made at the regional level, regional variation in health state preferences may be important. We propose that shrinkage analysis and Bland-Altman plots can be a helpful way to investigate regional variation. Methods. The presence of regional variation can be investigated by introducing interactions between regions and the regression coefficients in the scoring algorithm. When variation is present, regional scoring algorithms can be derived through shrinkage analysis. The impact of using regional algorithms in place of the national algorithm can be investigated using simulation and illustrated using Bland-Altman plots. We applied this methodological approach to the Canadian EQ-5D-5L valuation study, which used time-tradeoff (TTO) tasks to elicit health state preferences from 1073 participants from 4 regions (Alberta, British Columbia, Ontario, and Quebec). Results. There were statistically significant interactions between the fixed effects of the scoring algorithm and region. On computing regional scoring algorithms and applying them to the EQ-5D-5L health states reported by our population, the mean utility using the Canada-wide scoring algorithm was 0.87 (standard error, 0.0013), compared to 0.85 (0.0013) on using the algorithm for Alberta, 0.80 (0.0013) on using the algorithm for British Columbia, 0.91 (0.0013) for Ontario, and 0.89 (0.0014) for Quebec. Conclusions. When health care falls under regional jurisdiction, shrinkage estimators can be used to generate regional scoring algorithms for the EQ-5D-5L and Bland-Altman plots used to assess the importance of regional variation in health state preferences. Our results suggest that mean health state preferences vary among Canada’s regions and make a sizable impact on estimates of population mean utility.


2017 ◽  
Vol 90 (1) ◽  
pp. 49-53
Author(s):  
Nicolae Petre ◽  
Daniela Homorodean ◽  
Carmen Monica Pop

Background and aim. In the last two and a half decades the dynamics of tuberculosis has been modelled by social and economic conditions, with consequences on the life style, and effects on the onset and evolution of the disease. The Jiu Valley is an area with social problems: mining, mines closing down and ceasing activity, poverty. We looked for a relationship between changes of life style in the Jiu Valley and the dynamics of tuberculosis.Methods. We studied 528 patients who asked for medical services in different hospitals in the Jiu Valley between 2010-2013. We structurally characterized this group, we identified the characteristics of life style, and we assessed the health state, in particular the relation with tuberculosis.Results. We found out that the quality of life was influenced by the health state, especially by tuberculous disease. Quality of life was influenced by the life style, professional factors and their long term consequences. The study evidenced a strong relationship between apparently very different factors such as life style, professional factors on one side and those characterizing tuberculosis.Conclusions. We report the first detailed epidemiological data on tuberculosis in an economically poor area, the Jiu Valley.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Daniela Viramontes Horner ◽  
Fiona Willingham ◽  
Zoe Pittman ◽  
Nicholas Selby ◽  
Maarten Taal

Abstract Background and Aims Health-related quality of life (HRQoL) is severely impaired in dialysis patients compared to the general population. Previous studies have shown that malnutrition, a frequent complication and independent risk factor for mortality in the dialysis population, is associated with poor HRQoL. However, there is no published evidence regarding the impact of malnutrition on change in HRQoL over time. We sought to determine the most important predictors of poor HRQoL as well as the determinants of change in HRQoL over time in dialysis patients, with a particular focus on malnutrition. Method We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in a 1-year single-centre prospective observational study. HRQoL was assessed using the physical and mental component scores (PCS and MCS, respectively) from the 36-Item Short Form Health Survey and the health state and visual analogue scores from the European Quality of Life 5-Dimensions (EQ5D) questionnaire. The 7-point scale Subjective Global Assessment (SGA) was performed to evaluate nutritional status. Energy, protein and fat intake, biochemical variables, anthropometric measurements and handgrip strength (HGS) were also measured. All study assessments were performed at baseline, 6 and 12 months. Results Mean age was 64±14 years. Malnutrition was present in 37% of the population (as determined by 7-point SGA). Patients with malnutrition and diabetes had significantly lower MCS, PCS and EQ5D scores compared to well-nourished and non-diabetic patients, respectively. At baseline, chronological age, serum albumin, energy and protein intake, and HGS correlated positively with PCS and EQ5D health state score. Multivariable analysis at baseline identified malnutrition as the strongest independent predictor of decreased HRQoL, after adjusting for confounders (Table 1). Patients who stayed or became malnourished during one year showed a significant decrease in MCS, PCS and EQ5D health state score at 12 months compared to baseline. This same group of patients had significantly lower MCS, PCS and EQ5D scores at baseline and 12 months compared to those who stayed or became well-nourished during one year. Prevalent/development of malnutrition was independently and significantly associated with the 1-year decrease in MCS and EQ5D health state score. In addition, a decrease in serum total protein and dietary protein intake (markers of malnutrition) were identified as independent determinants of 1-year decrease in MCS, PCS and EQ5D health state score. Conclusion We observed in this prospective observational study that presence of malnutrition was the most important and strongest independent predictor of decreased HRQoL in this dialysis population. Furthermore, prevalence/development of malnutrition and a decrease in markers of nutritional status were independently associated with a decrease in some HRQoL scores over 1 year. These findings strengthen the importance of undertaking screening to identify malnutrition, and providing specialised, individualised nutritional advice to all dialysis patients in order to prevent and/or improve nutritional status. Future studies with larger sample sizes, longer follow-up, and which include evaluation of barriers to effective nutritional interventions are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S636-S636
Author(s):  
Matthew Pichiello ◽  
Meghan McDarby ◽  
Elissa K Kozlov ◽  
Brian Carpenter

