Measure Health-related Quality Of Life In Patients Research Articles

The Impact of Osteoarthritis on the Quality of Life of the Patient in the Kingdom of Bahrain

Osteoarthritis (OA) is a leading cause of disability and a decline in health-related quality of life (HRQoL). Healthcare professionals should prioritize the optimal measurement of HRQoL in patients with OA. To examine and assess the influence of Osteoarthritis on patients' quality of life in the Kingdom of Bahrain. In this cross-sectional study, a cohort of 149 individuals diagnosed with Osteoarthritis was included. Data related to QoL was collected by using Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) and Western Ontario &McMaster Osteoarthritis Index (WOMAC). The Spearman rank correlation test was used to assess the correlation between assessments on different instruments used in osteoarthritis patients. The study involved participants with a mean age of 56.7 ± 11.7 years. Most of the patients experienced extreme pain during prostrating in prayer time (45.6%), sitting (32.2%), and while doing heavy domestic duties (30.9%). The Cronbach alpha coefficients for Mini-OAKHQOL and WOMAC ranged from 0.83 to 0.89 and 0.85 to 0.96 respectively. Only a few demographic factors significantly and positively correlated with Mini-OAKHQoL. This study concludes that OA has a substantial impact on HRQoL. This study can benefit healthcare professionals and policymakers to develop specific interventions and public health initiatives to address the multifaceted nature of osteoarthritis and improve the lives of those affected.

Measuring health-related quality of life in solid rare cancer patients: A study protocol

Rare cancer patients often face delayed diagnosis and lack of expert care which are a challenge to clinical practice. Patients diagnosed with a rare tumour report poorer psychosocial outcomes and impaired health-related quality of life (HRQoL). The impairment might be explained by the challenges patients with rare cancer face during their disease trajectory. Specific HRQoL assessment is important to understand the variances in the quality of life patients experience. This study aims to examine how HRQoL is currently assessed in clinical adult solid rare cancer research and identify specific HRQoL issues patients experience and issues faced in the healthcare system due to the disease’s rarity. Further, this study aims to test the content validity of existing HRQoL questionnaires. In this mixed-method research, two literature reviews will be conducted, and clinical data will be collected worldwide in a multicentre approach via interviews and questionnaires. Basic quantitative analysis will be used to analyse patient and HCP data. The project outcomes will result in standards of the HRQoL measurement in patients diagnosed with a solid rare cancer.

Health-Related Quality of Life in Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review.

Background: The EQ-5D-5L is a generic preference-based questionnaire developed by the EuroQol Group to measure health-related quality of life (HRQoL) in 2005. Since its development, it has been increasingly applied in populations with various diseases and has been found to have good reliability and sensitivity. This study aimed to summarize the health utility elicited from EQ-5D-5L for patients with different diseases in cross-sectional studies worldwide.Methods: Web of Science, MEDLINE, EMBASE, and the Cochrane Library were searched from January 1, 2012, to October 31, 2019. Cross-sectional studies reporting utility values measured with the EQ-5D-5L in patients with any specific disease were eligible. The language was limited to English. Reference lists of the retrieved studies were manually searched to identify more studies that met the inclusion criteria. Methodological quality was assessed with the Agency for Health Research and Quality (AHRQ) checklist. In addition, meta-analyses were performed for utility values of any specific disease reported in three or more studies.Results: In total, 9,400 records were identified, and 98 studies met the inclusion criteria. In the included studies, 50 different diseases and 98,085 patients were analyzed. Thirty-five studies involving seven different diseases were included in meta-analyses. The health utility ranged from 0.31 to 0.99 for diabetes mellitus [meta-analysis random-effect model (REM): 0.83, (95% CI = 0.77–0.90); fixed-effect model (FEM): 0.93 (95% CI = 0.93–0.93)]; from 0.62 to 0.90 for neoplasms [REM: 0.75 (95% CI = 0.68–0.82); FEM: 0.80 (95% CI = 0.78–0.81)]; from 0.56 to 0.85 for cardiovascular disease [REM: 0.77 (95% CI = 0.75–0.79); FEM: 0.76 (95% CI = 0.75–0.76)]; from 0.31 to 0.78 for multiple sclerosis [REM: 0.56 (95% CI = 0.47–0.66); FEM: 0.67 (95% CI = 0.66–0.68)]; from 0.68 to 0.79 for chronic obstructive pulmonary disease [REM: 0.75 (95% CI = 0.71–0.80); FEM: 0.76 (95% CI = 0.75–0.77)] from 0.65 to 0.90 for HIV infection [REM: 0.84 (95% CI = 0.80–0.88); FEM: 0.81 (95% CI = 0.80–0.82)]; from 0.37 to 0.89 for chronic kidney disease [REM: 0.70 (95% CI = 0.48–0.92; FEM: 0.76 (95% CI = 0.74–0.78)].Conclusions: EQ-5D-5L is one of the most widely used preference-based measures of HRQoL in patients with different diseases worldwide. The variation of utility values for the same disease was influenced by the characteristics of patients, the living environment, and the EQ-5D-5L value set.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42020158694.

