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Sakurada Y, Matsuda Y, Motohashi K, Hasegawa T, Otsuka Y, Nakano Y, Tokumasu K, Yamamoto K, Sunada N, Honda H, Hagiya H, Ueda K, Otsuka F. Clinical characteristics of female long COVID patients with menstrual symptoms: a retrospective study from a Japanese outpatient clinic. J Psychosom Obstet Gynaecol 2024; 45:2305899. [PMID: 38270210 DOI: 10.1080/0167482x.2024.2305899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
PURPOSE To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated. METHODS Symptoms of long COVID, QOL, mental health, and related endocrine data were compared between two groups with and without menstrual disturbances. RESULTS Of 349 female patients who visited our clinic between February 2021 and March 2023, 223 patients with long COVID (aged 18-50 years) were included. Forty-four (19.7%) of the patients had menstrual symptoms associated with long COVID. The patients with menstrual symptoms were older than those without menstrual symptoms (42.5 vs. 38 years). The percentage of patients with menstrual symptoms was higher during the Omicron phase (24%) than during the Preceding (13%) and Delta (12%) phases. Cycle irregularity was the most frequent (in 63.6% of the patients), followed by severe pain (25%), heavy bleeding (20.5%), perimenopausal symptoms (18.2%), and premenstrual syndrome (15.9%). Fatigue and depression were the most frequent complications. Scores for fatigue and for QOL were significantly worse in long COVID patients with menstrual symptoms. Results of endocrine examinations showed significantly increased cortisol levels in patients with menstrual complaints. CONCLUSION Long COVID has an impact on menstrual conditions and on QOL related to menstrual conditions.
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Affiliation(s)
- Yasue Sakurada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yui Matsuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kanon Motohashi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toru Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideharu Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan
| | - Keigo Ueda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan
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Bhanupriya R, Haridoss M, Lakshmi GS, Bagepally BS. Health-related quality of life in Parkinson's disease: systematic review and meta-analysis of EuroQol (EQ-5D) utility scores. Qual Life Res 2024; 33:1781-1793. [PMID: 38581635 DOI: 10.1007/s11136-024-03646-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 04/08/2024]
Abstract
INTRODUCTION Evaluating the Health-related quality of life (HRQoL) of individuals with Parkinson's disease (PD) holds significant importance in clinical and research settings. The EQ-5D is a widely recognized tool for comprehensive measurement of HRQoL using utility values. This study aims to systematically review and synthesize EQ-5D utility values from existing literature on patients with PD and their caregivers. METHODS We conducted a systematic search for studies that provided EQ-5D utility scores for patients with PD, using PubMed-Medline, Scopus, and Embase and selected the studies. The selected studies underwent systematic review, including an assessment of their quality. We performed a meta-analysis using a random-effect model and conducted a meta-regression analysis to investigate sources of heterogeneity among the studies. RESULTS The search result of 13,417 articles that were reviewed, 130 studies with 33,914 participants were selected for systematic review, and 79 studies were included for meta-analysis. The pooled EQ-5D utility values and visual analog score (VAS) among PD were 62.72% (60.53-64.93, I2 = 99.56%) and 0.60 (0.55-0.65, I2 = 99.81%), respectively. The pooled scores for caregivers' EQ-VAS and EQ-5D utility were 70.10% (63.99-76.20, I2 = 98.25%) and 0.71 (0.61-0.81, I2 = 94.88%), respectively. Disease duration (P < 0.05) showed a negative correlation with EQ-5D utility values on meta-regression. CONCLUSION The pooled utility values of PD and their caregivers help to understand their HRQoL and aid in conducting health economics research. The negative association between disease duration and utility values highlights the evolving nature of HRQoL challenges, suggesting the need for appropriate long-term disease management.
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Affiliation(s)
| | | | | | - Bhavani Shankara Bagepally
- ICMR-National Institute of Epidemiology, Chennai, India.
- Health Technology Assessment Resource Centre ICMR-NIE, ICMR-National Institute of Epidemiology, Ayapakkam, Chennai, 600077, India.
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Shiroiwa T, King MT, Norman R, Müller F, Campbell R, Kemmler G, Murata T, Shimozuma K, Fukuda T. Japanese value set for the EORTC QLU-C10D: A multi-attribute utility instrument based on the EORTC QLQ-C30 cancer-specific quality-of-life questionnaire. Qual Life Res 2024; 33:1865-1879. [PMID: 38724771 PMCID: PMC11176232 DOI: 10.1007/s11136-024-03655-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE This study aimed to develop a Japanese value set for the EORTC QLU-C10D, a multi-attribute utility measure derived from the cancer-specific health-related quality-of-life (HRQL) questionnaire, the EORTC QLQ-C30. The QLU-C10D contains ten HRQL dimensions: physical, role, social and emotional functioning, pain, fatigue, sleep, appetite, nausea, and bowel problems. METHODS Quota sampling of a Japanese online panel was used to achieve representativeness of the Japanese general population by sex and age (≥ 18 years). The valuation method was an online discrete choice experiment. Each participant considered 16 choice pairs, randomly assigned from 960 choice pairs. Each pair included two QLU-C10D health states and life expectancy. Data were analyzed using conditional logistic regression, parameterized to fit the quality-adjusted life-year framework. Preference weights were calculated as the ratio of each dimension-level coefficient to the coefficient for life expectancy. RESULTS A total of 2809 eligible panel members consented, 2662/2809 (95%) completed at least one choice pair, and 2435/2662 (91%) completed all choice pairs. Within dimensions, preference weights were generally monotonic. Physical functioning, role functioning, and pain were associated with the largest utility weights. Intermediate utility weights were associated with social functioning and nausea; the remaining symptoms and emotional functioning were associated with smaller utility decrements. The value of the worst health state was - 0.221, lower than that seen in most other existing QLU-C10D country-specific value sets. CONCLUSIONS The Japan-specific QLU-C10D value set is suitable for evaluating the cost and utility of oncology treatments for Japanese health technology assessment and decision-making.
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Affiliation(s)
- T Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, Wako, Saitama, Japan.
| | - M T King
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
- European Organisation for Research and Treatment of Cancer Quality of Life Group, Brussels, Belgium
| | - R Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - F Müller
- Medical Psychology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam Public Health, Global Health, Amsterdam, Netherlands
| | - R Campbell
- Faculty of Science, School of Psychology, University of Sydney, Sydney, NSW, Australia
| | - G Kemmler
- European Organisation for Research and Treatment of Cancer Quality of Life Group, Brussels, Belgium
- Department of Psychiatry, Psychotherapy and Psychosomatics I, Medical University of Innsbruck, Innsbruck, Austria
| | - T Murata
- Crecon Medical Assessment Co., Ltd, Tokyo, Japan
| | - K Shimozuma
- College of Life Sciences, Ritsumeikan University, Kusatsu, Japan
| | - T Fukuda
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, Wako, Saitama, Japan
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Fujisawa C, Nakashima H, Komiya H, Watanabe K, Yamada Y, Tajima T, Umegaki H. Association of marital relationship with quality of life among older adults with mild cognitive impairment and mild dementia. Geriatr Gerontol Int 2024; 24:646-647. [PMID: 38651626 DOI: 10.1111/ggi.14868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
The marital relationship is associated with the quality of life among those with cognitive impairment, but sarcopenia status seems to play an important role in the association.
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Affiliation(s)
- Chisato Fujisawa
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Tomihiko Tajima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan
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Ito K, Mitobe Y, Inoue R, Momoeda M. The quality of life and work productivity are affected by the presence of nausea/vomiting in patients taking iron preparations for heavy menstrual bleeding or anemia: a population-based cross-sectional survey in Japan. BMC Womens Health 2024; 24:303. [PMID: 38773463 PMCID: PMC11106985 DOI: 10.1186/s12905-024-03104-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/21/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Patients with iron deficiency anemia are treated with iron preparations, but gastrointestinal symptoms such as nausea and vomiting occur frequently. These symptoms may negatively affect the quality of life and work productivity in patients with iron deficiency anemia. This study assessed the impact of nausea and vomiting on the quality of life and work productivity of patients taking iron preparations for heavy menstrual bleeding or anemia. METHODS An online survey was conducted among patients taking iron preparations for heavy menstrual bleeding or anemia. Demographic data and information about medication use and the health condition were collected. The patients were asked to answer the 5-level EQ-5D version, and work productivity and activity impairment questionnaires. The outcomes were reported by patients in the presences of nausea, vomiting, and nausea or vomiting. The association with the 5-level EQ-5D version utility score for the severity and frequency of the symptoms were also assessed. RESULTS A total of 385 patients were enrolled, and 96 were patients with nausea or vomiting, of which 94 were with nausea and 27 were with vomiting. The 5-level EQ-5D version utility scores for the patients with nausea, vomiting, and nausea or vomiting were significantly lower than those of the patients without these symptoms (p < 0.001 for each). The 5-level EQ-5D version utility score was correlated with the severity of nausea and the frequency of vomiting per day (p < 0.001 for each). As for the work productivity and activity impairment, the presenteeism, the overall work impairment, and the activity impairment of the patients with nausea, vomiting, and nausea or vomiting were significantly higher than those without these symptoms (p < 0.001 for each). The absenteeism was slightly higher trend was observed, but not significant. CONCLUSION Patients taking iron preparations who have nausea or vomiting experience a significant burden in terms of poorer quality of life and higher work productivity impairment. TRIAL REGISTRATION UMIN000045700 ( http://www.umin.ac.jp/ctr/ ). Registered on October 11, 2021.
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Affiliation(s)
- Kyoko Ito
- Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-Ku, Tokyo, 103-8439, Japan
| | - Yuko Mitobe
- Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-Ku, Tokyo, 103-8439, Japan
| | - Ryo Inoue
- Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-Ku, Tokyo, 103-8439, Japan
| | - Mikio Momoeda
- Aiiku Maternal and Child Health Center, Aiiku Hospital, 1-16-10 Shibaura, Minato-Ku, Tokyo, 105-8321, Japan.
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Takahashi H, Suzuki K, Nishino T, Shibao Y, Noguchi H, Kanamori A, Yoshioka T, Kikuchi N, Nozawa D, Mishima H, Koda M, Yamazaki M. Safety and feasibility of in-hospital autonomous transportation using a driverless mobility for patients with musculoskeletal disorders: preliminary clinical study to achieve mobility as a service in medical care. BMC Musculoskelet Disord 2024; 25:352. [PMID: 38702633 PMCID: PMC11067163 DOI: 10.1186/s12891-024-07417-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/04/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Recent advancements in and the proliferation of autonomous mobility technology, such as intelligent wheelchairs, have made it possible to provide mobility services for patients with reduced mobility due to musculoskeletal disorders. In the present study, we conducted a preliminary clinical study to assess the safety and feasibility of in-hospital autonomous transportation using a driverless mobility (wheelchair) for patients with musculoskeletal disorders. METHODS From January to February 2022, 51 patients with musculoskeletal disorders exhibiting gait disturbance who presented to our institution were included in the present study. Driverless mobility rides were conducted over a straight-line distance of 100 m from the orthopaedic outpatient reception to the payment counter after the outpatient consultation. We assessed the quality of life using an EQ-5D-5 L index and pain using a VAS score before riding the mobility to investigate the patient's condition. After the ride, a questionnaire survey was conducted to assess patient satisfaction on a 5-point scale. In addition, adverse events during the mobility ride were investigated. RESULTS Overall satisfaction levels showed that 44 out of 51 (86%) patients rated the level as 3 or higher. There were no significant differences in the level of satisfaction based on the cause of disorders or EQ-5D-5 L Index. Among 19 patients who rated the level of satisfaction as 2-3, the ratio of postoperative patients and those with pain tended to be higher (p < 0.05). While 26 of 51 (51%) patients reported moments of feeling unsafe during the mobility ride, no actual adverse events, such as collisions, were observed. CONCLUSIONS An in-hospital autonomous transportation service using a driverless mobility for patients with musculoskeletal disorders demonstrated high satisfaction levels and was safe with no severe adverse events observed. The expansion of autonomous mobility deployment is expected to achieve mobility as a service in medical care.
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Affiliation(s)
- Hiroshi Takahashi
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan.
