Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
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Randomized Controlled Trial Clinical Trial
Responsiveness of the EuroQol (EQ 5-D) and the SF-36 in elderly patients with displaced femoral neck fractures.
To evaluate the responsiveness of the EuroQol (EQ-5D) and Short-Form 36 (SF-36) instruments, i.e. their ability to capture clinically important changes, in elderly patients with a displaced femoral neck fracture. The study was part of a prospective randomised study comparing two different surgical procedures, internal fixation (IF) and total hip replacement (THP). ⋯ The results showed high responsiveness for both the EQ-5D and the SF-36, indicating that both instruments are suitable for use as outcome measures in clinical trials in elderly hip fracture patients.
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Headache impact test (HIT) is a precise, practical tool that quantifies the impact of headache on respondents' lives. It is the first widely-available dynamic health assessment (DynHA). Applications of this brief, precise survey include population based screening for disabling headaches, tracking of individual patient scores over time, disease management programs and others. We use data from Internet HIT assessments during the fall of 2000 to (1) evaluate characteristics of respondents and assessments, (2) assess the utility of joint administration of HIT and the SF-8 Health Survey (SF-8) to screen for migraine and depression, and (3) explore associations between HIT scores and subsequent healthcare-related attitudes and behaviors. ⋯ It is feasible to use Internet-based dynamic assessments to measure health status. These data complement previous results showing that HIT differentiates respondents according to headache characteristics (severity and frequency). HIT plus SF-8 yields a practical screen for migraine and depression in headache patients and may lead to more effective treatment for patients with these conditions. Preliminary findings suggest that the experience of taking HIT on the Internet may motivate headache patients to seek care and discuss headaches with their providers.
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To evaluate the feasibility of computerized adaptive testing (CAT) and the reliability and validity of CAT-based estimates of headache impact scores in comparison with 'static' surveys. ⋯ CAT-based administrations of headache impact items achieved very large reductions in respondent burden without compromising validity for purposes of patient screening or monitoring changes in headache impact over time. IRT models and CAT-based dynamic health assessments warrant testing among patients with other conditions.
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Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact. ⋯ The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.
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Item response theory (IRT) scoring of health status questionnaires offers many advantages. However, to ensure 'backwards comparability' and to facilitate interpretations of results, we need the ability to express the IRT score in the metrics of the traditional scales. ⋯ The theoretical advantage of IRT models in scale calibration is supported by our results. This approach to achieving comparability of new and widely-used scales and accelerating the accumulation of interpretation guidelines based on previous work warrant testing for measures of other generic and disease-specific concepts.