Validation of the Japanese Version of The Wisconsin Stone Quality of Life Questionnaire: Results from SMART Study Group.

Background: The Wisconsin Stone Quality of Life questionnaire (WISQOL) is a health-related quality of life (HRQOL) measure designed for patients with urinary stones. It has been translated and used in several languages. This study aimed to validate the Japanese version of the WISQOL (J-WISQOL). Materials and Methods: The J-WISQOL was translated and validated using a multistep process proposed by the World Health Organization that involved forward translation, back-translation, and pilot testing with a group of patients. This study enrolled 150 patients with urinary stones who visited three academic hospitals for stone treatment. We assessed convergent validity of correlation patterns and internal consistency of the J-WISQOL and Short-Form 36-item survey version 2 (SF-36v2). Results: Overall, 150 patients were enrolled. The mean total score of the J-WISQOL was 108.18 ± 20.26 (raw score min-max, 28-140), suggesting that the onset and symptoms of urinary stones reduced the HRQOL in the patients. The J-WISQOL showed good internal consistency (Cronbach's α = 0.96) and interdomain associations (Spearman's correlation coefficient r = 0.67-0.94). The J-WISQOL was correlated with the SF-36v2 in all domains: social, emotional, health, and vitality impact (r = 0.47-0.66). Conclusion: The J-WISQOL is a reliable instrument for evaluating HRQOL measures in patients with urinary stones. It could be a useful quality of life questionnaire for urinary stones in Japan. Clinical Trial 60-20-0047.

Dehydroepiandrosterone sulfate indicates decreased sulfation capacity and impaired quality of life in patients with primary sclerosing cholangitis.

Impaired elimination of toxic compounds via inadequate sulfation may contribute to the pathogenesis of primary sclerosing cholangitis (PSC). Dehydroepiandrosterone (DHEA), which is metabolized into its sulfated form (DHEA-S) in the liver, has been linked with health-related quality of life (HRQoL) in various conditions. We aimed to assess the sulfation capacity of the liver in PSC using DHEA-S as a surrogate marker. We assessed serum levels of DHEA-S in 233 patients with PSC and in 201 patients with other liver conditions serving as controls. We also evaluated the effect of low levels of DHEA-S on the course of PSC and HRQoL assessed using the 36-Item Short Form Health Survey (SF-36) and the PBC-40. The proportion of patients with low DHEA-S in the PSC group was 7-fold higher than in the control group (21% vs 3%; P <⁠0.001). Patients with decreased levels of DHEA-S were younger at the time of PSC diagnosis (median age, 23 vs 29 years; P = 0.007) and presented with lower HRQoL scores, particularly regarding the physical domains of the SF-36. Patients with low DHEA-S also complained of more severe fatigue (31 vs 23; P = 0.006) assessed with the PBC-40. Our findings support the role of impaired liver sulfation capacity in the development of PSC. Low levels of DHEA-S are associated with increased fatigue, a devastating symptom significantly affecting HRQoL. Thus, the effects of DHEA administration on chronic fatigue and other measures of HRQoL in patients with PSC warrant further attention.