| | - Kenji Suzuki
- Center for Cybernics Research, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Tomofumi Nishino
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Yosuke Shibao
- Department of Orthopaedic Surgery, Ibaraki Western Medical Center, 555, Otsuka, Chikusei City, Ibaraki, 308-0813, Japan
| | - Hiroshi Noguchi
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Akihiro Kanamori
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Tomokazu Yoshioka
- Department of Orthopaedic Surgery, Kikkoman General Hospital, 100, Miyazaki, Noda City, Chiba, 278-0005, Japan
| | - Naoya Kikuchi
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Daisuke Nozawa
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Hajime Mishima
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
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Shiroiwa T, Fukuda T. Are Web-Based Valuation Surveys for Preference-Based Measures as Reliable as Face-to-Face Surveys? TTO, DCE and DCE with Duration. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:391-400. [PMID: 38217791 PMCID: PMC11021234 DOI: 10.1007/s40258-023-00865-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Valuation surveys of preference-based measures are typically conducted face-to-face or on web panels. In this survey, we considered whether face-to-face and online surveys were reliable using three tasks: composite time trade-off (cTTO), discrete choice experiment (DCE), and DCE with duration. METHODS Respondents (aged 20-69 years) for both face-to-face (N = 1000, target sample size) and web surveys were selected through quota sampling by sex and age from each panel of the general population in Japan. They were then allocated to one of the three tasks and divided into six groups (two survey modes × three tasks, N = 334 per group). For the cTTO, respondents were asked to rate ten health states described by the EQ-5D-5L. For the DCE and DCE with duration surveys, respondents were asked about 15 health-state pairs. For all participants, as in the second-stage survey, a similar process was repeated two weeks after the first survey. Reliability was evaluated by calculating the percentage of agreement and intraclass correlation coefficients. RESULTS The cTTO scores of the face-to-face and web surveys were systematically different. Between the face-to-face and web surveys, the agreement of the TTO survey was not good. The intraclass correlation coefficient (ICC) was 0.37 for the face-to-face test-test and 0.59 for the web test-retest. Discrete choice experiment (DCE) and DCE with duration had similarly good agreement (more than 70%), regardless of face-to-face or web surveys. However, between the first and second surveys (test-retest) of DCE and DCE with duration, the agreement depends on whether the positions of the two cards (health states) are identical. CONCLUSION If the face-to-face cTTO score is the gold standard, a web-based survey of cTTO is not recommended regardless of the ICC. If a DCE survey is performed, positioning effects should be considered.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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Tamai K, Terai H, Iwamae M, Kato M, Toyoda H, Suzuki A, Takahashi S, Sawada Y, Okamura Y, Kobayashi Y, Nakamura H. Residual Paresthesia After Surgery for Degenerative Cervical Myelopathy: Incidence and Impact on Clinical Outcomes and Satisfaction. Spine (Phila Pa 1976) 2024; 49:378-384. [PMID: 38126538 DOI: 10.1097/brs.0000000000004907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023]
Abstract
STUDY DESIGN Multicenter, prospective cohort study. OBJECTIVE The current study aimed to identify the incidence of residual paresthesias after surgery for degenerative cervical myelopathy (DCM), and to demonstrate the impact of these symptoms on clinical outcomes and patient satisfaction. SUMMARY OF BACKGROUND DATA Surgery for DCM aims to improve and/or prevent further deterioration of physical function and quality-of-life (QOL) in the setting of DCM. However, patients are often not satisfied with their treatment for myelopathy when they have severe residual paresthesias, even when physical function and QOL are improved after surgery. MATERIALS AND METHODS The authors included 187 patients who underwent laminoplasty for DCM. All patients were divided into two groups based on their visual analog scale score for paresthesia of the upper extremities at one year postoperatively (>40 vs. ≤40 mm). Preoperative factors, changes in clinical scores and radiographic factors, and satisfaction scales at one year postoperatively were compared between groups. The authors used mixed-effect linear and logistic regression modeling to adjust for confounders. RESULTS Overall, 86 of 187 patients had severe residual paresthesia at one year postoperatively. Preoperative patient-oriented pain scale scores were significantly associated with postoperative residual paresthesia ( P =0.032). A mixed-effect model demonstrated that patients with severe postoperative residual paresthesia showed significantly smaller improvements in QOL ( P =0.046) and myelopathy ( P =0.037) than patients with no/mild residual paresthesia. Logistic regression analysis identified that residual paresthesia was significantly associated with lower treatment satisfaction, independent of improvements in myelopathy and QOL (adjusted odds ratio: 2.5, P =0.010). CONCLUSION In total, 45% of patients with DCM demonstrated severe residual paresthesia at one year postoperatively. These patients showed significantly worse treatment satisfaction, even after accounting for improvements in myelopathy and QOL. As such, in patients who experience higher preoperative pain, multidisciplinary approaches for residual paresthesia, including medications for neuropathic pain, might lead to greater clinical satisfaction. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Koji Tamai
- Department of Orthopedics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Hagiya H, Tokumasu K, Otsuka Y, Sunada N, Nakano Y, Honda H, Furukawa M, Otsuka F. Relevance of complement immunity with brain fog in patients with long COVID. J Infect Chemother 2024; 30:236-241. [PMID: 37866620 DOI: 10.1016/j.jiac.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/05/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION This study aimed to elucidate the prevalence and clinical characteristics of patients with long COVID (coronavirus disease 2019), especially focusing on 50% hemolytic complement activity (CH50). METHODS This retrospective observational study focused on patients who visited Okayama University Hospital (Japan) for the treatment of long COVID between February 2021 and March 2023. CH50 levels were measured using liposome immunometric assay (Autokit CH50 Assay, FUJIFILM Wako Pure Chemical Corporation, Japan); high CH50 was defined as ≥59 U/mL. Univariate analyses assessed differences in the clinical background, long COVID symptoms, inflammatory markers, and clinical scores of patients with normal and high CH50. Logistic regression model investigated the association between high CH50 levels and these factors. RESULTS Of 659 patients who visited our hospital, 478 patients were included. Of these, 284 (59.4%) patients had high CH50 levels. Poor concentration was significantly more frequent in the high CH50 group (7.2% vs. 13.7%), whereas no differences were observed in other subjective symptoms (fatigue, headache, insomnia, dyspnea, tiredness, and brain fog). Multivariate analysis was performed on factors that could be associated with poor concentration, suggesting a significant relationship to high CH50 levels (adjusted odds ratio [aOR], 2.70; 95% confidence interval [CI], 1.33-5.49). Also, high CH50 was significantly associated with brain fog (aOR, 1.66; 95% CI, 1.04-2.66). CONCLUSIONS High CH50 levels were frequently reported in individuals with long COVID, indicating a relationship with brain fog. Future in-depth research should examine the pathological role and causal link between complement immunity and the development of long COVID.
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Affiliation(s)
- Hideharu Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, 700-8558, Japan.
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Masanori Furukawa
- Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan
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Okubo R, Kondo M, Imasawa T, Saito C, Kai H, Tsunoda R, Hoshino J, Watanabe T, Narita I, Matsuo S, Makino H, Hishida A, Yamagata K. Health-related Quality of Life in 10 years Long-term Survivors of Chronic Kidney Disease: A From-J Study. J Ren Nutr 2024; 34:161-169. [PMID: 37832838 DOI: 10.1053/j.jrn.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/06/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE The Chronic Kidney Disease (CKD) practice facilitation program in the Frontier of Renal Outcome Modifications in Japan study reduced cardiovascular disease (CVD) events in patients with CKD. 10-year long-term survivors with CKD lived with serious complications, including end-stage kidney disease and CVD. This study aimed to measure health-related quality of life in 10-year long-term CKD survivors and examine the predictors and determinants of clinical indices for measured quality of life (QOL) scores. METHODS The EQ-5D-5L, a generic preference-based instrument, was administered to 1,473 CKD survivors enrolled in the Frontier of Renal Outcome Modifications in JapanFrontier of Renal Outcome Modifications in JapanFrontier of Renal Outcome Modifications in Japan study. The 10th-year data collection was performed by either primary care physicians or participants who filled out questionnaires from October 2018 to March 31, 2019. RESULTS The response rate was 38.2% (423/1,473). The mean QOL score was 0.893 (95% confidence interval (CI), 0.880-0.906), and the median QOL score was 1.000 (interquartile range (IQR), 0.826-1.000). The mean QOL score in participants with renal replacement therapy was 0.824 (95% CI, 0.767-0.881), and the median was 0.828 (IQR, 0.755-1.000). The mean QOL score in participants with CVD was 0.877 (95% CI, 0.811-0.943), and the median was 1.000 (IQR, 0.723-1.000). The mean QOL score in participants with 50% decline in estimated glomerular filtration was 0.893 (95% CI, 0.860-0.926), and the median was 0.889 (IQR, 0.825-1.000). The decrease in QOL scores with baseline CKD stages was significant according to the Jonckheere-Terpstra test for trend (P = .002). Baseline age, systolic blood pressure, and history of hyperuricemia were significant predictors of 10th-year QOL scores. CONCLUSION We suggest that CKD complications negatively affect the QOL scores in 10-year long-term survivors with CKD. CKD guideline-based practices, prevention of end-stage kidney disease/CVD and management of hypertension, diabetes and hyperuricemia, might contribute to future health-related quality of life in patients with CKD.
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Affiliation(s)
- Reiko Okubo
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Clinical Laboratory Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan; Department of Nephrology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Toshiyuki Imasawa
- Department of Nephrology, National Hospital Organization Chibahigashi National Hospital, Chuo-ku Chiba City, Chiba, Japan
| | - Chie Saito
- Department of Nephrology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hirayasu Kai
- Department of Nephrology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ryoya Tsunoda
- Department of Nephrology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | | | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Science, Niigata, Niigata, Japan
| | | | | | | | - Kunihiro Yamagata
- Department of Nephrology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Matsumoto K, Hamatani S, Shimizu E. Long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy for obsessive-compulsive disorder: 24-month follow-up. Internet Interv 2024; 35:100725. [PMID: 38362159 PMCID: PMC10867335 DOI: 10.1016/j.invent.2024.100725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/09/2024] [Accepted: 02/07/2024] [Indexed: 02/17/2024] Open
Abstract
This study investigated the long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy (ICBT) for obsessive-compulsive disorder (OCD). Twenty-five patients with OCD who had undergone guided ICBT in a randomized controlled trial or a single-arm trial were followed up for 6, 12, and 24 months. Missing data were imputed using the mice package in R, and a one-way analysis of variance with repeated measures was performed. The total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score significantly decreased from baseline to all endpoints (p < 0.001). OCD remission (the total Y-BOCS score < 14) rates significantly increased from post-treatment (48 %) at the 12 months (80 %) and 24 months (76 %) follow-up (χ2 (1) = 7.11-11.08, p < 0.01) post guided ICBT. Regression analysis predicted the maintenance of remission at 12 and 24 months following post-treatment remission (z = 2.20, p = 0.03). An incremental cost-effectiveness ratio was calculated to assess the cost-effectiveness of guided ICBT. The incremental cost-effectiveness ratio was JPY 999,495, below the JPY 5 million threshold for willingness to pay in Japan. Our findings demonstrate the long-term effectiveness and cost-effectiveness of guided ICBT for OCD. Guided ICBT can mitigate the severity of OCD even after treatment.
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Affiliation(s)
- Kazuki Matsumoto
- Division of Clinical Psychology, Kagoshima University Medical and Dental Hospital, Research and Education Assembly Medical and Dental Sciences Area, Kagoshima University, Kagoshima-City, Kagoshima, Japan
- Research Center for Child Mental Development, Chiba University, Chiba-City, Chiba, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba-City, Chiba, Japan
- Research Center for Child Mental Development, University of Fukui, Yoshida-Gun, Fukui, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba-City, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba-City, Chiba, Japan
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Kitamura T, Shigemura T, Yamamoto Y, Murata Y. Effective Management of Sacral Stress Fractures in Gastric Cancer: Iliosacral Screw Fixation Following a Type 3 Hemipelvectomy. Cureus 2024; 16:e56435. [PMID: 38638739 PMCID: PMC11024781 DOI: 10.7759/cureus.56435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/20/2024] Open
Abstract
Metastatic pelvic tumors pose a significant challenge in oncologic orthopedics due to their complex management and the high potential for postoperative complications. This case study discusses a 75-year-old male with a sacral stress fracture following a type 3 internal hemipelvectomy for a metastatic lesion from gastric cancer in the left pubic bone. Initial conservative treatments failed to yield satisfactory improvement, leading to surgical intervention. Open reduction and internal fixation with an iliosacral screw, despite complications, significantly alleviated pain and improved mobility. This case underscores the difficulty in diagnosing sacral stress fractures versus metastatic lesions and highlights the effectiveness of iliosacral screw fixation in managing postoperative sacral stress fractures. It emphasizes the procedure's role in providing early pain relief and enhancing daily activity levels. Additionally, it points out the importance of addressing altered bone metabolism in the postoperative care of patients with metastatic pelvic tumors. This contributes to the literature by stressing the incidence of sacral stress fractures as a critical, though often overlooked, complication and demonstrating the benefits of iliosacral screw fixation in such scenarios for better recovery and quality of life.
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Affiliation(s)
- Takaki Kitamura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, JPN
| | - Tomonori Shigemura
- Department of Orthopaedics, Teikyo University Chiba Medical Center, Ichihara, JPN
| | - Yohei Yamamoto
- Department of Orthopaedics, Teikyo University Chiba Medical Center, Ichihara, JPN
| | - Yasuaki Murata
- Department of Orthopaedics, Teikyo University Chiba Medical Center, Ichihara, JPN
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Shiroiwa T, Murata T, Morii Y, Hoshino E, Fukuda T. Comparison of four value sets derived using different TTO and DCE approaches: application to the new region-specific PBM, AP-7D. Health Qual Life Outcomes 2024; 22:16. [PMID: 38341575 DOI: 10.1186/s12955-024-02233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND AP-7D is a newly developed preference-based measure (PBM) in East and Southeast Asia. However, no value set has been established yet. Comparison of the characteristics of value sets obtained by different methods is necessary to consider the most appropriate methodology for valuation survey of AP-7D. METHOD We surveyed the general population's preference of AP-7D health states by four valuation methods (a) composite time trade-off (cTTO); (b) simple discrete choice experiment (DCE); (c) DCE with duration; and (d) ternary DCE. In Japan, we collected approximately 1,000 samples for cTTO tasks through a face-to-face survey and 2,500 samples for each of the three DCE tasks. Respondents were selected through quota sampling based on the sex and age. The cTTO data were analyzed using a linear mixed and tobit model; the DCE data were analyzed using a simple and panel conditional logit model. Where the results of the analysis showed inconsistencies, a constrained model was used. RESULTS Since all the unconstrained models, except simple DCE, showed one or more inconsistencies, the constrained model was used for the analyses. The minimum values for the models were as follows: TTO model, -0.101; simple DCE model, -0.106; DCE with duration model, -0.706; ternary DCE model, -0.306. The score for the DCE with the duration model was much lower than that for the other models. Although the value sets for AP-7D differed among the four valuation methods, the ternary DCE model showed intermediate characteristics between those of the cTTO and DCE with duration models. As compared with to EQ-5D-5L, the distributions of all the scores on the Japanese AP-7D moved to the left. Although "Energy" was one of the domains with the least influence on the AP-7D score in all four models, "Burden to others" had the largest impact on the preferences. CONCLUSION We constructed four value sets using different TTO and DCE methods. Our findings are expected not only to contribute to the development of AP-7D, but also other preference-based measures.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Tatsunori Murata
- Crecon Medical Assessment Inc, 2-12-15, Shibuya, Tokyo, Shibuya-Ku, 150-0002, Japan
| | - Yasuhiro Morii
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Eri Hoshino
- Division of Policy Evaluation, Department of Health Policy, Research Institute, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-0074, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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Tsutsui H, Sakamaki H, Momomura S, Sakata Y, Kotobuki Y, Linden S, Idehara K, Nitta D. Empagliflozin cost-effectiveness analysis in Japanese heart failure with mildly reduced and preserved ejection fraction. ESC Heart Fail 2024; 11:261-270. [PMID: 37969049 PMCID: PMC10804196 DOI: 10.1002/ehf2.14565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/19/2023] [Accepted: 10/05/2023] [Indexed: 11/17/2023] Open
Abstract
AIMS Empagliflozin, a sodium-glucose co-transporter 2 inhibitor, was shown to be effective in patients with heart failure with preserved ejection fraction (HFpEF) in the EMPEROR-Preserved trial. The present study aims to evaluate the cost-effectiveness of empagliflozin among Japanese patients with HFpEF. METHODS AND RESULTS A Markov cohort model was developed to evaluate the cost-effectiveness of empagliflozin added to standard of care (SoC) compared with SoC alone in patients with HFpEF from the perspective of the Japanese healthcare system and with a lifetime horizon. In addition to clinical events, the progression of disease severity was modelled based on the migration of Kansas City Cardiomyopathy Questionnaire-Clinical Summary Scores (KCCQ-CSS). Model inputs, including risk of clinical events, costs, and utilities/disutilities, were derived from EMPEROR-Preserved trial data, a claims database and published literature. The generalizability of model results was investigated by applying various subgroups including age, body mass index (BMI), and region Asia, based on the subgroup analysis of EMPEROR-Preserved data. In the base-case analysis, empagliflozin yielded additional quality-adjusted life years (QALYs; 0.11) with an incremental cost of $1408 per patient for Japanese patients with HFpEF. Incremental cost, mainly derived from drug acquisition cost ($1963 per patient), was largely offset by reduced cost in hospitalization for heart failure (HHF) and cardiovascular death (-$537 per patient and -$166 per patient, respectively). Treatment of empagliflozin provided incremental 0.11 QALYs and 0.08 life years compared with SoC alone. The incremental cost-effectiveness ratio (ICER) was $12 772 (¥1 662 689)/QALY, which was below the Japanese willingness-to-pay (WTP) threshold of $38 408 (¥5 000 000)/QALY. The results were consistent across all the subgroups considered, and empagliflozin was dominant over SoC alone in the region Asia and BMI < 25 kg/m2 subgroups. ICERs for the remaining subgroups ranged from $7520/QALY (¥978 972/QALY, patients with baseline age ≥ 75 years) to $31 049/QALY (¥4 041 896/QALY, patients with baseline New York Heart Association class III/IV). Deterministic sensitivity analysis result showed that the treatment effect on HHF is the biggest driver of the cost-effectiveness analysis, while the ICER will be still under the threshold even if no effect of empagliflozin on HHF was assumed. The probabilistic sensitivity analysis result showed that 64% of simulations were cost-effective based on the Japanese WTP threshold. CONCLUSIONS Empagliflozin was demonstrated to be cost-effective for patients with HFpEF in Japan based on EMPEROR-Preserved trial data.