Abstract Adult children often help older parents make medical decisions when their health is compromised. To do so in a way that respects parent values requires children to know how their parent views health states and consequent quality of life. The current study compared older parent and adult child valuations of quality of life in different health contexts. Families consisted of older parents (n = 37) and their adult children (n = 66). Parents rated perceived quality of life in 14 compromised health states on a scale from 1 (difficult but acceptable) to 5 (not worth living). Children estimated how their parent responded to each health state, yielding an index of their knowledge of parent perceptions. Overall, parents described all compromised health states as less acceptable than adult children thought they would, t(99) = 2.19, p &lt; .05. Notably, parents believed situations that caused financial or emotional burden to their family were much less acceptable than their children estimated. Children were more knowledgeable about parent valuations for more extreme circumstances, such as living with a feeding tube. Within families, children demonstrated only slight knowledge about parent quality of life valuations (kappa = .081). Across the entire sample of families, there was a broad range of knowledge (kappas = -.181 – .351), but at best, knowledge was still only fair. Results from this study suggest that adult children may underestimate the impact of compromised health states on parent estimations of quality of life, which could affect collaborations on healthcare decisions.


Rheumatology ◽  
2021 ◽  
Author(s):  
Ting Zhao ◽  
Tania Winzenberg ◽  
Dawn Aitken ◽  
Barbara de Graaff ◽  
Hasnat Ahmad ◽  
...  

Abstract Objective To investigate the impact of total number and patterns of comorbidities on health-related quality of life (HRQoL) and identify the most prevalent and influential comorbidity patterns in people with osteoarthritis (OA) over ten years. Methods Participants from the Tasmanian Older Adult Cohort aged 50-80 years, with self-reported OA and data on comorbidities and HRQoL were included. Participants were interviewed at baseline (n = 398), 2.5-years (n = 304), 5-years (n = 269) and 10-years (n = 191). Data on the self-reported presence of 10 chronic comorbidities were collected at baseline. HRQoL was assessed using the Assessment of Quality of Life-4-Dimensions. The long-term impacts of the number and of the nine most prevalent combinations of cardiovascular (CVD), non-OA musculoskeletal (Ms), metabolic, and respiratory comorbidities on HRQoL over ten years were analysed using linear mixed regressions. Results Compared with comorbidity-free OA participants, the health state utility (HSU) of those with 2 or ≥ 3 comorbidities was respectively -0.07 and -0.13 units lower over ten years, largely driven by reduced scores for independent living, social relationships and psychological wellness. Comorbidity patterns including ‘CVD+Ms’ were most influential, and associated with up to 0.13 units lower HSU, mostly through negative impacts on independent living (up to -0.12), psychological wellness (up to -0.08) and social relationship (up to -0.06). Conclusion Having more comorbidities negatively impacted OA patients’ long-term HRQoL. OA patients with CVD and non-OA musculoskeletal conditions had the largest HSU impairment, therefore optimal management and prevention of these conditions may yield improvements in OA patients’ HRQoL.


2015 ◽  
Vol 6 (4) ◽  
pp. 306-313 ◽  
Author(s):  
Matthew D. Alvin ◽  
Jacob A. Miller ◽  
Daniel Lubelski ◽  
Amy S. Nowacki ◽  
Judith Scheman ◽  
...  

2020 ◽  
Vol 14 (10) ◽  
pp. e0008761
Author(s):  
Carolina Rosadas ◽  
Tatiane Assone ◽  
Marina Yamashita ◽  
Adine Adonis ◽  
Marzia Puccioni-Sohler ◽  
...  

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