PND5 Relationship between the Short-Form 12 (SF-12) and Schizophrenia Symptom Rating Scales in a Randomized Controlled Clinical Trial of Paliperidone Palmitate 3 Monthly Formulation

There is increasing emphasis on understanding impact of core symptoms and functioning on well-being and quality-of-life (QOL) to achieve holistic outcomes in schizophrenia. The short-form-12 (SF-12) is a widely used generic measure of self-reported health-related QOL (HRQOL). Relationship of SF-12 as an outcome measure of HRQOL in patients with schizophrenia with clinically relevant symptom rating scales for schizophrenia was evaluated.

Associations between Disease Activity/Severity and Damage and Health-Related Quality of Life in Adult Patients with Localized Scleroderma-A Comparison of LoSCAT and Visual Analogue Scales.

Localized scleroderma (LoS) is a chronic fibrosing disorder of the skin and, less commonly, subcutaneous tissues. As the disease causes subjective symptoms, cosmetic defects, and, at times, functional disability, subjects with LoS experience deterioration of their health-related quality of life (HRQoL). The influence of disease activity/severity and damage status on HRQoL measures in patients with LoS is scarcely known. Physician-reported measures (modified LoS skin severity index, LoS skin damage index, physician global assessments of the disease activity/severity and damage) and patient-derived measures (patient global assessments of the disease activity/severity and damage) were obtained in adult LoS patients. Their HRQoL was measured with Skindex-29 and Short Form-36. The patients’ assessments of disease activity/severity and damage in LoS differed from the assessments by the physicians. The patients’ predominant concerns centered on LoS-related damage, whereas the physicians’ concerns focused on features of disease activity. Visual analogue scales bore some relation to the HRQoL, and they seem to be important in a holistic approach to the patient and should not be omitted in LoS evaluation.

304. Disturbed sleep is associated with worse health outcomes after spine surgery

BACKGROUND CONTEXT Sleep hygiene is an important and essential component of wellbeing; however, little is known regarding the association between sleep disturbance and health-related quality of life (HRQL) in patients undergoing spine surgery. PURPOSE The purpose of this study is determine the association between sleep disturbance and other HRQL measures in patients undergoing spine surgery. We hypothesize that sleep disturbance is significantly correlated with HRQL in patients undergoing surgical treatment of cervical and lumbar spinal disorders, and that patients with preoperative sleep disturbance have significant improvement in sleep postoperatively. STUDY DESIGN/SETTING Prospective cohort study. PATIENT SAMPLE A total of 583 spine surgery patients (cervical, lumbar and spinal deformity) with postoperative followup PROMIS scores. OUTCOME MEASURES Improvement in HRQL domains. Including PROMIS pain, fatigue, anxiety, depression, physical function, social satisfaction, Short Form -12 (SF12) and ODI scores. METHODS Spine surgery patients completed the Oswestry Disability Index (ODI), Short Form-12 (SF12) mental (MCS) health and PROMIS sleep, fatigue, physical function, anxiety, depression and social satisfaction domains at preop and 6-week postoperative visit. Pearson correlation was used to assess for correlation between sleep and HRQL measures, significance was set at p RESULTS In 583 patients (mean age 60 years, 55% female) sleep disturbance was prevalent in 177 (30%) and 94 (16%) patients preoperatively and 6 weeks following surgery, respectively. Sleep disturbance was most significantly correlated with MCS and ODI disability scores (r= - 0.485 and 0.405, respectively), p CONCLUSIONS Preoperative sleep disturbance in patients undergoing surgical treatment of spinal disorders is significantly correlated with several established HRQL measurement instruments. Moreover, improvement in sleep disturbance is also a significant predictor of improvement in postop pain, fatigue, depression, anxiety, physical function, social satisfaction and ODI scores. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Validity of the EQ-5D in patients with pemphigus vulgaris and pemphigus foliaceus.