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Affiliation(s)
- Hiroyuki Tsutsui
- School of Medicine and Graduate SchoolInternational University of Health and WelfareTokyoJapan
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hiroyuki Sakamaki
- Kanagawa University of Human Services, School of Health InnovationKawasakiJapan
| | | | - Yasushi Sakata
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Yutaro Kotobuki
- Medicine DivisionNippon Boehringer Ingelheim Co., Ltd.ShinagawaTokyoJapan
| | - Stephan Linden
- Boehringer Ingelheim International GmbHIngelheim am RheinGermany
| | - Koki Idehara
- Real World Evidence Solutions & HEORIQVIA Solutions Japan K.K.TokyoJapan
| | - Daisuke Nitta
- Medicine DivisionNippon Boehringer Ingelheim Co., Ltd.ShinagawaTokyoJapan
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15
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Shimizu A, Yamaguchi K, Tohara H. Impact of pureed and liquidised diets on health-related quality of life scores in older patients during postacute rehabilitation: A pilot study. J Hum Nutr Diet 2024; 37:227-233. [PMID: 37805824 DOI: 10.1111/jhn.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/24/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Consuming texture-modified diets was considered to negatively affect health-related quality of life (HR-QoL). However, the precise relationship between the levels of food texture consumed and HR-QoL remains uncertain. The present study aimed to determine the association between levels of food texture consumed and HR-QoL. METHODS This cross-sectional study included 122 hospitalised patients aged ≥ 65 years (mean ± SD age 78.9 ± 7.9 years; 48.4% female) who required postacute rehabilitation. Consumed food texture levels were classified using the International Dysphagia Diet Standardization Initiative (IDDSI) framework 2.0. HR-QoL was evaluated using the five-level EuroQoL five-dimension (EQ-5D-5L). The association between food texture levels and HR-QoL was analysed using a multivariate linear regression model. RESULTS The lower food texture levels consumed were associated with significantly lower EQ-5D-5L scores. Consumption of pureed (IDDSI Level 4) and liqudised (IDDSI Level 3) diets were associated with lower EQ-5D-5L scores among older patients undergoing postacute rehabilitation (regression coefficient -0.304; 95% confidence interval = -0.472 to -0.137 and regression coefficient, -0.444, 95% confidence interval = -0.676 to -0.213, respectivly). CONCLUSIONS The findings suggest a link between the consumption of pureed and liquidised diets and lower HR-QoL scores in older hospitalised patients undergoing rehabilitation. To establish a clearer cause-and-effect relationship, future research should encompass multicentre and longitudinal studies, building upon the insights from the present study.
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Affiliation(s)
- Akio Shimizu
- Department of Food and Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, Japan
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan
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16
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Kikuchi Y, Nakano H, Goda A, Mori K, Abiko T, Mitsumaru N, Murata S. The Influence of Physical, Mental, and Cognitive Factors on Health-Related Quality of Life among Community-Dwelling Older Adults: A Focus on Central Sensitization-Related Symptoms. Geriatrics (Basel) 2024; 9:11. [PMID: 38247986 PMCID: PMC10801621 DOI: 10.3390/geriatrics9010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/26/2023] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
Most older adults wish to maintain independence in their familiar communities. However, many experience pain and pain-related disabilities which reduce their health-related quality of life (HRQOL), leading to increased hospitalizations and mortality. This study aimed to determine the impact of physical, mental, and cognitive factors, particularly central sensitization-related symptoms (CSS), on the HRQOL of community-dwelling older adults. A total of 206 participants were included in the analysis, which measured HRQOL, basic attributes, physical functions and body pain, mental factors, cognitive factors, and CSS severity using validated tools. A correlation analysis was used to examine the association between HRQOL and each measure. Furthermore, multiple regression analysis (forced entry method) was performed to identify the factors influencing the HRQOL. The study found that pain intensity and CSS severity significantly influenced the HRQOL among community-dwelling older adults. The higher the pain intensity and CSS severity, the lower their HRQOL. The participants had mild pain and CSS, demonstrating the need to monitor, address, and treat even non-severe issues in community-dwelling older adults. This association, revealed for the first time in this study, suggests that approaches to reduce pain and CSS are important for maintaining and improving the HRQOL of community-dwelling older adults.
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Affiliation(s)
- Yuki Kikuchi
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (H.N.); (T.A.); (S.M.)
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan;
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (H.N.); (T.A.); (S.M.)
| | - Akio Goda
- Department of Physical Therapy, Faculty of Health and Medical Science, Hokuriku University, Ishikawa 920-1180, Japan;
| | - Kohei Mori
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan;
- Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, Osaka 582-0026, Japan
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (H.N.); (T.A.); (S.M.)
| | | | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (H.N.); (T.A.); (S.M.)
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17
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Kobayashi J, Baron SJ, Takagi K, Thompson CA, Jiao X, Yamabe K. Cost-effectiveness analysis of transcatheter aortic valve implantation in aortic stenosis patients at low- and intermediate-surgical risk in Japan. J Med Econ 2024; 27:697-707. [PMID: 38654415 DOI: 10.1080/13696998.2024.2346397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To analyze the cost-effectiveness of transcatheter aortic valve implantation (TAVI) using the SAPIEN 3 (Edwards Lifesciences, Irvine, CA) compared to surgical aortic valve replacement (SAVR) in low- and intermediate-risk patients from a Japanese public healthcare payer perspective. METHODS A Markov model cost-effectiveness analysis was developed. Clinical and utility data were extracted from a systematic literature review. Cost inputs were obtained from analysis of the Medical Data Vision claims database and supplemented with a targeted literature search. The robustness of the results was assessed using sensitivity analyses. Scenario analyses were performed to determine the impact of lower mean age (77.5 years) and the effect of two different long-term mortality hazard ratios (TAVI versus SAVR: 0.9-1.09) on both risk-level populations. This analysis was conducted according to the guidelines for cost-effectiveness evaluation in Japan from Core 2 Health. RESULTS In intermediate-risk patients, TAVI was a dominant procedure (TAVI had lower cost and higher effectiveness). In low-risk patients, the incremental cost effectiveness ratio (ICER) for TAVI was ¥750,417/quality-adjusted-life-years (QALY), which was below the cost-effectiveness threshold of ¥5 million/QALY. The ICER for TAVI was robust to all tested sensitivity and scenario analyses. CONCLUSIONS TAVI was dominant and cost-effective compared to SAVR in intermediate- and low-risk patients, respectively. These results suggest that TAVI can provide meaningful value to Japanese patients relative to SAVR, at a reasonable incremental cost for patients at low surgical risk and potentially resulting in cost-savings in patients at intermediate surgical risk.
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Affiliation(s)
- Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Suzanne J Baron
- Interventional Cardiology, Massachusetts General Hospital, Boston, MA, USA
- BAIM Institute for Clinical Research, Boston, MA, USA
| | - Kensuke Takagi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Christin A Thompson
- Global Health Economics & Reimbursement, Edwards Lifesciences, Irvine, CA, USA
| | - Xiayu Jiao
- Global Health Economics & Reimbursement, Edwards Lifesciences, Irvine, CA, USA
| | - Kaoru Yamabe
- Market Access, Edwards Lifesciences, Tokyo, Japan
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Matsuno K, Asaoka D, Sugano K, Takahashi K, Miyauchi K. Rationale and design of Juntendo Sarcopenia Registration to explore the predictors and prognosis of sarcopenia and frailty in the elderly in TOKYO (JUSTICE-TOKYO). Geriatr Gerontol Int 2024; 24:168-172. [PMID: 38102932 DOI: 10.1111/ggi.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/16/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023]
Abstract
AIM This study aimed to clarify the prevalence, predictors, and prognosis of frailty and sarcopenia in both cross-sectional and longitudinal study of the real world. METHODS The JUSTICE-TOKYO study is a single-center, prospective observational study of elderly patients. Patients aged ≥65 years who regularly visited our center were enrolled and followed up for 4 years (n = 1042). The diagnosis of sarcopenia and frailty in the enrolled patients was based on the criteria established by the Asian Working Group for Sarcopenia and Japanese version of the Cardiovascular Health Study criteria, respectively. The primary end point is the incidence of all-cause mortality and hospitalization for treatment. The secondary end points are clinically significant bleeding, cardiovascular events, strokes, malignancies, incidence of falling, fractures, pneumonia, and the onset of new dementia cases. RESULTS A total of 1042 patients were enrolled in this study. The mean age of the cohort at baseline was 78.2 years, with 56% being women. Among the enrolled patients, 223 (21.4%) diagnosed with sarcopenia, 172 (16.5%) exhibited frailty, and 541 (51.9%) fell into the prefrailty category. CONCLUSIONS The JUSTICE-TOKYO study provides valuable insights into the prevalence of sarcopenia and frailty among older adult outpatients in a real-world context and contributes to measures aimed at extending healthy life expectancy. Geriatr Gerontol Int 2024; 24: 168-172.
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Affiliation(s)
- Kei Matsuno
- Department of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Japan
- Department of Sports Medicine, Juntendo University, Bunkyo-ku, Japan
| | - Daisuke Asaoka
- Department of Gastroenterology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Japan
| | - Koji Sugano
- Department of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | - Katsumi Miyauchi
- Department of Cardiology, Juntendo Tokyo Koto Geriatric Medical Center, Koto-ku, Japan
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19
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Okada M, Ishida N, Kanzaki S, Kawada I, Nagashima K, Terai H, Hiruma G, Namkoong H, Asakura T, Masaki K, Ohgino K, Miyata J, Chubachi S, Kodama N, Maeda S, Sakamoto S, Okamoto M, Nagasaki Y, Umeda A, Miyagawa K, Shimada H, Minami K, Hagiwara R, Ishii M, Sato Y, Fukunaga K. Upper Respiratory Symptoms as Long COVID: Insight from a Multicenter Cohort Study. OTO Open 2024; 8:e120. [PMID: 38435484 PMCID: PMC10909391 DOI: 10.1002/oto2.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Objective This study aimed to investigate the clinical features of long COVID cases presenting with upper respiratory symptoms, a topic not yet fully elucidated. Study Design Prospective cohort study. Setting A multicenter study involving 26 medical facilities in Japan. Methods Inclusion criteria were patients aged ≥18 years old with a confirmed COVID-19 diagnosis via severe acute respiratory syndrome coronavirus 2 polymerase chain reaction or antigen testing, who were hospitalized at the participating medical facilities. Analyzing clinical information and patient-reported outcomes from 1009 patients were analyzed. The outcome measured the degree of initial symptoms for taste or olfactory disorders and assessed the likelihood of these symptoms persisting as long COVID, as well as the impact on quality of life if the upper respiratory symptoms persisted as long COVID. Results Patients with high albumin, low C-reactive protein, and low lactate dehydrogenase in laboratory tests tended to experience taste or olfactory disorders as part of long COVID. Those with severe initial symptoms had a higher risk of experiencing residual symptoms at 3 months, with an odds ratio of 2.933 (95% confidence interval [CI], 1.282-6.526) for taste disorders and 3.534 (95% CI, 1.382-9.009) for olfactory disorders. Presence of upper respiratory symptoms consistently resulted in lower quality of life scores. Conclusion The findings from this cohort study suggest that severe taste or olfactory disorders as early COVID-19 symptoms correlate with an increased likelihood of persistent symptoms in those disorders as long COVID.
