scholarly journals Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb

2015 ◽  
Vol 14 (3) ◽  
pp. 8861-8870 ◽  
Author(s):  
Y.Q. Jiang ◽  
Y.X. Zhu ◽  
X.L. Chen ◽  
X. Xu ◽  
F. Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Quality Adjusted Life Years ◽  
Lung Function Decline ◽  
Walk Distance ◽  
Life Years ◽  
Minute Walk Distance ◽  
Minute Walk ◽  
Quality Adjusted Life

scholarly journals Characteristics and health status of patients with and without confirmed HFpEF

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Deaton ◽  
F Forsyth ◽  
J Mant ◽  
D Edwards ◽  
R Hobbs ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cohort Study ◽  
Health Status ◽  
Functional Impairment ◽  
Funding Source ◽  
Walk Distance ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Aims Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF. Methods Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS). Results 151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (>5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales. Conclusions Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research

Utilities and Quality-Adjusted Life Years

1989 ◽  
Vol 5 (4) ◽  
pp. 559-575 ◽  
Author(s):  
George W. Torrance ◽  
David Feeny
Keyword(s):  
Quality Of Life ◽  
Cost Utility ◽  
Health Improvement ◽  
Quality Adjusted Life Years ◽  
Utility Analysis ◽  
Quality Adjustment ◽  
Life Years ◽  
Quality Adjusted Life ◽  
Broad Overview

Utilities and quality-adjusted life years (QALYs) are reviewed, with particular focus on their use in technology assessment. This article provides a broad overview and perspective on these two techniques and their interrelationship, with reference to other sources for details of implementation. The historical development, assumptions, strengths/weaknesses, and applications of each are summarized.Utilities are specifically designed for individual decision-making under uncertainty, but, with additional assumptions, utilities can be aggregated across individuals to provide a group utility function. QALYs are designed to aggregate in a single summary measure the total health improvement for a group of individuals, capturing improvements from impacts on both quantity of life and quality of life– with quality of life broadly defined. Utilities can be used as the quality-adjustment weights for QALYs; they are particularly appropriate for that purpose, and this combination provides a powerful and highly useful variation on cost-effectiveness analysis known as cost-utility analysis.

scholarly journals Manfaat Tai chi terhadap Pasien Penyakit Paru Obstruksi Kronis

2019 ◽  
Vol 10 (3) ◽  
pp. 208
Author(s):  
Qurratu Iffoura ◽  
Agung Waluyo
Keyword(s):  
Quality Of Life ◽  
Tai Chi ◽  
Complementary Therapy ◽  
Chronic Obstructive ◽  
Walk Distance ◽  
The World ◽  
St George's Respiratory Questionnaire ◽  
Minute Walk Distance ◽  
Minute Walk

The prevalence of Chronic Obstructive Pulmonary Disease (COPD) continues to increase in the world and predicted in 2030 to rank third in the world. COPD causes people to have difficulty breathing, limit mobility and lifestyle, and can cause more serious complications and lead to a decrease in quality of life. One of the nonpharmacological treatments that can be done is Tai chi a traditional Chinese mind-body exercise. Objective: This literature study aims to describe benefits of Tai chi in improving the quality of life of patients with COPD. Literature review was conducted from various sources such as CINAHL, MEDLINE, science Direct and proquest. Tai chi was a meditative martial art consisting of three basic concepts namely physical exercise, breathing techniques, and full awareness. Tai chi movements that were practiced vary, such as 24 movements which were or 6 movements that have been modified and simplified. Some of the benefits of doing Tai chi include increased muscle strength, reduced tightness, improved pulmonary function, increased 6-minute walk distance (6MWD) and increased St. George’s Respiratory Questionnaire (SGRQ) scores. Tai chi can be used as a complementary therapy in COPD patients according to their preferences and values. In addition this exercise can be recommended in patients with other chronic diseases. Keywords: Tai chi; COPD; complementary therapy ABSTRAK Prevalensi Penyakit Paru Obstruksi Kronis (PPOK) terus meningkat di dunia dan diprediksikan pada tahun 2030 akan menempati urutan ketiga di dunia. PPOK menyebabkan penderita sulit bernafas, membatasi mobilitas dan gaya hidup, serta dapat menyebabkan komplikasi yang lebih serius dan mengarah kepada penurunan kualitas hidup. Salah satu penatalaksanaan non farmakologis yang dapat dilakukan ialah Tai chi, latihan mind-body tradisional Tiongkok. Studi literatur ini bertujuan untuk menggambarkan manfaat Tai chi pada peningkatan kualitas hidup pada pasien PPOK. Penulusuran literature dilakukan dari berbagai sumber seperti CINAHL, MEDLINE, Science Direct dan proquest. Tai chi merupakan seni bela diri yang bersifat meditasi yang terdiri dari tiga konsep dasar yaitu latihan fisik, teknik pernapasan, dan kesadaran penuh. Gerakan Tai chi yang dipraktikkan bervariasi, seperti 24 gerakan Yang atau 6 gerakan yang telah dimodifikasi dan disederhanakan. Beberapa manfaat melakukan Tai chi seperti peningkatan kekuatan otot, mengurangi sesak, meningkatkan fungsi paru, meningkatkan 6-minute walk distance (6MWD) dan peningkatan skor St. George’s Respiratory Questionnaire (SGRQ). Tai chi dapat dijadikan terapi pelengkap pada pasien PPOK sesuai dengan preference dan nilai yang dimiliki individu. Latihan ini dapat direkomendasikan pada pasien penyakit kronis lainnya. Kata kunci: Tai chi; PPOK; terapi komplementer