No studies to date have employed the EuroQoL EQ-5D questionnaire to assess health-related quality of life (HRQoL) in patients with pemphigus. To evaluate the HRQoL of patients with pemphigus by the EQ-5D and to analyse the convergent and known-groups validity of the EQ-5D in this patient population. Between 2014 and 2017, a multicentre cross-sectional study was carried out. Outcome measures included the five-level EQ-5D (EQ-5D-5L), Dermatology Life Quality Index (DLQI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and an average pain intensity visual analogue scale (VAS) for the past 3 months. In total, 109 consecutive patients with pemphigus participated in the study (mean age 57 years; 64% women). Among the EQ-5D dimensions, the most problems were reported regarding pain/discomfort (50%), mobility (43%) and anxiety/depression (43%). No significant difference was found in mean EQ-5D index scores between patients with pemphigus vulgaris and those with pemphigus foliaceus (0·81 vs. 0·86, P = 0·14). The mean EQ-5D index scores of patients with limited, moderate, significant and extreme pemphigus were 0·88, 0·82, 0·72 and 0·67, respectively (P = 0·001). The number of comorbidities was associated with greater impairment in EQ-5D index scores (P < 0·001). DLQI (rs = -0·62, P < 0·001) and the average pain intensity VAS (rs = -0·59, P < 0·001) more strongly correlated with the EQ-5D index scores than did ABSIS (rs = -0·40, P < 0·001). This is the first study employing the EQ-5D questionnaire in pemphigus. The EQ-5D is a valid measure of HRQoL in patients with pemphigus that can be useful both in clinical practice and in economic evaluations to assess the health gains associated with new effective treatments.

Chronic Urticaria Patient Perspective (CUPP): The First Validated Tool for Assessing Quality of Life in Clinical Practice

There is a need for validated tools to assess health-related quality of life (HRQoL) in routine clinical practice. The aim of this study was to validate the Chronic Urticaria Patient Perspective (CUPP) for assessment of patients with chronic urticaria (CU) in clinical practice. A provisional CUPP was developed from candidate items identified by following an iterative process in a retrospective analysis of 249 Chronic Urticaria Quality of Life Questionnaire questionnaires. The psychometric properties of the CUPP were then tested on a sample of patients enrolled in 13 Italian centers. The study population in the validation phase comprised 152 patients. The 10-item version of the CUPP showed satisfactory internal consistency (Cronbach's alpha values of 0.76 at visit 1 and 0.90 at visit 2), good criteria, and discriminative and convergent validity. Reliability was assessed in 34 patients with no changes in health (Global Rating Scale= 0 at visit 2) and was satisfactory (CCC [concordance correlation coefficient] = 0.9). Changes in CUPP scores were significantly associated with changes in Urticaria Activity Score (UAS)-Hive count (r= 0.36, P<.001), UAS-Itch severity (r= 0.48, P < .001), and UAS-Total score (r= 0.342, P < .001), all of which indicated good responsiveness. The minimal important difference was 1.5. CUPP is a simple 10-question tool with good psychometric properties that provides a valid, reliable, and standardized measurement of HRQoL in patients with CU.

The burden of common skin diseases assessed with the EQ5D™: a European multicentre study in 13 countries.