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Affiliation(s)
- Masahiko Okada
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
| | - Noriyuki Ishida
- Biostatistics Unit, Clinical and Translational Research CenterKeio University HospitalTokyoJapan
| | - Sho Kanzaki
- Department of Otorhinolaryngology–Head and Neck SurgeryKeio UniversityTokyoJapan
- Laboratory of Auditory Disorders, National Institute of Sensory Organs NationalHospital Organization Tokyo Medical CenterTokyoJapan
| | - Ichiro Kawada
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
- Health CenterKeio UniversityYokohamaJapan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research CenterKeio University HospitalTokyoJapan
| | - Hideki Terai
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
- Keio Cancer CenterKeio University School of MedicineTokyoJapan
| | - Gaku Hiruma
- Biostatistics Unit, Clinical and Translational Research CenterKeio University HospitalTokyoJapan
| | - Ho Namkoong
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
- Department of Infectious DiseasesKeio University School of MedicineTokyoJapan
| | - Takanori Asakura
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
- Department of Respiratory MedicineKitasato University Kitasato Institute HospitalTokyoJapan
| | - Katsunori Masaki
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
| | - Keiko Ohgino
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
| | - Jun Miyata
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
| | - Shotaro Chubachi
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
| | - Nobuhiro Kodama
- Department of General Internal MedicineFukuoka Tokushukai HospitalFukuokaJapan
| | - Shunsuke Maeda
- Department of General Internal MedicineFukuoka Tokushukai HospitalFukuokaJapan
| | - Satoshi Sakamoto
- Department of RespirologyNational Hospital Organization Kyushu Medical CenterFukuokaJapan
| | - Masaki Okamoto
- Department of RespirologyNational Hospital Organization Kyushu Medical CenterFukuokaJapan
| | - Yoji Nagasaki
- Department of Infectious Disease and Clinical Research CenterNational Hospital Organization Kyushu Medical CenterFukuokaJapan
| | - Akira Umeda
- Department of General Medicine, School of Medicine, IUHW Shioya HospitalInternational University of Health and Welfare (IUHW)TochigiJapan
| | - Kazuya Miyagawa
- Department of PharmacologyInternational University of Health and WelfareTochigiJapan
| | - Hisato Shimada
- Department of Respiratory MedicineInternational University of Health and Welfare Shioya HospitalTochigiJapan
| | - Kazuhiro Minami
- Department of Internal MedicineSaitama Medical CenterSaitamaJapan
| | - Rie Hagiwara
- Department of Internal MedicineSaitama Medical CenterSaitamaJapan
| | - Makoto Ishii
- Department of Respiratory MedicineNagoya University Graduate School of MedicineNagoyaJapan
| | - Yasunori Sato
- Department of Preventive Medicine and Public HealthKeio University School of MedicineTokyoJapan
| | - Koichi Fukunaga
- Department of Medicine, Division of Pulmonary MedicineKeio University School of MedicineTokyoJapan
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Matza LS, Stewart KD, Redig J, Howell TA, Morris W, Newson RS, Yasui A, Ishak J, Boye KS. Health state utilities associated with weight loss: preferences of people with type 2 diabetes and obesity in Japan. J Med Econ 2024; 27:370-380. [PMID: 38347819 DOI: 10.1080/13696998.2024.2316400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/06/2024] [Indexed: 03/12/2024]
Abstract
AIMS Health state utilities associated with weight change are needed for cost-utility analyses (CUAs) examining the value of treatments for type 2 diabetes and obesity. Previous studies have estimated the utility benefits associated with various amounts of weight reduction in the US and Europe, but preferences for weight change in Asian cultures may differ from these published values. The purpose of this study was to estimate utilities associated with reductions in body weight based on preferences of individuals with type 2 diabetes and obesity in Japan. METHODS Health state vignettes represented type 2 diabetes with respondents' own current weight and weight reductions of 2.5%, 5%, 7.5%, 10%, 12.5%, 15%, and 20%. Utilities were elicited in time trade-off interviews with a sample of respondents in Japan with type 2 diabetes and body mass index (BMI) ≥25 kg/m2 (the cutoff for obesity in Japan). RESULTS Analyses were conducted with data from 138 respondents (84.8% male; mean age = 58.0 years; mean BMI = 29.4 kg/m2) from all eight regions of Japan. Utility gains gradually increased with rising percentage of weight reductions ranging from 2.5% to 15%. Weight reductions of 2.5% to 15% resulted in utility increases of 0.013 to 0.048. The health state representing a 20% weight reduction yielded a wide range of preferences (mean utility increase of 0.044). Equations are recommended for estimating utility change based on any percentage of weight reduction (up to 20%) in Japanese people with type 2 diabetes and obesity. LIMITATIONS This study was conducted in a sample with limited representation of patients with BMI >35 kg/m2 (n = 13) and relatively few women (n = 21). CONCLUSION Results may be used to provide inputs for CUAs examining the value of treatments that are associated with weight loss in patients with type 2 diabetes and obesity in Japan.
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Watanabe S, Liu K, Kozu R, Yasumura D, Yamauchi K, Katsukawa H, Suzuki K, Koike T, Morita Y. Association Between Mobilization Level And Activity of Daily Living Independence in Critically Ill Patients. Ann Rehabil Med 2023; 47:519-527. [PMID: 37990499 PMCID: PMC10767217 DOI: 10.5535/arm.23056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/11/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70. METHODS This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL. RESULTS Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07-1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69). CONCLUSION These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.
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Affiliation(s)
- Shinichi Watanabe
- Department of Rehabilitation, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Australia
| | - Ryo Kozu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Daisetsu Yasumura
- Department of Rehabilitation, Naha City Hospital, Naha, Japan
- Department of Healthcare Administration, The University of Kyushu, Fukuoka, Japan
| | - Kota Yamauchi
- Department of rehabilitation, Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | | | - Keisuke Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Takayasu Koike
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Yasunari Morita
- Department of Critical Care Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
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Prevolnik Rupel V, Ogorevc M. EQ-5D-5L Value Set for Slovenia. PHARMACOECONOMICS 2023; 41:1515-1524. [PMID: 37341959 PMCID: PMC10570207 DOI: 10.1007/s40273-023-01280-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES The aim of this valuation study was to produce a value set to support the use of EQ-5D-5L data in decision making in Slovenia. METHODS The study design followed the published EuroQol research protocol, and a quota sample was defined according to age, sex, and region. Overall, 1012 adult respondents completed 10 time trade-off and seven discrete choice experiment tasks in face-to-face interviews. The Tobit model was used to analyse the composite time trade-off (cTTO) data in order to generate values for the 3125 EQ-5D-5L health states. RESULTS The data showed logical consistency, with more severe states being given lower values. The greatest disutility was shown in the pain/discomfort and anxiety/depression dimensions. In the EQ-5D-5L value set, the values range from -1.09 to 1. With the exception of UA5 (unable to perform usual activities), all other levels on all health dimensions were statistically different from 0 and from each other. Compared with the existing EQ-5D-3L value set, there is a slightly lower share of 'worse than dead' states (32.1% compared with 33.7%) and the minimum value is lower. CONCLUSIONS Results have important implications for users of the EQ-5D-5L in Slovenia and regions. It is a robust and up-to-date value set and should be the preferred value set used in adults in Slovenia and in neighbouring countries without their own value set.
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Affiliation(s)
- Valentina Prevolnik Rupel
- Institute for Economic Research, Kardeljeva ploščad 17, Ljubljana, Slovenia.
- DOBA Faculty, Prešernova cesta 1, 2000, Maribor, Slovenia.
| | - Marko Ogorevc
- Institute for Economic Research, Kardeljeva ploščad 17, Ljubljana, Slovenia
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Dewilde S, Phillips G, Paci S, De Ruyck F, Tollenaar NH, Janssen MF. People Diagnosed with Myasthenia Gravis have Lower health-related quality of life and Need More Medical and Caregiver Help in Comparison to the General Population: Analysis of Two Observational Studies. Adv Ther 2023; 40:4377-4394. [PMID: 37490259 PMCID: PMC10499690 DOI: 10.1007/s12325-023-02604-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Myasthenia gravis (MG) is a neuromuscular disease causing extreme muscular fatigue, triggering problems with vision, swallowing, speech, mobility, dexterity, and breathing. This analysis intended to estimate the health-related quality-of-life impact, the medical burden, and the need for caregiver help of people diagnosed with MG. METHODS MyRealWorld-MG (MRW) is an observational study among adults diagnosed with MG in 9 countries. The General Population Norms (POPUP) observational study enrolled representative members of the general population in 8 countries. In both digital studies, respondents entered personal characteristics and provided data on medical conditions, EQ-5D-5L, HUI3, MG-Activities of Daily Living (MG-ADL), sick leave, caregiver help, and medical care utilization. RESULTS In MRW (n = 1859), 58.4% of respondents had moderate-to-severe MG. Average utility values were lower in MRW versus POPUP (0.739 vs. 0.843 for EQ-5D-5L; 0.493 vs. 0.746 for HUI3), and declined with more severe disease (0.872, 0.707, 0.511 EQ-5D-5L utilities and 0.695, 0.443, 0.168 HUI3 utilities for mild, moderate, and severe MG, respectively). Taking sick leave in the past month was 2.6 times more frequent among people diagnosed with MG compared to the general population (34.4% vs. 13.2%) and four times more people diagnosed with MG reported needing help from a caregiver (34.8% vs. 8.3%). Use of medical care was twice as likely in MRW in comparison with POPUP (51.9% vs. 24.6%). CONCLUSION This direct comparison of people diagnosed with MG and the general population using two large international studies revealed significant negative impact of MG. Results were consistent across all outcomes, in all countries.
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Affiliation(s)
- S Dewilde
- Services in Health Economics (SHE), Rue JG Eggerickx 36, 1150, Brussels, Belgium.
| | | | - S Paci
- Argenx BV, Ghent, Belgium
| | | | - N H Tollenaar
- Services in Health Economics (SHE), Rue JG Eggerickx 36, 1150, Brussels, Belgium
| | - M F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
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Takasaki H, Yamasaki C. Immediate neck hypoalgesic effects of craniocervical flexion exercises and cervical retraction exercises among individuals with non-acute neck pain and a directional preference for retraction or extension: preliminary pretest-posttest randomized experimental design. J Man Manip Ther 2023; 31:368-375. [PMID: 37052492 PMCID: PMC10566415 DOI: 10.1080/10669817.2023.2201918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Selective deep neck flexor muscle activation through craniocervical flexion exercises has been considered to be different from cervical retraction exercises. OBJECTIVE To compare the immediate analgesic effect of craniocervical flexion versus cervical retraction exercises in individuals with nonacute, directional preference (DP) for cervical retraction or extension. METHODS A two-arm, assessor-blinded, pretest-posttest randomized experiment was conducted. Participants were randomly assigned to either craniocervical flexion or cervical retraction exercises and those who were confirmed at the post-intervention examination to have a DP for cervical retraction or extension were analyzed. The primary outcome measure was pressure pain thresholds at the C2 and C5-C6 levels. RESULTS A total of 10 (mean age = 20.6 years) and nine participants (mean age = 19.4 years) undertook craniocervical flexion and retraction exercises, respectively. One-way analysis of variance demonstrated no statistically significant (p > 0.05) interaction effect regardless of the neck level. In the pre-post change percentages, retraction exercises provided greater analgesic effects compared to craniocervical flexion exercises at the C2 (Hedges' g = 0.679) and C5-C6 levels (g = 0.637). CONCLUSION This study showed a comparable or greater immediate neck analgesic effect from cervical retraction exercises compared to craniocervical flexion exercises in individuals with a DP for cervical retraction or extension.
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Affiliation(s)
- Hiroshi Takasaki
- CONTACT Hiroshi Takasaki Department of Physical Therapy, Saitama343-8540, Japan
| | - Chisato Yamasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
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Wang X, Yamato K, Kojima Y, Paris JJ, Peterse EFP, Simons MJHG, Bennison C. Modeling Monthly Migraine-Day Distributions Using Longitudinal Regression Models and Linking Quality of Life to Inform Cost-Effectiveness Analysis: A Case Study of Fremanezumab in Japanese-Korean Migraine Patients. PHARMACOECONOMICS 2023; 41:1263-1274. [PMID: 37318748 PMCID: PMC10492773 DOI: 10.1007/s40273-023-01288-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVES As regression approaches have been used more recently to model the effectiveness and health-related quality of life (HRQOL) of novel migraine treatments, an example is provided for fremanezumab. The objective is to estimate the distribution of mean monthly migraine days (MMD) as a continuous variable and corresponding migraine-specific utility values as a function of the MMD, to inform health states in a cost-effectiveness model (CEM). METHODS Three longitudinal regression models (zero-adjusted gamma [ZAGA], zero-inflated beta-binomial [ZIBB], and zero-inflated negative binomial [ZINBI]) were fitted to Japanese-Korean clinical trial data of episodic (EM) and chronic migraine (CM) patients treated with fremanezumab or placebo, to estimate MMD over a period of 12 months. The EQ-5D-5L and the migraine-specific quality-of-life (MSQ), mapped to the EQ-5D-3L, questionnaires were used to measure HRQOL. Migraine-specific utility values were estimated as a function of MMD using a linear mixed effects model. RESULTS The ZIBB models fitted the data best in estimating the distribution of mean MMD over time. MSQ-derived values were more sensitive than the EQ-5D-5L values for the effect of the number of MMD on HRQOL, with higher values for less MMD and more time on treatment. CONCLUSIONS Using longitudinal regression models to estimate MMD distributions and linking utility values as a function is an appropriate method to inform CEMs and capture inter-patient heterogeneity. The observed distribution shifts demonstrated fremanezumab's effect at reducing MMD for both EM and CM patients, while treatment effect on HRQOL was captured by MMD and time on treatment.