Quality of life and quality-adjusted life years of chronic schistosomiasis mansoni patients in Brazil in 2015

2018 ◽  
Vol 112 (5) ◽  
pp. 238-244
Author(s):  
Gilmara Lima Nascimento ◽  
Ana Lúcia Coutinho Domingues ◽  
Ricardo Arraes de Alencar Ximenes ◽  
Alexander Itria ◽  
Luciane Nascimento Cruz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Quality Adjusted Life Years ◽  
Schistosomiasis Mansoni ◽  
Life Years ◽  
Quality Adjusted Life

scholarly journals The Use of “Quality-Adjusted Life Years” (QALYs) to Evaluate Treatment in Intensive Care

1995 ◽  
Vol 23 (3) ◽  
pp. 322-331 ◽  
Author(s):  
R. K. Kerridge ◽  
P. P. Glasziou ◽  
K. M. Hillman
Keyword(s):  
Quality Of Life ◽  
Patient Outcome ◽  
Intensive Care ◽  
Pulmonary Oedema ◽  
Trauma Patients ◽  
Quality Adjusted Life Years ◽  
Economic Justification ◽  
Life Years ◽  
Quality Adjusted Life

This study examines the feasibility of using Quality-Adjusted Life Years (QALYs) to assess patient outcome and the economic justification of treatment in an Intensive Care Unit (ICU). 248 patients were followed for three years after admission. Survival and quality of life for each patient was evaluated. Outcome for each patient was quantified in discounted Quality-Adjusted Life Years (dQALYs). The economic justification of treatment was evaluated by comparing the total and marginal cost per dQALY for this patient group with the published cost per QALY for other medical interventions. 150 patients were alive after three years. Quality of life for most longterm survivors was good. Patient outcome (QALYs) was greatest for asthma and trauma patients, and least for cardiogenic pulmonary oedema. The tentative estimated cost- effectiveness of treatment varied from AUD $297 per QALY for asthma to AUD $2323 per QALY for patients with pulmonary oedema. This compares favourably with many preventative and non-acute medical treatments. Although the methodology is developmental, the measurement of patient outcome using QALYs appears to be feasible in a general hospital ICU.

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

2014 ◽  
Vol 13 (2) ◽  
pp. 178-188 ◽  
Author(s):  
Zarina S. Ali ◽  
Robert L. Bailey ◽  
Lawrence B. Daniels ◽  
Venus Vakhshori ◽  
Daniel J. Lewis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Surgical Approaches ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Subtotal Removal ◽  
Quality Adjusted Life

Object No clear treatment guidelines for pediatric craniopharyngiomas exist. The authors developed a decision analytical model to evaluate outcomes of 4 surgical approaches for craniopharyngiomas in children, including attempted gross-total resection (GTR), planned subtotal removal plus radiotherapy, biopsy plus radiotherapy, and endoscopic resections of all kinds. Methods Pooled data, including the authors' own experience, were used to create evidence tables, from which incidence, relative risks, and summary outcomes in quality-adjusted life years (QALYs) were calculated for the 4 management strategies. Results Quality-adjusted life years at the 5-year follow-up were 2.3 ± 0.1 for attempted GTR, 2.9 ± 0.2 for planned subtotal removal plus radiotherapy, 3.9 ± 0.2 for biopsy plus radiotherapy, and 3.7 ± 0.2 for endoscopic resection (F = 17,150, p < 0.001). Similarly, QALYs at 10-year follow-up were 4.5 ± 0.2 for attempted GTR, 5.7 ± 0.5 for planned subtotal removal plus radiotherapy, and 7.8 ± 0.5 for biopsy plus radiotherapy (F = 6,173, p < 0.001). On post hoc pairwise comparisons, the differences between all pairs compared were also highly significant (p < 0.001). Since follow-up data at 10 years are lacking for endoscopic cases, this category was excluded from 10-year comparisons. Conclusions Biopsy with subsequent radiotherapy is the preferred approach with respect to improved overall quality of life. While endoscopic approaches also show promise in preserving quality of life at five-year follow-up, there are not sufficient data to draw conclusions about this comparison at 10 years.

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