Generic instruments measuring health-related quality of life (HRQoL), like EQ5D™, enable comparison of skin diseases with healthy populations and nondermatological medical conditions, as well as calculation of utility data. To measure HRQoL in patients with common skin diseases and healthy controls across Europe using the EQ5D. This multicentre observational cross-sectional study was conducted in 13 European countries. Each dermatology clinic recruited at least 250 consecutive adult outpatients to complete questionnaires, including the EQ5D. There were 5369 participants (4010 patients and 1359 controls). Mean ± SD self-rated health state reported by patients was 69·9±19·7; for controls it was 82·2±15·5. When adjusted for confounding factors, including comorbidity, mean patient EQ visual analogue scores were 10·5 points lower than for controls (standardized β=-0·23). Odds ratio with 95% confidence interval for impairment in all five dimensions of EQ5D adjusted for confounders was doubled for patients compared with controls. Patients with hidradenitis suppurativa (HS), blistering conditions, leg ulcers, psoriasis and eczemas had the highest risk for reduction in HRQoL in most dimensions (2-10-fold). Data on differences of impairment by dimensions offer new insights. This study confirms the large impact skin conditions have on patients' well-being, differentiating between aspects of HRQoL. Patients with HS, blistering diseases, leg ulcers, infections and most chronic skin diseases reported reduced HRQoL compared with patients with chronic obstructive lung disease, diabetes mellitus, cardiovascular disease and cancers. These findings are important in the prioritization of resource allocation between medical fields and within dermatological subspecialities.

Determinants of quality of life of patients with heart failure and iron deficiency treated with ferric carboxymaltose: FAIR-HF sub-analysis

Heart failure (HF) is a burden to patients and health care systems. The objectives of HF treatment are to improve health related quality of life (HRQoL) and reduce mortality and morbidity. We aimed to evaluate determinants of health-related quality of life (HRQoL) in patients with iron deficiency and HF treated with intravenous (i.v.) iron substitution or placebo. A randomised, double-blind, placebo-controlled trial (n = 459) in iron-deficient chronic heart failure (CHF) patients with or without anaemia studied clinical and HRQoL benefits of i.v. iron substitution using ferric carboxymaltose (FCM) over a 24-week trial period. Multivariate analysis was carried out with various clinical variables as independent variables and HRQoL measures as dependent variables. Mean change from baseline of European Quality of Life - 5 Dimensions (EQ-5D) (value set-based) utilities (on a 0 to 100 scale) at week 24 was 8.91 (i.v. iron) and 0.68 (placebo; p < 0.01). In a multivariate analysis excluding baseline HRQoL, a higher exercise tolerance and i.v. iron substitution positively influenced HRQoL, whereas impaired renal function and a history of stroke had a negative effect. The level of HRQoL was also influenced by country of residence. When baseline HRQoL was factored in, the multivariate model remained stable. In this study, i.v. iron substitution, exercise tolerance, stroke, country of residence and renal function influenced measures of HRQoL in patients with heart failure and iron deficiency.

Quality of life measures as a preliminary clinical indicator in patients with primary brain tumors

Background:The health-related quality of life (HRQOL) measures serve as valuable indicators of survival in patients with newly diagnosed primary brain tumors (PBTs). HRQOL outcomes may benefit clinical decision-making by individualizing patient treatment and improving communications between the doctor, patient, and families. Exploring the individual items of the European Organization and Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QOL) measures may be predictive of prognosis.Methods:We prospectively collected the validated HRQOL and standard clinical and radiological measures from 48 patients with newly diagnosed PBT. The patients were followed every 3 months over 2 years. No proxies were allowed. Questionnaire responses were compared between two groups: Patients with recurrence and/or death (n = 26) and patients without a recurrence (n = 22). A total of 17 patients succumbed to a tumor-related death. Statistical analysis utilizing nonparametric t-tests and Wilcoxon sign tests assessed QOL responses.Results:Significant group differences were noted in the QOL measures with more negative responses in the recurrence group. EORTC QLQ-C30 questions revealed a poor global HRQOL scale (P < 0.005) and pain interfering with daily activities (P < 0.05). EORTC QLQ-BN20 questions revealed weakness of the legs (P < 0.05), coordination difficulties (P < 0.005), and unsteady gait (P < 0.05). Hospital Anxiety and Depression Scale (HADS) questions reflected a patient who is slowed down (P < 0.01) and “frightened” (P < 0.05).Conclusion:Our analysis of longitudinal HRQOL measures may shed light on the prognostic significance of HRQOL measures in patients with newly diagnosed PBT. Further research is warranted to determine which selected individual measures of the EORTC QOL measures may be predictive of a patient's progression-free and overall survival and to test their validity and reliability in clinical trials.