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Affiliation(s)
- Xinyu Wang
- Otsuka Pharmaceuticals Co., Ltd., Medical Affairs HEOR/RWE, Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan.
| | - Kentaro Yamato
- Otsuka Pharmaceuticals Co., Ltd., Medical Affairs HEOR/RWE, Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan
| | - Yoshitsugu Kojima
- Otsuka Pharmaceuticals Co., Ltd., Medical Affairs HEOR/RWE, Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan
| | - Josef J Paris
- OPEN Health, Evidence & Access, Chatsworth House, Sandy Lane West, Oxford, OX4 6LB, UK
| | - Elisabeth F P Peterse
- OPEN Health, Evidence & Access, Marten Meesweg 107, 3068 AV, Rotterdam, The Netherlands
| | - Martijn J H G Simons
- OPEN Health, Evidence & Access, Marten Meesweg 107, 3068 AV, Rotterdam, The Netherlands
| | - Craig Bennison
- OPEN Health, Evidence & Access, Enterprise House, Innovation Way, York, YO10 5NQ, UK
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Ito K, Mitobe Y, Inoue R, Momoeda M. Impact of nausea/vomiting on EQ-5D-5L utility scores in patients taking iron preparations for heavy menstrual bleeding or anemia. BMC Womens Health 2023; 23:505. [PMID: 37735374 PMCID: PMC10512526 DOI: 10.1186/s12905-023-02652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND The purpose of this study was to establish an estimating equation to predict the 5-level EQ-5D version (EQ-5D-5L) utility score in patients taking iron preparations for heavy menstrual bleeding (HMB) or anemia and to evaluate whether the presence of nausea or vomiting was a significant predictor of EQ-5D-5L-based quality of life. METHODS A cross-sectional survey was conducted to collect EQ-5D-5L utility scores and other patient reported outcomes from 385 patients taking iron preparations for HMB or anemia who were selected from the disease patient panel. Using the utility scores as objective variables, explanatory variable candidates were selected considering correlations, multicollinearity, and clinical validity. Predicting models were constructed using regression-based models (linear model, generalized linear model (GLM), Tobit model). Stepwise regression method was applied for selecting statistically significant (p < 0.05) predictors. Goodness-of-fit of models were assessed by mean absolute error and mean squared error (MSE). RESULTS The EQ-5D-5L utility scores (mean ± standard deviation) of 96 patients with nausea/vomiting and 289 patients without nausea/vomiting were 0.67 ± 0.16 and 0.84 ± 0.14, respectively (p < 0.001). The presence of nausea/vomiting was shown to be the most significant factor reducing the utility score in the statistical models using the explanatory variable candidates selected in the study. As the results of the goodness-of-fit test, GLM with the smallest MSE was selected to establish the estimating equation. CONCLUSION The estimating equation to predict the EQ-5D-5L utility scores in patients taking iron preparations for HMB or anemia was established. The presence of nausea/vomiting was found to be a factor significantly reducing utility scores, with a decrement of the value estimated to be -0.117. TRIAL REGISTRATION UMIN000045700 ( http://www.umin.ac.jp/ctr/ ). Registered on October 11, 2021.
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Affiliation(s)
- Kyoko Ito
- Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8439, Japan
| | - Yuko Mitobe
- Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8439, Japan
| | - Ryo Inoue
- Medical Affairs Department, Torii Pharmaceutical Co., Ltd., 3-4-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8439, Japan
| | - Mikio Momoeda
- Aiiku Maternal and Child Health Center, Aiiku Hospital, 1-16-10 Shibaura, Minato-ku, Tokyo, 105-8321, Japan.
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Yamamoto H, Tanaka S, Kasugai D, Shimizu M, Tsuchikawa Y, Hori Y, Fugane Y, Inoue T, Nagaya M, Omote N, Higashi M, Yamamoto T, Jingushi N, Numaguchi A, Goto Y, Nishida Y. Physical function and mental health trajectories in COVID-19 patients following invasive mechanical ventilation: a prospective observational study. Sci Rep 2023; 13:14529. [PMID: 37666912 PMCID: PMC10477337 DOI: 10.1038/s41598-023-41684-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
This prospective observational cohort study was performed to investigate the physical function and mental health trajectories of novel coronavirus disease 2019 (COVID-19) patients requiring invasive mechanical ventilation (IMV) after discharge from the intensive care unit (ICU). The study population consisted of 64 patients (median age, 60 years; 85.9% male; median IMV duration, 9 days). At ICU discharge, 28.1% of the patients had Medical Research Council (MRC) sum score < 48 points, and prolonged IMV was significantly associated with lower MRC sum score and handgrip strength. Symptoms were similar between groups at ICU discharge, and the symptoms most commonly reported as moderate-to-severe were impaired well-being (52%), anxiety (43%), tiredness (41%), and depression (35%). Although muscle strength and mobility status were significantly improved after ICU discharge, Edmonton Symptom Assessment System score did not improve significantly in the prolonged IMV group. EuroQol five-dimension five-level summary index was significantly lower in the prolonged than short IMV group at 6 months after ICU discharge. We found substantial negative physical function and mental health consequences in the majority of surviving COVID-19 patients requiring IMV, with prolonged period of IMV showing greater negative effects not only immediately but also at 6 months after discharge from the ICU.
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Affiliation(s)
- Hiromasa Yamamoto
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Shinya Tanaka
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Daisuke Kasugai
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan.
| | - Miho Shimizu
- Department of Rehabilitation, Mie University Hospital, Tsu, Japan
| | - Yohei Tsuchikawa
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yuto Hori
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yuki Fugane
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Takayuki Inoue
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Motoki Nagaya
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Norihito Omote
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michiko Higashi
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Takanori Yamamoto
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Naruhiro Jingushi
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Atsushi Numaguchi
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Yukari Goto
- Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Tsurumai-Cho 65, Syowa-Ku, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Imai K, Suzuki Y, Hiiragi K, Hotta Y, Shigeta H. Comparison of quality of life after robotic-transvaginal natural orifice transluminal endoscopic surgery and robot-assisted laparoscopic hysterectomy. Eur J Obstet Gynecol Reprod Biol 2023; 288:211-215. [PMID: 37572450 DOI: 10.1016/j.ejogrb.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES We investigated quality of life (QOL) of patients who underwent total hysterectomy for benign uterine diseases using two surgical approaches: robotic-transvaginal natural orifice transluminal endoscopic surgery (R-vNOTES) and robot-assisted laparoscopic hysterectomy (RALH). STUDY DESIGN This single-center retrospective study was conducted in a tertiary academic setting and included 65 patients who underwent robotic-assisted hysterectomy for benign uterine diseases. Total hysterectomy was performed using R-vNOTES or RALH by the same gynecologist between December 2021 and June 2022. The primary outcome was a comparison of QOL over time and complete QOL recovery (postoperative QOL score/preoperative QOL score ≥ 1) by postoperative day 28 (POD28) in the R-vNOTES and RALH groups. QOL was examined using EQ-5D-5L in this study. The secondary outcome was a comparison of the surgical outcomes in the R-vNOTES and RALH groups. RESULTS Complete QOL recovery was achieved by 62.7% in the R-vNOTES group and 7.3% in the RALH group at POD7 (p <.001) and by 100% in the R-vNOTES group and 56.1% in the RALH group at POD28 (p <.001). In a multivariable model, patients who underwent R-vNOTES achieved higher complete QOL recovery at POD 28 [adjusted hazard ratio: 4.03, 95% confidence interval: 2.03-8.04]. There was no significant difference between the R-vNOTES and RALH groups in terms of operating time (p =.07), intraoperative blood loss (p =.35), uterus weight (p =.76), or postoperative complications (p =.71). CONCLUSION The R-vNOTES approach for total hysterectomy for benign uterine diseases provided better complete QOL recovery by POD28 compared to the RALH approach. The surgical outcomes for R-vNOTES were equivalent to those for RALH, suggesting that R-vNOTES may provide a safe approach for robot-assisted hysterectomy.
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Affiliation(s)
- Kazuaki Imai
- Department Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yukio Suzuki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
| | - Kazuya Hiiragi
- Department Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yuichiro Hotta
- Department Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroyuki Shigeta
- Department Obstetrics and Gynecology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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Xie S, Wu J, Xie F. Whose Time Trade-Off Should Be Used? Anchoring Discrete Choice Experiment Latent Utilities in Health State Valuation. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1405-1412. [PMID: 37285916 DOI: 10.1016/j.jval.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To compare anchored discrete choice experiment (DCE) utility values using own versus others' time trade-off (TTO) responses in the valuation of SF-6Dv2. METHODS A representative sample of the general population was recruited in China. Through face-to-face interviews, both DCE and TTO data were collected from a randomly selected half of the respondents (own TTO sample), whereas only TTO data were collected from the other half (others' TTO sample). Conditional logit model was used to estimate DCE latent utilities. Three anchoring methods, including using the observed and the modeled TTO values for the worst state, and mapping DCE values onto TTO, were used to scale the latent utilities to health utilities. Prediction accuracy was assessed using intraclass correlation coefficient, mean absolute difference, and root mean squared difference compared with the mean observed TTO values between the anchoring results using the own versus others' TTO data. RESULTS Demographic characteristics were comparable between the own TTO sample (n = 252) and the others' TTO sample (n = 251). The mean (SD) observed TTO value for the worst state was -0.259 (0.591) for the own TTO sample and -0.236 (0.616) for the others' TTO sample. Anchoring DCE using own TTOs consistently showed a better prediction accuracy than using others' TTOs across the 3 anchoring methods in terms of the intraclass correlation coefficient (0.835-0.873 vs 0.771-0.804), mean absolute difference (0.127-0.181 vs 0.146-0.203), and root mean squared difference (0.164-0.237 vs 0.192-0.270). CONCLUSION When anchoring DCE-derived latent utilities onto the health utility scale, respondents' own TTO data would be preferred to TTO data obtained from a different sample.
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Affiliation(s)
- Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China; Center for Social Science Survey and Data, Tianjin University, Tianjin, China
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
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Osawa T, Fujii Y, Kimura G, Kitamura H, Nagashima Y, Iizumi S, Osaka T, Tsubouchi R, Shinohara N. Electronic patient-reported outcome (e-PRO) monitoring for adverse event management during cabozantinib treatment in patients with advanced renal cell carcinoma: protocol for a three-arm, randomised, multicentre phase II trial (e-PRO vs paper-PRO or usual care). BMJ Open 2023; 13:e070275. [PMID: 37495393 PMCID: PMC10373669 DOI: 10.1136/bmjopen-2022-070275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION Cabozantinib monotherapy is an option for treatment of advanced renal cell carcinoma (RCC). However, cabozantinib dose modification and discontinuation due to symptomatic adverse events (AEs) remains a challenge. The use of patient-reported outcomes (PROs) may help manage symptomatic AEs, which is reported to lead to improved quality of life (QOL), avoidance of drug discontinuation and better survival. This study aims to investigate the clinical benefits of PROs in patients with RCC receiving cabozantinib and the most appropriate medium for PRO monitoring (electronic [e]-PRO or paper-PRO). METHODS AND ANALYSIS This study is being conducted at about 35 sites in Japan. Patients aged ≥18 years with unresectable or metastatic RCC initiating treatment with cabozantinib monotherapy are eligible and will be randomised to: (1) e-PRO monitoring, (2) paper-PRO monitoring or (3) usual care without PRO monitoring. Recruitment began in December 2021 (target sample size, 105). Patients start treatment with cabozantinib 60 mg once daily, and in the PRO groups, will record daily medication intake, weight, temperature, blood pressure and AEs. Endpoints include the proportion of patients with a ≥5-point deterioration on the Functional Assessment of Cancer Therapy-Kidney Cancer Symptom Index (FKSI-19; primary endpoint), progression-free survival, QOL, dose adjustments, relative dose intensity, treatment-emergent AEs and frequency of interventions for AEs outside of the scheduled visits. Patient and physician opinions of the PRO monitoring systems and patient compliance with e-PRO/paper-PRO input are also being measured. ETHICS AND DISSEMINATION The study is being conducted in compliance with the Declaration of Helsinki, the International Council for Harmonisation guidelines for Good Clinical Practice and the Clinical Trials Act. Written informed consent is being obtained from all patients, and the protocol has been approved by the Hokkaido University Hospital Certified Review Board (approval number, CRB021-005). The results will be presented at conferences and submitted to a peer-reviewed journal. TRIAL REGISTRATION NUMBER jRCTs011210055.
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Affiliation(s)
- Takahiro Osawa
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Go Kimura
- Department of Urology, Nippon Medical School, Tokyo, Japan
| | - Hiroshi Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women's Medical University, Tokyo, Japan
| | - Sakura Iizumi
- Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Tsuyoshi Osaka
- Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Ryoichi Tsubouchi
- Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Maeshige N, Hayashi H, Kawabe N, Imaoka S, Sakaki S, Matsumoto J, Kondo E, Ishii T, Kiyota N, Furukawa M, Terashi H, Sonoda Y. Effect of Early Rehabilitation on Walking Independence and Health-Related Quality of Life in Patients With Chronic Foot Wounds: A Multicenter Randomized Clinical Trial. INT J LOW EXTR WOUND 2023:15347346231187178. [PMID: 37448201 DOI: 10.1177/15347346231187178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
Rehabilitation is usually provided to patients with chronic foot wounds (CFWs) after surgery. This study aimed to assess whether early postoperative rehabilitation could maintain walking independence in hospitalized patients with CFWs. This single-blind, randomized clinical trial was performed between September 10, 2018 and March 2019, involving 60 patients who underwent both surgical procedures and rehabilitation. Participants were randomly allocated into the early rehabilitation (EG, n = 30) or the control (CG, n = 30) groups. EG received early rehabilitation immediately after surgery, while CG received late rehabilitation after wound closure. Both groups received rehabilitation sessions 5 times per week until discharge. The primary outcome was walking independence, measured via Functional Independence Measure (FIM)-gait scores. Secondary outcomes included health-related quality of life (HRQoL) using EuroQol 5 dimensions 5-level (EQ-5D-5L) and the presence of rehabilitation-related adverse events, including dehiscence of wounds and falls. Differences in intervention timing effects were analyzed using nonparametric split-plot factorial design analysis, including Fisher's exact test, Mann-Whitney U test, and Wilcoxon signed-rank test (P < .05). Out of the 60 participants, 53 patients completed the discharge follow up. Three participants (10.0%) from the EG and 4 (13.3%) from the CG dropped out due to postoperative complications unrelated to rehabilitation intervention. No rehabilitation-related adverse events were found. Participants in the EG maintained greater FIM-gait scores during hospitalization than the CG (difference, -1; P = .0001), with a difference of 0 (P = .109) at discharge. EQ-5D-5L significantly improved in both groups (EG: difference, 0.13 [P = .014], CG: difference, 0.17 [P = .0074]). The EG intervention was associated more with maintaining walking independence at discharge than CG intervention. Postoperative rehabilitation improved HRQoL without adverse events, indicating that clinicians should recommend early rehabilitation for patients with CFW to enhance walking independence.
