Evidence of disagreement between patient-perceived change and conventional longitudinal evaluation of change in health-related quality of life among older adults

McPhail, Steven, Comans, Tracy and Haines, Terry (2010) Evidence of disagreement between patient-perceived change and conventional longitudinal evaluation of change in health-related quality of life among older adults. Clinical Rehabilitation, 24 11: 1036-1044. doi:10.1177/0269215510371422


Author McPhail, Steven
Comans, Tracy
Haines, Terry
Title Evidence of disagreement between patient-perceived change and conventional longitudinal evaluation of change in health-related quality of life among older adults
Journal name Clinical Rehabilitation   Check publisher's open access policy
ISSN 0269-2155
1477-0873
Publication date 2010-11
Sub-type Article (original research)
DOI 10.1177/0269215510371422
Volume 24
Issue 11
Start page 1036
End page 1044
Total pages 9
Place of publication London, U.K.
Publisher Sage Publications
Collection year 2011
Language eng
Abstract Objective: To identify agreement levels between conventional longitudinal evaluation of change (post—pre) and patient-perceived change (post—then test) in health-related quality of life. Design: A prospective cohort investigation with two assessment points (baseline and six-month follow-up) was implemented. Setting: Community rehabilitation setting. Subjects: Frail older adults accessing community-based rehabilitation services. Intervention: Nil as part of this investigation. Main measures: Conventional longitudinal change in health-related quality of life was considered the difference between standard EQ-5D assessments completed at baseline and follow-up. To evaluate patient-perceived change a ‘then test’ was also completed at the follow-up assessment. This required participants to report (from their current perspective) how they believe their health-related quality of life was at baseline (using the EQ-5D). Patient-perceived change was considered the difference between ‘then test’ and standard follow-up EQ-5D assessments. Results: The mean (SD) age of participants was 78.8 (7.3). Of the 70 participants 62 (89%) of data sets were complete and included in analysis. Agreement between conventional (post—pre) and patient-perceived (post—then test) change was low to moderate (EQ-5D utility intraclass correlation coefficient (ICC) = 0.41, EQ-5D visual analogue scale (VAS) ICC = 0.21). Neither approach inferred greater change than the other (utility P =0.925, VAS P =0.506). Mean (95% confidence interval (CI)) conventional change in EQ-5D utility and VAS were 0.140 (0.045,0.236) and 8.8 (3.3,14.3) respectively, while patient-perceived change was 0.147 (0.055,0.238) and 6.4 (1.7,11.1) respectively. Conclusions: Substantial disagreement exists between conventional longitudinal evaluation of change in health-related quality of life and patient-perceived change in health-related quality of life (as measured using a then test) within individuals. © The Author(s), 2010.
Keyword Response shift
Agreement
EQ-5D
Rehabilitation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Sun, 14 Nov 2010, 00:03:22 EST