RhinAsthma Patient Perspective: a short daily asthma and rhinitisQoLassessment

The present study aimed to develop a short validated patient-completed questionnaire, the RhinAsthma Patient Perspective (RAPP), to assess the health-related quality of life (HRQoL) in patients with asthma and comorbid allergic rhinitis in clinical practice. A provisional RAPP questionnaire was formed from candidate items identified through retrospective analysis of 333 RHINASTHMA questionnaires. This was then tested on 150 asthma patients with allergic rhinitis. Psychometric analyses identified eight items fitting a unidimensional model to form RAPP. Internal consistency (Cronbach's alpha coefficient>0.8) and agreement with RHINASTHMA (r=-0.31, P=0.0001) were excellent. Criterion, discriminant, and convergent validity were good. Reliability in 47 stable patients was very good (intra-class and concordance correlation coefficients were 0.90 and 0.89, respectively). Responsiveness in 103 patients with health improvement or deterioration was significantly associated with changes in Global Rating Scale (r=-0.4965, P<0.01), Rhinitis Visual Analogue Scale (r=0.5722, P<0.01) and asthma control test (r=-0.6483, P<0.01). Minimal clinical difference in the analyzed population was 2. RhinAsthma Patient Perspective is a simple eight-question questionnaire with good measurement properties and sensitivity to health changes, which will provide a valid, reliable and standardized HRQoL measurement in patients with asthma and comorbid allergic rhinitis in clinical practice.

Validation of the Mexican–Spanish version of the EORTC QLQ‐C15‐PAL questionnaire for the evaluation of health‐related quality of life in patients on palliative care

Health-related quality of life (HRQL) is an important outcome in oncology, particularly in the palliative care setting. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C15-PAL questionnaire is a brief version of QLQ-C30. Our aim is to validate the Mexican-Spanish version of the QLQ-C15-PAL questionnaire to measure HRQL in patients with terminal cancer. Consecutive patients with biopsy proven cancer were included in the study. All were treated in a cancer center in Mexico and were referred for palliative care because of far-advanced, recurrent or metastatic cancer. QLQ-C15-PAL questionnaire was applied in the first visit to the Unit and palliative care was offered to all patients depending on their specific necessities. Eighty-three patients were enrolled in this study (mean age, 61.2 years). Compliance rates were high; all patients completed to the questionnaire in <20 min and the instrument was well-received. Five missing values in five different items were found. QLQ-C15 scales distinguished between other clinically distinct groups of patients. Multi-trait scaling analysis demonstrated good convergent and discriminant validity. Cronbach's α coefficients were >0.7 in three of four multi-item scales (0.67 in the fourth). Test-retest scores were consistent in some scales, while improve or worsen in others. Better Global health, Dyspnea, Insomnia, Fatigue and Appetite scales were associated with longer survival. The Mexican-Spanish version of the EORTC QLQ-C15-PAL questionnaire is reliable and valid for HRQL measurement in patients with terminal cancer, and is appropriate for use in clinical trials of Mexican patients.

Health-Related Quality of Life after Posterolateral Lumbar Arthrodesis in Patients Seventy-Five Years of Age and Older