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Affiliation(s)
- Noriaki Maeshige
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
| | - Hisae Hayashi
- Faculty of Health and Medical Sciences, Aichi Shukutoku University, Nagakute, Aichi, Japan
| | - Nobuhide Kawabe
- Faculty of Makuhari Human Care, Tohto University, Makuhari, Chiba, Japan
| | - Shinsuke Imaoka
- Department of Rehabilitation, Oita Oka Hospital, Oita, Oita, Japan
| | - Satoko Sakaki
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Kasukabe, Saitama, Japan
| | - Junichi Matsumoto
- Department of Rehabilitation, Kasukabe Chuo General Hospital, Kasukabe, Saitama, Japan
| | - Eriko Kondo
- Department of Rehabilitation Medicine, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan
| | - Tatsuya Ishii
- Department of Rehabilitation Medicine, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan
| | - Naruaki Kiyota
- Department of Rehabilitation Medicine, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan
| | | | - Hiroto Terashi
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Yuma Sonoda
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Hyogo, Japan
- Advanced Research Center for Well-being, Kobe University, Kobe, Hyogo, Japan
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Nishida Y, Tokunaga M, Kameyama A, Miyamoto M, Yoshifuku S, Sasahara K, Otagiri N, Tauchi K. A prospective clinical study evaluating short-term changes in body composition and quality of life after gastrectomy in elderly patients receiving postoperative exercise and nutritional therapies. BMC Surg 2023; 23:181. [PMID: 37386398 DOI: 10.1186/s12893-023-02086-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Muscle mass loss after gastrectomy is associated with a negative impact on quality of life (QOL) and long-term prognosis following gastric cancer treatment, especially in elderly patients. We conducted a prospective study to examine short-term changes in body composition and QOL after gastrectomy in elderly patients with gastric cancer who received exercise and nutritional therapies. METHODS Patients over aged 65 years of age who underwent gastrectomies for gastric cancer were enrolled in our study. Patients received exercise and nutritional therapies with branched-chain amino acid (BCAA)-rich supplements during 1 month after surgery. Body composition was evaluated using InBody S10 before surgery, and at 1 week and 1 month postoperatively. Other variables including QOL status (EQ-5D-5 L), serum albumin level, hand grip strength, and gait speed were evaluated at the same time. RESULTS Eighteen patients were analyzed. The mean loss of skeletal muscle mass index (SMI) was 4.6% (1 week) and 2.1% (1 month) compared to the preoperative period. QOL scores showed almost the same degree of recovery at 1 month after gastrectomy as preoperative scores. Serum albumin levels, hand grip strength, and gait speed decreased at 1 week and then increased at 1 month after surgery, similar to the changes seen in SMI. CONCLUSIONS Multidisciplinary approaches play key role in the surgical treatment of elderly patients. Postoperative exercise and nutritional therapies with BCAA-rich supplements may benefit elderly patients after gastrectomy by reducing loss of SMI and decreases in QOL. TRIAL REGISTRATION UMIN Clinical Trials Registry; UMIN000034374 (registration date: 10/10/2018).
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Affiliation(s)
- Yasunori Nishida
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan.
| | - Mai Tokunaga
- Rehabilitation Center, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
| | - Akira Kameyama
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
| | - Masatake Miyamoto
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
| | - Seijiro Yoshifuku
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
| | - Kotaro Sasahara
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
| | - Noriaki Otagiri
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
| | - Katsunori Tauchi
- Department of Surgery, Aizawa Hospital, 2-5-1 Honjou Matsumoto, Nagano, 390-8510, Japan
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Chang J, Yuan Y, Fu M, Wang D. Health-related quality of life among patients with knee osteoarthritis in Guangzhou, China: a multicenter cross-sectional study. Health Qual Life Outcomes 2023; 21:50. [PMID: 37244981 DOI: 10.1186/s12955-023-02133-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023] Open
Abstract
PURPOSES To investigate health-related quality of life (HRQoL) of patients with knee osteoarthritis (KOA) in Guangzhou, China, and examine its association with selected sociodemographic characteristics as well as knee function. METHODS This multicenter cross-sectional study included 519 patients with KOA in Guangzhou from April 1 to December 30, 2019. Data on sociodemographic characteristics were obtained using the General Information Questionnaire. The disability was measured using the KOOS-PS, resting pain using the Pain-VAS, and HRQoL using the EQ-5D-5L. The association of selected sociodemographic factors, KOOS-PS and Pain-VAS scores with HRQoL (EQ-5D-5L utility and EQ-VAS scores) were analyzed using linear regression analyses. RESULTS The median (interquartile range [IQR]) of EQ-5D-5L utility and EQ-VAS scores were 0.744 (0.571-0.841) and 70 (60-80) respectively, lower than the average HRQoL in the general population. Only 3.661% of KOA patients reported no problems in all EQ-5D-5L dimensions, with Pain/Discomfort being the most frequently affected dimension (78.805%). The correlation analysis showed that the KOOS-PS score, Pain-VAS score and HRQoL were moderately or strongly correlated. Patients with cardiovascular disease, no daily exercise, and high KOOS-PS or Pain-VAS scores had lower EQ-5D-5L utility scores; and patients with body mass index (BMI) > 28 ,high KOOS-PS or Pain-VAS scores had lower EQ-VAS scores. CONCLUSIONS Patients with KOA had relatively low HRQoL. Various sociodemographic characteristics as well as knee function were associated with HRQoL in regression analyses. Providing social support and improving their knee function through methods such as total knee arthroplasty might be crucial to improve their HRQoL.
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Affiliation(s)
- Jinghui Chang
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Yuxin Yuan
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Ministry of Education, and Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Manru Fu
- The Third Affiliated Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, 510515, China.
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Che M, Xie F, Thomas S, Pullenayegum E. Bayesian Models with Spatial Correlation Improve the Precision of EQ-5D-5L Value Sets. Med Decis Making 2023:272989X231173699. [PMID: 37243474 DOI: 10.1177/0272989x231173699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Health utilities from value sets for the EQ-5D-5L are commonly used in economic evaluations. We examined whether modeling spatial correlation among health states could improve the precision of the value sets. METHODS Using data from 7 EQ-5D-5L valuation studies, we compared the predictive precision of the published linear model, a recently proposed cross-attribute level effects (CALE) model, and 2 Bayesian models with spatial correlation. Predictive precision was quantified through the root mean squared error (RMSE) for out-of-sample predictions of state-level mean utilities on omitting individual states, as well as omitting blocks of states. RESULTS In all 7 countries, on omitting single health states, Bayesian models with spatial correlation improved upon the published linear model: the RMSEs for the originally published models, 0.050, 0.051, 0.060, 0.061, 0.039, 0.050, and 0.087 for Canada, China, Germany, Indonesia, Japan, Korea, and the Netherlands, respectively, could be reduced to 0.043, 0.042, 0.051, 0.054, 0.037, 0.037, and 0.085, respectively. On omitting blocks of health states, Bayesian models with spatial correlation led to smaller RMSEs in 3 countries, while the CALE model led to smaller RMSEs in the remaining 4 countries. DISCUSSION Bayesian models incorporating spatial correlation and CALE models are promising for improving the precision of value sets for the EQ-5D-5L. The differential performance of the Bayesian models on omitting single states versus blocks of states suggests that designing valuation studies to capture more health states may further improve precision. We suggest that Bayesian and CALE models be considered as candidates when creating value sets and that alternative designs be explored; this is vital as the prediction errors in value sets need to be smaller than the minimal important difference of the instrument. HIGHLIGHTS The accuracy of value sets of multi-attribute utility instruments is typically of the same order of magnitude as the instrument's minimal important difference and would benefit from improvement.Bayesian models with spatial correlation have been shown to improve value set accuracy in isolated cases.We showed that Bayesian approaches with spatial correlation improved predictive precision in 7 EQ-5D-5L valuation studies.We recommend that Bayesian models incorporating spatial correlation be considered when creating value sets and have provided code for fitting them.
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Affiliation(s)
- Menglu Che
- Department of Biostatistics, Yale University School of Public Health, New Haven, CT, USA
| | - Feng Xie
- Centre for Health Economics and Policy Analysis, Department of Health Research Methods, Evidence & Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Stephanie Thomas
- Sobey School of Business, Saint Mary's University, Halifax, NS, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
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Fujita K, Otsuka Y, Sunada N, Honda H, Tokumasu K, Nakano Y, Sakurada Y, Obika M, Hagiya H, Otsuka F. Manifestation of Headache Affecting Quality of Life in Long COVID Patients. J Clin Med 2023; 12:jcm12103533. [PMID: 37240639 DOI: 10.3390/jcm12103533] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/09/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
Objectives: The present study aimed to elucidate the characteristics of long COVID patients with headaches. Methods: A single-center retrospective observational study was performed for long COVID outpatients who visited our hospital from 12 February 2021 to 30 November 2022. Results: A total of 482 long COVID patients, after excluding 6, were divided into two groups: the Headache group of patients with complaints of headache (113 patients: 23.4%) and the remaining Headache-free group. Patients in the Headache group were younger (median age: 37 years) than patients in the Headache-free group (42 years), while the ratio of females (56%) in the Headache group was nearly the same as that in the Headache-free group (54%). The proportion of patients in the Headache group who were infected in the Omicron-dominant phase (61%) was larger than the proportions of patients infected in the Delta (24%) and preceding (15%) phases, and that trend was significantly different from the trend in the Headache-free group. The duration before the first visit for long COVID was shorter in the Headache group (71 days) than in the Headache-free group (84 days). The proportions of patients in the Headache group with comorbid symptoms, including general fatigue (76.1%), insomnia (36.3%), dizziness (16.8%), fever (9.7%), and chest pain (5.3%) were larger than the proportions of patients in the Headache-free group, whereas blood biochemical data were not significantly different between the two groups. Interestingly, patients in the Headache group had significant deteriorations of scores indicating depression and scores for quality of life and general fatigue. In multivariate analysis, headache, insomnia, dizziness, lethargy, and numbness were shown to be involved in the quality of life (QOL) of long COVID patients. Conclusions: The manifestation of headaches related to long COVID was found to have a significant impact on social and psychological activities. Alleviation of headaches should be a priority for the effective treatment of long COVID.
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Affiliation(s)
- Kana Fujita
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Yuki Otsuka
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Naruhiko Sunada
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Yasue Sakurada
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Mikako Obika
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Fumio Otsuka
- Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
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Olariu E, Mohammed W, Oluboyede Y, Caplescu R, Niculescu-Aron IG, Paveliu MS, Vale L. EQ-5D-5L: a value set for Romania. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:399-412. [PMID: 35688994 PMCID: PMC10060331 DOI: 10.1007/s10198-022-01481-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/12/2022] [Indexed: 05/16/2023]
Abstract
OBJECTIVE We aimed to develop an EQ-5D-5L value set for Romania. METHODS In line with the EuroQoL standardized valuation protocol, computer-assisted interviews were conducted face-to-face in a representative sample in Romania (November 2018-November 2019). Valuation methods included composite time trade-off and discrete choice experiment tasks. Several models were tested, including models that accounted for data censoring, panel structure of the data, heteroscedasticity, conditional logit, and hybrid models. The final model was selected based on logical consistency, theoretical considerations, and use of all available data. We compared our value set with other value sets from Central and Eastern Europe region. RESULTS Data from 1493 respondents was used to estimate the value set. A censored hybrid model corrected for heteroscedasticity was selected to represent the value set. The highest decrements in utility were observed for the pain/discomfort dimension (0.375), followed by the mobility dimension (0.293). Health utilities ranged from 1.000 to - 0.323 and 1.3% of the values were negative. The model was corrected with survey weights to better reflect the representativeness of the sample, but the first two coefficients of the self-care dimension stopped being logically consistent. Differences were found between the Romanian, Hungarian and Polish EQ-5D-5L value sets. Good agreement was noted with the Romanian EQ-5D-3L value set, with a swap between pain/discomfort and mobility in ranking of dimensions. CONCLUSION A value set for EQ-5D-5L is now available for Romania. This will push one-step further the development of health technology assessment and encourage more health-related quality-of-life research to be conducted locally.
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Affiliation(s)
- Elena Olariu
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Wael Mohammed
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - Yemi Oluboyede
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - Raluca Caplescu
- Department of Statistics and Econometrics, Faculty of Economic Cybernetics, Statistics and Informatics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Ileana Gabriela Niculescu-Aron
- Department of Statistics and Econometrics, Faculty of Economic Cybernetics, Statistics and Informatics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Marian Sorin Paveliu
- Department of Pharmacology and Pharmaeconomics, Faculty of General Medicine, Titu Maiorescu University, Bucharest, Romania
| | - Luke Vale
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
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Watanabe K, Hiratsuka Y, Yamamoto S, Murakami A. Economic Impacts and Quality of Life for Caregivers of Patients with Retinitis Pigmentosa: A Cross-Sectional Japanese Study. Healthcare (Basel) 2023; 11:healthcare11070988. [PMID: 37046915 PMCID: PMC10093847 DOI: 10.3390/healthcare11070988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Retinitis pigmentosa (RP) is the second leading cause of visual impairment in Japan and causes progressive vision loss in affected patients. Caregiving for patients with RP is associated with socioeconomic impacts; however, data on the magnitude and scope of these impacts are lacking. This cross-sectional study surveyed informal caregivers of patients with RP in Japan. The questionnaire assessed the socioeconomic status of participants; work impacts through the Work Productivity and Activity Impairment Questionnaire adapted for caregivers; and quality of life impacts through the Japanese version of the Caregiver Reaction Assessment (CRA) and the 5-level EQ-5D version (EQ-5D-5L). Of the 37 participating caregivers, 28 (75.7%) were employed. Among those, the average annual income was 2,722,080 yen (n = 20) and the mean loss of work productivity was 6.6%. The mean EQ-5D-5L index score was 0.882, and the mean CRA total score was 2.1. A mild to very severe impact on family life, leisure and hobbies, social life, and mental health was experienced by 83.8%, 78.4%, 75.7%, and 70.3%, respectively. These results suggest that caregivers of patients with RP may be disadvantaged in terms of employment and income and may experience wide-ranging impacts on their quality of daily life.
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Affiliation(s)
- Katsuhiko Watanabe
- Medical Affairs Division, Novartis Pharma K.K., Tokyo 105-6333, Japan
- Correspondence: ; Tel.: +81-80-3026-4262
| | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | | | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
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A national survey of Iranian general population to estimate a value set for the EQ-5D-5L. Qual Life Res 2023:10.1007/s11136-023-03378-1. [PMID: 36897530 DOI: 10.1007/s11136-023-03378-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES The main aim of this study is to estimate a national value set of the EQ-5D-5L questionnaire for Iran. METHODS The composite time trade-off (cTTO) and discrete choice experiment (DCE) methods; and the protocol for EuroQol Portable Valuation Technology (EQ-PVT) were used to estimate the Iran national value set. 1179 face-to-face computer-assisted interviews were conducted with adults that were recruited from five Iran major cities in 2021. Generalized least squares, Tobit, heteroskedastic, logit, and hybrid models were used to analyze the data and to identify the best fitting model. RESULTS According to the logical consistency of the parameters, significance levels and prediction accuracy indices of the MAE; a heteroscedastic censored Tobit hybrid model combining cTTO and DCE responses was considered as the best fitting model to estimate the final value set. The predicted values ranged from - 1.19 for the worst health state (55555) to 1 for full health (11111), with 53.6% of the predicted values being negative. Mobility was the most influential dimension on health state preference values. CONCLUSIONS The present study estimated a national EQ-5D-5L value set for Iranian policy makers and researchers. The value set enables the EQ-5D-5L questionnaire to use to calculate QALYs to assist the priority setting and efficient allocation of limited healthcare resources.
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Tsuji M, Tsukioka R, Oishi M. [Patient Safety Management Practiced by Pharmacy Pharmacists Using Their Training at Oncology Hospital]. YAKUGAKU ZASSHI 2023; 143:223-228. [PMID: 36858552 DOI: 10.1248/yakushi.22-00160-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Recent changes in the environment surrounding community pharmacists include "follow-up after dispensing" becoming mandatory, initiation of "certified pharmacy system with specific functions," with the discussions on post-graduate training, lifelong training and specialization, refill of prescriptions, as well as pros and cons of hospital pharmacies in preparation for the 2022 dispensing fee revision. In this regard, since 2019, I have been receiving training at The Cancer Institute Hospital of Japanese Foundation for Cancer Research (JFCR). In addition, to implementing community pharmacists' perspectives into collaboration between community pharmacists and hospital pharmacists, a tracing report model incorporating the Common Terminology Criteria for Adverse Events (CTCAE) ver. 5.0 has been created. And, a regimen of drugs and operation describing necessary supportive care has been published in The Cancer Institute Hospital of JFCR website. As a practice of patient safety management at pharmacies, we are working on the standardization of questionnaire criteria to assess the severity of adverse medication reactions in cancer patients and the measurement of health-related quality of life using EuroQol 5 dimensions 5-level (EQ-5D-5L), introduced with cooperation of universities, hospitals, and pharmacies. As medical care is advancing day by day, especially in cancer medication therapy, patient safety management by pharmacists becomes essential, when dealing with the complexity of administration schedule and the wide variety of side effects. For patient safety management, community pharmacists need to practice with pharmaceutical and medical knowledge, and have skills to acquire and convey information, with a researcher's perspective.
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Kajimoto Y, Honda K, Suzuki S, Mori M, Tsubouchi H, Nakao K, Azuma A, Shibutani T, Nagao S, Koyanagi T, Kohara I, Tamaki S, Yabuki M, Teng L, Fujiwara K, Igarashi A. Association between financial toxicity and health-related quality of life of patients with gynecologic cancer. Int J Clin Oncol 2023; 28:454-467. [PMID: 36648710 DOI: 10.1007/s10147-023-02294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Patients often struggle with their financial situation during cancer treatment due to treatment-related costs or loss of income. This resulting negative effect is called financial toxicity, which is a known as a side effect of cancer care. This study aimed to evaluate the association between financial toxicity and health-related quality of life among patients with gynecologic cancer using validated questionnaires. METHODS In this multicenter study, patients with gynecologic cancer receiving anti-cancer drug treatment for > 2 months were recruited. Patients answered the COmprehensive Score for Financial Toxicity (COST) tool, EORTC-QLQ-C30, disease-specific tools (EORTC-QLQ-OV28/CX24/EN24), and EQ-5D-5L. Spearman's rank correlation coefficient was used to determine associations. RESULTS Between April 2019 and July 2021, 109 cancer patients completed the COST questionnaire. The mean COST score was 19.82. Strong associations were observed between financial difficulty (r = - 0.616) in the EORTC-QLQ-C30 and body image (r = 0.738) in the EORTC-QLQ-CX24, while weak associations were noted between the global health status/quality of life (r = 0.207), EQ-5D-5L index score (r = 0.252), and several function and symptom scale scores with the COST score. CONCLUSIONS Greater financial toxicity was associated with worse health-related quality of life scores, such as financial difficulty in gynecologic cancer patients and body image in cervical cancer patients as strong associations, and weakly associated with general health-related quality of life scores and several function/symptom scales.
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Affiliation(s)
- Yusuke Kajimoto
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan. .,Oncology Science Unit, MSD K.K., 1-13-12 Kudan-Kita, Chiyodaku, Tokyo, 102-8667, Japan.
| | - Kazunori Honda
- Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Shiro Suzuki
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Masahiko Mori
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Hirofumi Tsubouchi
- Department of Gynecologic Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Kohshiro Nakao
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi City, Gunma, 371-8511, Japan
| | - Anri Azuma
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi City, Gunma, 371-8511, Japan
| | - Takashi Shibutani
- Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kitaoujicho, Akashi, Hyogo, 673-8558, Japan
| | - Shoji Nagao
- Department of Gynecologic oncology, Hyogo Cancer Center, 13-70 Kitaoujicho, Akashi, Hyogo, 673-8558, Japan.,Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Takahiro Koyanagi
- Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Izumi Kohara
- School of Nursing, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shuko Tamaki
- Nursing Department, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Midori Yabuki
- Nursing Department, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Lida Teng
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Ataru Igarashi
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.,Department of Public Health, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan
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Hagiwara Y, Shiroiwa T, Taira N, Kawahara T, Konomura K, Noto S, Fukuda T, Shimozuma K. Gradient Boosted Tree Approaches for Mapping European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 Onto 5-Level Version of EQ-5D Index for Patients With Cancer. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:269-279. [PMID: 36096966 DOI: 10.1016/j.jval.2022.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/10/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to develop direct and response mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 onto the 5-level version of EQ-5D index based on the gradient boosted tree (GBT), a promising modern machine learning method. METHODS We used the Quality of Life Mapping Algorithm for Cancer study data (903 observations from 903 patients) for training GBTs and testing their predictive performance. In the Quality of Life Mapping Algorithm for Cancer study, patients with advanced solid tumor were enrolled, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and 5-level version of EQ-5D were simultaneously evaluated. The Japanese value set was used for direct mapping, whereas the Japanese and US value sets were used for response mapping. We trained the GBTs in the training data set (80%) with cross-validation and tested the predictive performance measured by the root mean squared error (RMSE), mean absolute error (MAE), and mean error in the test data set (20%). RESULTS The RMSE and MAE in the test data set were larger in the GBT approaches than in the previously developed regression-based approaches. The mean error in the test data set tended to be smaller in the GBT approaches than in the previously developed regression-based approaches. CONCLUSIONS The predictive performances in the RMSE and MAE did not improve by the GBT approaches compared with regression approaches. The flexibility of the GBT approaches had the potential to reduce overprediction and underprediction in poor and good health, respectively. Further research is needed to establish the role of machine learning methods in mapping a nonpreference-based measure onto health utility.
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Affiliation(s)
- Yasuhiro Hagiwara
- Department of Biostatistics, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
| | - Naruto Taira
- Department of Breast and Thyroid Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Takuya Kawahara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Keiko Konomura
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
| | - Shinichi Noto
- Center for Health Economics and QOL Research, Niigata University of Health and Welfare, Niigata, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
| | - Kojiro Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, Kusatsu, Japan
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Igarashi A, Sakata Y, Azuma-Kasai M, Kamiyama H, Kawaguchi M, Tomita K, Ishii M, Ikeda M. Linguistic and Psychometric Validation of the Cognition Bolt-On Version of the Japanese EQ-5D-5L for the Elderly. J Alzheimers Dis 2023; 91:1447-1458. [PMID: 36641680 PMCID: PMC9986695 DOI: 10.3233/jad-221080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The need for a cognition bolt-on version of the EQ-5D, which would capture cognitive impairment by adding a dimension to the generic instrument assessing health status, has been increasing in Japan. OBJECTIVE To develop a cognition bolt-on version of the 5-level EQ-5D (EQ-5D-5L+C), we linguistically validated a cognition dimension and psychometrically validated the EQ-5D-5L+C. METHODS Following linguistic validation of the cognition dimension, psychometric validation of the EQ-5D-5L+C proxy version utilized anonymized data collected from nursing home residents between October 2021 to April 2022. The validity, reliability, and sensitivity to change were evaluated. RESULTS Data from 254 participants, including the finalized Japanese EQ-5D-5L+C proxy version, were analyzed for the psychometric validation. Mean (±standard deviation) age and Mini-Mental State Examination (MMSE) scores were 87.14±7.29 years and 15.76±8.46, respectively. The correlation was strongest between the cognition dimension and MMSE scores (rs = -0.640). Test-retest reliability was good in the cognition dimension in both baseline and two-time points (3 months: k = 0.644; 6 months: k = 0.656). Although a correlation between changes in the cognition dimension and those in the MMSE score from baseline was weak (3 months: rs = -0.191; 6 months: rs = -0.267), a correlation with changes in the MMSE score was higher when the cognition dimension was added compared to the EQ-5D alone (3 months: rs = -0.142 versus rs = -0.074). CONCLUSION The Japanese EQ-5D-5L+C proxy version developed is a valid tool that captures health status including cognitive function, with a consideration for an over-time assessment. The benefits in adding the cognition dimension to the EQ-5D-5L to assess health state were suggested.
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Affiliation(s)
- Ataru Igarashi
- Department of Public Health, Yokohama City University School of Medicine, Kanagawa, Japan.,Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | | | | | | | | | | | | | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
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Ichimura T, Nomura H, Shimizu H. Community pharmacists’ measurement of health-related quality of life for breast cancer with positive hormone receptors: A prospective observational study. SAGE Open Med 2023; 11:20503121231164491. [PMID: 37026108 PMCID: PMC10071216 DOI: 10.1177/20503121231164491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/02/2023] [Indexed: 04/03/2023] Open
Abstract
Objectives: Many patients with hormone-receptor positive breast cancer undergo prolonged treatment. However, the long-term patient quality of life assessment has not been examined. Using community pharmacists’ assistance is one method for assessing long-term quality of life. Thus, this study aimed to understand the ongoing health-related quality of life and quality-adjusted life year among breast cancer patients so that community pharmacists may contribute to their pharmacotherapy. Methods: We conducted a prospective observational study with 22 breast cancer patients who had health-related quality of life at the initial measurement and 6 months later. Results: Regarding the health-related quality of life, quality-adjusted life year concerning all patients was 0.890 (95% confidence interval: 0.846–0.935). Quality-adjusted life year concerning those younger than 65 years was 0.907 (95% confidence interval: 0.841–0.973), and that for individuals older than 65 years was 0.874 (95% confidence interval: 0.804–0.943). The adjuvant chemotherapy group had a lower health-related quality of life at the initial measurement (0.887; 95% confidence interval: 0.833–0.941) but showed a higher quality of life 6 months later (0.951; 95% confidence interval: 0894–1.010). Quality-adjusted life year for individuals regarding adjuvant chemotherapy was 0.919 (95% confidence interval: 0.874–0.964). In contrast, the life-prolonged group had a higher health-related quality of life at the initial measurement, which was lower 6 months later. Conclusions: As a result of measuring quality of life using the EuroQol 5-dimensions-5-levels, this study revealed a decline in health-related quality of life in patients undergoing hormonal therapy for breast cancer. The study is expected to assist community pharmacists in managing outpatients.
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Affiliation(s)
- Takenori Ichimura
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Shinagawa-ku, Tokyo, Japan
| | - Hisanaga Nomura
- Department of Data Science/Pharmacy, National Cancer Center Hospital East, Kashiwa City, Chiba, Japan
| | - Hisanori Shimizu
- Department of Pharmacy, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
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Sun S, Chuang LH, Sahlén KG, Lindholm L, Norström F. Estimating a social value set for EQ-5D-5L in Sweden. Health Qual Life Outcomes 2022; 20:167. [PMID: 36564844 PMCID: PMC9780618 DOI: 10.1186/s12955-022-02083-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The study aims to elicit a value set based on the EQ-VT for the EQ-5D-5L that can be used to support decision-making in Sweden. METHODS Participants were recruited from the general population based on age, sex and urban/rural area quota sampling from five regions across Sweden. In total, 785 interviews were conducted from February 2020 to April 2021 using the EQVT 2.1 protocol, and both composite time trade-off (c-TTO) and discrete choice experiments (DCE) were used to elicit health preferences. A variety of models have been tested for the c-TTO data (generalized least square, Tobit, heteroskedastic models) and DCE data (conditional logit model), as well as the combined c-TTO and DCE data (hybrid modelling). Model selection was based on theoretical considerations, logical consistency of the parameter estimates, and significance of the parameters (p = 0.05). Model goodness-of-fit was assessed by AIC and BIC, and prediction accuracy was assessed in terms of mean absolute error. The predictions for the EQ-5D-5L health states between models were compared using scatterplots. RESULTS The preferred model for generating the value set was the heteroskedastic model based on the c-TTO data, with the health utilities ranging from -0.31 for the worst (55,555) to 1 for the best (11111) EQ-5D-5L states. CONCLUSION This is the first c-TTO-based social value set for the EQ-5D-5L in Sweden. It can be used to support the health utility estimation in economic evaluations for reimbursement decision making in Sweden.