Retrospective cohort analysis of prospectively collected data. The purpose of this study is to report health-related quality of life (HRQOL) outcomes in patients 75 years of age and older who underwent one- to two-level instrumented posterolateral lumbar arthrodesis. HRQOL measures are increasingly used to measure clinical success after spinal surgery. There is limited data available to guide the clinician caring for the growing geriatric population with degenerative lumbar spine conditions. From a database of prospectively collected HRQOL measures in patients undergoing instrumented lumbar arthrodesis, we identified 35 patients 75 years of age and older who underwent one- or two-level instrumented posterolateral lumbar arthrodesis who had complete preoperative and 2-year postoperative data. HRQOL measures included the Oswestry Disability Index (ODI), Short Form-36 Physical Component Score (PCS) and Mental Component Score (MCS), and back and leg pain numerical rating scales. Paired sample t tests were used to compare preoperative and 2-year postoperative scores. The percentage of patients reaching previously established thresholds for Minimum Clinically Important Difference (MCID) and Substantial Clinical Benefit (SCB) were calculated. There were 11 men and 24 women with a mean age of 78.3 years (range 75-85). Diagnoses included stenosis (20), spondylolisthesis (12), instability (1), disc pathology (1), and scoliosis (1). Twelve patients (34%) had complications, 8 (23%) major and 4 (11%) minor. There was a statistically significant improvement in all of the HRQOL measures from preoperative to 2-years postoperative. Sixty percent (21 of 35) of the patients reached the MCID threshold for ODI, PCS, and leg pain, whereas 83% (29 of 35) reached the MCID for back pain. More than half of the patients reached the SCB threshold for leg pain (19 of 35, 54%), back pain (21 of 35, 60%), ODI (19 of 35, 54%), and PCS (21 of 35, 60%). Properly selected patients 75 years of age and older can achieve substantial clinical improvements, based on patient reported HRQOL measures, 2 years after one- and two-level instrumented posterolateral lumbar arthrodesis.

Clinical validation of the EORTC QLQ‐OG25 questionnaire for the evaluation of health‐related quality of life in Mexican patients with esophagogastric cancers

Quality of life questionnaires (QLQ) QLQ-STO22 and QLQ-OES18 are currently available to measure Health-related quality of life (HRQL) in patients with Esophageal (EC) or Gastric cancer (GC). The QLQ-OG25 integrates questions from both questionnaires to be useful for EC, Esophagogastric junction carcinoma (EGJC), and GC. Our aim was to validate the Mexican-Spanish version. The translation procedure followed European Organization for Research and Treatment of Cancer (EORTC) guidelines. QLQ-C30 and QLQ-OG25 instruments were completed by patients with EC, EGJC, and GC. Patients were divided into three groups: (1) palliative treatment; (2) treatment with curative intent, and (3) survivors. Reliability and validity tests were performed. One-hundred sixty-three patients were included: 62 women and 101 men (mean age, 54.9 years; range, 22-82 years). Sixty-nine, seventy-three, and twenty-one patients were allocated into groups 1, 2, and 3, respectively. Questionnaire compliance rates were high and were well accepted. Group 3 patients reported better functional HRQL scores and lower symptom scores than patients in groups 2 and 1. Scales in the QLQ-C30 and QLQ-OG25 distinguished among other clinically distinct groups of patients. Cronbach's α coefficients of all multi-item scales of the QLQ-OG25 instrument were >0.7 (range, 0.7-0.83). Multitrait scaling analysis demonstrated good convergent and discriminant validity, even adjusting by location. Test-retest scores were consistent. The Mexican-Spanish version of the EORTC QLQ-OG25 questionnaire is reliable and valid for HRQL measurement in patients with esophagogastric cancer and can be used in clinical trials in the Mexican community.

Validity of the Patient Generated Index as a Quality-of-Life Measure in Radiation Oncology