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Affiliation(s)
- Sun Sun
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden. .,Research Group Health Outcomes and Economic Evaluation, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
| | - Ling-Hsiang Chuang
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden
| | - Klas-Göran Sahlén
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, 90185, Umeå, Sweden
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Hara K, Nakabe T, Tanaka M, Imanaka Y. Measuring the quality of life of long-term care service users in Japan: a cross-sectional questionnaire study. BMC Geriatr 2022; 22:955. [PMID: 36510174 PMCID: PMC9746158 DOI: 10.1186/s12877-022-03662-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In Japan's super-aging society, the number of long-term care service providers is increasing, and the quality of care is a matter of concern. One aspect of the quality of care is the user's quality of life. The questionnaires EQ-5D and WHO-5 are representative indicators of quality of life. Herein, we aimed to measure the quality of life in long-term care service users in Japan and to clarify the relationship between quality of life and the level of care required. METHODS A questionnaire study was conducted in 106 facilities of 22 corporations. In addition to the EQ-5D and WHO-5, sex, age, and the level of care required were assessed by descriptive statistics. Bonferroni's multiple comparison test was used to analyze each quality of life score, and the differences by sex and age were analyzed multiple regression analyses, with each quality of life score as the objective variable. RESULTS Of 4647 cases collected, 2830 were analyzed, with no missing data. Both indicators tended to be lower than the general older population. Those scores tended to be higher in females than males (EQ-5D: males, 0.58 ± 0.26; females, 0.60 ± 0.24; P = 0.06 and WHO-5: males, 13.8 ± 5.92; females 14.9 ± 5.70; P < 0.001). In terms of age, those under 65 years old with specific diseases had lower EQ-5D scores than those in other age groups (P < 0.001); however, WHO-5 scores did not differ by age. Multiple regression analysis showed a significant association between the EQ-5D score and level of care required, except for support-required level 1, which tended to worsen as the level of care required increased. Conversely, the WHO-5 score was significantly lower for care need levels 2, 4, and 5. CONCLUSIONS The quality of life of long-term care service users was worse than that of the general older population, it tended to be low among males and those under 65 years old with specific diseases. Furthermore, it gradually decreased as the level of care required increased. It is important to monitor users' quality of life as a quality indicator of care, to improve and manage it.
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Affiliation(s)
- Koji Hara
- grid.258799.80000 0004 0372 2033Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto City, 606-8501 Japan ,grid.268441.d0000 0001 1033 6139School of Economics and Business Administration, Yokohama City University, 22-2 Seto, Kanazawa, Yokohama, 236-0027 Japan
| | - Takayo Nakabe
- grid.258799.80000 0004 0372 2033Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto City, 606-8501 Japan ,grid.412708.80000 0004 1764 7572The Database Center of the National University Hospitals, Tokyo Central Hospital North F8, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655 Japan
| | - Masayuki Tanaka
- grid.258799.80000 0004 0372 2033Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto City, 606-8501 Japan
| | - Yuichi Imanaka
- grid.258799.80000 0004 0372 2033Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-Cho, Sakyo-Ku, Kyoto City, 606-8501 Japan
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Gupta S, Bansal T, Kashyap A, Sural S. Correlation between clinical scoring systems and quantitative MRI parameters in degenerative lumbar spinal stenosis. J Clin Orthop Trauma 2022; 35:102050. [PMID: 36317084 PMCID: PMC9617196 DOI: 10.1016/j.jcot.2022.102050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/02/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background Many quantitative MRI parameters and clinical scores have been used patients with lumbar spinal stenosis (LSS). However, the correlation between clinical scores and MRI parameters is not very clear. The objective of the study was to find out the correlation between commonly used clinical scoring systems and quantitative MRI parameters. Methods Eighty two patients (more than 40 years) with clinical and radiological characteristics of degenerative LSS completed 10 clinical questionnaires which included Oswestry disability index (ODI), Swiss spinal stenosis (SSS) questionnaire, Quebec pain disability scale (QPD), Visual analogue scale (VAS), modified Japanese orthopaedic association scale (mJOA), Pain disability index (PDI), Short form health survey (SF-36), Self-paced walking test (SPWT), Euro quality of life-5D (EQ-5D) and Neurogenic claudication outcome score (NCOS). Lumbosacral MRIs were performed and 8 quantitative parameters namely transverse & AP diameter of dural sac (TDD, APDD), anteroposterior diameter of spinal canal (APDS), ligamentous interfacet distance (LID), mid-sagittal diameter of thecal sac (MSDT), cross-sectional area dural sac (CSAD), lateral recess depth and angle (LRD, LRA) were measured at the maximum stenotic level at the level of the disc. The clinical and radiological parameters were then statistically analysed. Results There were 51 females and 31 males in the study with a mean age of 53.0253.02 ± 9.18 years. NCOS score had a moderate correlation with CSAD, LID and TDS (p<0.05,0.7>r ≥ 0.3). MSDT showed a moderate negative correlation with SSS, VAS, ODI and QPD (p<0.05,0.7>r ≥ 0.3). LRD had a moderate negative correlation with ODI and VAS score (p<0.05,0.7>r ≥ 0.3). LRA had a moderate correlation with the EQ-5D and ODI (p<0.05,0.7>r ≥ 0.3). The CSAD had a moderate negative correlation with PDI (r = -0.383, p = 0.000). For all other comparisons, there was poor or no correlation. MRI parameters showed poor or no correlation with most of components of SF-36 score. Conclusions A poor correlation or no correlation was noted for most of the MRI parameters when compared to commonly used clinical scores. Hence, poor MRI's don't necessarily mean poor clinical scores in LSS. The role of MRI parameters should be supplementary and overreliance on them in LSS management should be avoided.
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Affiliation(s)
- Siddharth Gupta
- Department of Orthopaedics, ESIC Medical College and Hospital, Faridabad, Haryana, India
| | - Tungish Bansal
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India
| | - Abhishek Kashyap
- Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India
| | - Sumit Sural
- Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India
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Kreimeier S, Mott D, Ludwig K, Greiner W. EQ-5D-Y Value Set for Germany. PHARMACOECONOMICS 2022; 40:217-229. [PMID: 35604633 PMCID: PMC9124748 DOI: 10.1007/s40273-022-01143-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Demand is increasing for youth-specific preference-based health-related quality-of-life measures for inclusion in evaluations of healthcare interventions for children and adolescents. The EQ-5D-Youth (EQ-5D-Y) has the potential to become such a preference-based measure. OBJECTIVE This study applied the recently published EQ-5D-Y valuation protocol to develop a German EQ-5D-Y value set and explored the differences between values given to youth health by parents and non-parents. METHODS To elicit EQ-5D-Y health state preferences, a representative sample of 1030 adults of the general population completed a discrete choice experiment (DCE) online survey, and 215 adults participated in face-to-face interviews applying composite time trade-off (cTTO). Respondents were asked to consider a 10-year-old child living in the health states. DCE data were modelled using a mixed logit model. To derive the value set, DCE latent scale values were anchored onto adjusted mean cTTO values using a linear mapping approach. RESULTS Adult respondents considered pain/discomfort and feeling worried/sad/unhappy as the two most important dimensions in terms of youth health. Adjusted mean cTTO values ranged from - 0.350 for health state 33333 to 0.970 for health state 21111. The EQ-5D-Y value set showed a logical order for all parameter estimates, and predicted values ranged from - 0.283 to 1. Differences in preferences by parental status were mainly observed for cTTO results, where mean values were larger for parents than for non-parents. CONCLUSIONS Applying the valuation protocol, a German EQ-5D-Y value set with internally consistent coefficients was developed. This enables the instrument to be used in economic evaluations of paediatric healthcare interventions.
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Affiliation(s)
- Simone Kreimeier
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany.
| | | | - Kristina Ludwig
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
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Yang Z, Jiang J, Wang P, Jin X, Wu J, Fang Y, Feng D, Xi X, Li S, Jing M, Zheng B, Huang W, Luo N. Estimating an EQ-5D-Y-3L Value Set for China. PHARMACOECONOMICS 2022; 40:147-155. [PMID: 36396878 PMCID: PMC9758244 DOI: 10.1007/s40273-022-01216-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 05/08/2023]
Abstract
INTRODUCTION The standard EQ-5D-Y-3L valuation protocol applies DCE data as the primary preference source to model the relative importance of dimensions while cTTO data served to anchor the DCE coefficients onto the QALY scale. This study aims to estimate an EQ-5D-Y-3L value set for China following this protocol, but with a larger cTTO design to better understand the role of cTTO data in estimating EQ-5D-Y-3L value sets. METHODS In total, 150 choice sets and 28 EQ-5D-Y-3L health states were valued using DCE and cTTO methods with two independent samples, respectively. General public from 14 different regions were recruited using quota sampling method to achieve representativeness. We compared two modelling strategies: (1) fit the DCE data with mixed logit model with correlated coefficients and a subsequent mapping procedure for anchoring; (2) fit the DCE and TTO data jointly in a hybrid model. Two evaluation criteria (1) coefficient significance and monotonicity; (2) prediction accuracy of the observed cTTO values were used to select the value set. RESULTS In total, 1476 individuals participated in the study, with 1058 participated the DCE interview and 418 participated the cTTO interview. The highest mean TTO value was 0.924 for state 11112 and the lowest mean TTO value was - 0.088 for state 33333. The hybrid model with an A3 term performed the best and was selected as the value set. DISCUSSION Following the international protocol and using a larger cTTO design, this study established the EQ-5D-Y-3L value set using a hybrid model for China. Future EQ-5D-Y-3L valuation study could consider using a larger cTTO design for estimating the value set.
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Affiliation(s)
- Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Gui'an, China.
- College of Pharmacy, Jinan University, Guangzhou, China.
| | - Jie Jiang
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Xuejing Jin
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Yu Fang
- Department of Pharmacy Administration, School of Pharmacy, Health Science Centre, Xi'an Jiaotong University, Xi'an, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoyu Xi
- The Research Centre of National Drug Policy and Ecosystem, China Pharmaceutical University, Nanjing, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mingxia Jing
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, China
| | - Bin Zheng
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Clinical usefulness and safety in the early phase after a newly designed rotating-platform total knee arthroplasty: A prospective multicentre cohort study with a 2-year follow up. Knee 2022; 39:269-278. [PMID: 36288655 DOI: 10.1016/j.knee.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aimed to assess the clinical results and safety of a newly designed rotating-platform posterior-stabilised total knee arthroplasty (TKA) in the early postoperative phase, within 2 years of follow up. METHODS This prospective, multicentre cohort study included 100 consecutive patients who underwent rotating-platform posterior-stabilised (PS) TKA (Vanguard PSRP). After excluding dropouts, 93 patients were analysed. The objective Knee Society Score (KSS)-2011, subjective KSS-2011, knee range of motion, EuroQol 5 Dimension index, complications, and survival rates were assessed before TKA and at 6 months, 1 year, and 2 years postoperatively. The scores at each time-point were compared, and the survival rate was assessed with revision as the endpoint. To demonstrate non-inferiority, the clinical outcomes of patients who underwent rotating-platform PS TKA were compared with those collected retrospectively from 50 patients who underwent fixed-PS TKA (Vanguard PS), defined as the control group. RESULTS All clinical outcomes at the final follow up significantly improved compared with their preoperative values (P < 0.001). The objective KSS-2011 was 90.0 ± 8.2 points, subjective KSS-2011 satisfaction was 30.7 ± 8.6 points, expectation was 10.4 ± 2.1 points, and functional activity was 74.0 ± 18.5 points at 2 years postoperatively. Complications included knee dislocation in one patient and surgical site infection in one patient. The survival rate was 99% at 2 years postoperatively. Clinical outcomes, complications, and survival rates of newly designed TKA were not statistically different compared with the control group. CONCLUSION The newly designed rotating-platform PS TKA showed good clinical results and suitable safety during the early postoperative phase in this prospective multicentre cohort study.
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Ge L, Pereira MJ, Yap CW, Heng BH. Chronic low back pain and its impact on physical function, mental health, and health-related quality of life: a cross-sectional study in Singapore. Sci Rep 2022; 12:20040. [PMID: 36414674 PMCID: PMC9681885 DOI: 10.1038/s41598-022-24703-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/18/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic low back pain, defined as low back pain lasting more than 3 months, is a globally prevalent health problem with significantly high medical and economic burden on individuals and the society. This study aimed to estimate the prevalence of chronic low back pain and examine its association with health outcomes including physical function, mental health, and quality of life among adult population in Singapore. Cross-sectional secondary data analysis was performed using baseline data of the 1941 adults (mean age: 52.6 years, range: 21-97 years) from a representative population health survey conducted in the Central region of Singapore. Those with self-reported chronic low back pain in past six months were identified. The Late-Life Function and Disability Instrument, Patient Health Questionnaire-9, and EQ-5D-5L were used to measure physical function and limitation, mental health, and health-related quality of life, respectively. Generalized Linear Regressions were used to examine the association of chronic low back pain with physical function, limitation, depressive symptoms, and health-related quality of life. There were 8.1% (n = 180) participants reporting having chronic low back pain in past six months, among whom 80.5% sought treatments at either primary care, specialist outpatient, or Traditional Chinese Medicine clinics. Individuals with chronic low back pain reported poorer physical function, more limitations in performing major life tasks and social activities, more depressive symptoms, and lower health-related quality of life (all p < 0.01), even after adjusting for socio-demographics, lifestyle factors, and number of morbidities. The prevalence of chronic low back pain was 8.1% among the study population. Chronic low back pain was associated with poorer physical function, more limitations and depressive symptoms, and lower health-related quality of life. The findings highlight the significant impact of chronic low back pain on physical function and limitation, mental health, and health-related quality of life in a general population. Increased awareness on prevention, early and proper management of low back pain, and rehabilitation policies are required to better tackle the burden of low back pain at the population level.
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Affiliation(s)
- Lixia Ge
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
| | - Michelle Jessica Pereira
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
| | - Chun Wei Yap
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
| | - Bee Hoon Heng
- grid.466910.c0000 0004 0451 6215Health Services & Outcomes Research, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@One-North (South Lobby), Singapore, 13854 Singapore
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