To evaluate psychometric properties of an instrument designed to measure individualized health-related quality of life (HRQOL). Repeated measures of self-reported quality of life. An outpatient radiation therapy department in the western part of the United States. 86 adults with cancer receiving their first course of radiation therapy. The Patient Generated Index (PGI), the National Comprehensive Cancer Network's Distress Thermometer (DT), and the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core-30 (QLQ-C30). Convergent validity, responsiveness, sensitivity, and response shift. PGI scores were inversely correlated with scores on the DT (r = -0.49, -0.55, -0.44; p < 0.001), as well as the role (r = 0.31, 0.4, 0.38; p < 0.01), emotional (r = 0.33, 0.41, 0.33; p < 0.01), social functioning (r = 0.27, 0.49, 0.42; p < 0.05), pain (r = -0.29, -0.39, -0.39; p < 0.01), and fatigue (r = -0.35, -0.25, -0.47; p < 0.05) QLQ-C30 subscales at all measurement times. The PGI was responsive to those reporting high or low DT scores (t = 4.42, 3.32, 2.9; p < 0.05). A small-to-moderate effect size was detected in those who had an increase (effect size = 0.51) or decrease (effect size = 0.38) in HRQOL over time. Participants reconceptualized HRQOL over time. Data supported the PGI as a valid measure of individualized HRQOL. The PGI potentially provides a more patient-centered measure of HRQOL in patients with cancer. Additional testing is needed in larger, more diverse groups.

Health Related Quality of Life Assessment in Metastatic Disease of the Spine

Systematic literature review. To examine the available literature on health related quality of life (HRQOL) assessment in metastatic disease of the spine and identify the optimal functional outcome scales to be used in developing a disease-specific tool. There is a lack of consensus in the use of HRQOL measures in patients with metastatic spine disease. A systematic review was conducted using MEDLINE, EMBASE, the Science Citation Index (ISI), the Cumulative Index to Nursing and Allied Health Literature, the PsycINFO, the Allied and Complementary Medicine (AMED), Cochrane Reviews and Global Health databases for clinical studies addressing metastatic spine disease from 1966 through 2008. The validity of outcome tools was established by linkage analysis with the International Classification of Functioning Disability and Health (ICF). One hundred forty-one clinical studies met inclusion criteria including 10,347 patients. Only 5 moderate grade and 1 high grade study were identified. Thirty- four studies used a patient self-assessment instrument to assess health status. None of the instruments were validated for metastatic spine patients. The most commonly used Pi-by-no tools were SF-36, SIP 5, and the ADL. None of the studies defined health related quality of life (HRQOL) or justified the choice of instrument. The most commonly used cancer-specific tools were ECOG, EORTC QCQ-C30, and EUROQOL 5D. Based on frequency of citation and on correlation with the International Classification of Functioning Disability and Health, the ECOG and SF36 were judged as most valid and reliable. A systematic review of the available evidence suggests that valid and reliable health related quality of life measures exist for the assessment of oncology patients; however, a disease-specific tool for metastatic spine disease awaits development. Until such time as a disease-specific tool is available, we recommend that the ECOG and SF-36 be considered for use in studies addressing the outcome assessment of patients with metastatic spine disease.

Health‐related quality of life measures and psychiatric comorbidity in patients with migraine

The identification of factors associated to health-related quality of life (HRQoL) measures in patients with migraine has major implications in terms of prognosis and treatment. This study aimed at investigating associations between HRQoL and comorbid mood and anxiety disorders. Consecutive adult outpatients with a diagnosis of migraine with or without aura were assessed using the Mini International Neuropsychiatric Interview (M.I.N.I.) Plus version 5.0.0 and the Migraine-Specific Quality-of-Life Questionnaire (MSQ). Data of 112 patients (82 females), 69 without aura, mean age 41.2 +/- 13.3 years were analyzed. According to the M.I.N.I., 50% patients had a lifetime or current DSM-IV diagnosis of mood or anxiety disorder. There was no between-groups difference in MSQ total and subscale scores in relation to the presence/absence of psychiatric comorbidity, independently whether that was current or lifetime. In the group of subjects with psychiatric disorders, age at onset of migraine correlated with MSQ-total (rho = -0.407 P = 0.002), and subscale scores (Role Function-Restrictive, rho = -0.397, P = 0.002; Emotional Function, rho = -0.487, P < 0.001). Our findings suggest that current and/or lifetime psychiatric comorbidities are not associated with HRQoL measures in patients with migraine. However, patients with migraine and psychiatric comorbidities may represent a specific subgroup deserving particular attention for targeted interventions.