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The health economics of osteoporosis and estrogen replacement therapy
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
A further level of complexity is to consider a cost—utility analysis which involves an assessment of the quality of life with the aim of maximizing it; the units are cost per quality-adjusted life-year gained. The advantage of this approach is that health care is directed towards the maximization of quality as well as quantity of life. The disadvantage of this approach is that quality of life is, according to its very nature, subjective so that few people agree on the factors constituting quality of life. This becomes a particular problem when quality comes to he measured. A variety of approaches have been developed, all of which are dependent on questionnaires designed to determine the value that individuals put on a particular disease state. This may be done by asking how many years of life an individual would forgo to avoid the disease state in question (time trade-off). Alternatively, questionnaires have been developed, for example the Short Form 36 (SF 36), which include evaluation of a variety of quality-of-life ‘domains’. Other questionnaires include the Nottingham Health Profile and Euroquol. Although comprehensive, these questionnaires are often not sensitive or specific enough to detect the impact of a specific disease. Thus disease-specific questionnaires have been developed.
Cost–effectiveness analysis for heterogeneous data
Published in Elías Moreno, Francisco José Vázquez-Polo, Miguel Ángel Negrín-Hernández, Bayesian Cost—Effectiveness Analysis of Medical Treatments, 2019
Elías Moreno, Francisco José Vázquez-Polo, Miguel Ángel Negrín-Hernández
The data were obtained from a study to compare three methadone maintenance programs: high, medium and low intensity, for opioid–addicted patients (Puigdollers et al., 2003). A 12–month follow–up study of 586 patients beginning methadone treatment at four drug care centers in Barcelona was performed. The Nottingham Health Profile (NHP) was used to measure quality of life. This is a questionnaire of 38 items that measures quality of life through a scale that varies from 0, the normal health state, to 100, the worst health state.
Literature review and selection of clinical tools and scales
Published in Ramar Sabapathi Vinayagam, Integrated Evaluation of Disability, 2019
The Nottingham Health Profile (NHP) evaluates emotional status, social isolation, sleep, energy, pain, physical mobility, vocation, social life, family life, sex life, housework, hobbies, and holidays (59–62).
Using the refined ICF Linking Rules to compare the content of existing instruments and assessments: a systematic review and exemplary analysis of instruments measuring participation
Published in Disability and Rehabilitation, 2019
Carolina S. Ballert, Maren Hopfe, Sandra Kus, Luzius Mader, Birgit Prodinger
This study aimed to examine the comparability of existing instruments measuring participation while accounting for aspects of content, the perspective adopted in the items and the categorization of their response options by using the refined ICF Linking Rules. Most items were linked to the ICF chapters d8 Major Life Areas (19%), d4 Mobility and d9 Community, Social and Civic Life (17% each). The findings of this review indicate that existing instruments most often ask people to report about the problems or difficulties they experience in performing certain activities or tasks (75%). The appraisal perspective, which reflects how well a person’s performance meets her or his own expectations, revealed in 18% of the identified concepts. Need or dependency was the perspective which was least common with 7%. Twelve out of the 41 identified instruments were developed and published already before 2001 and are still used for measuring participation. Nevertheless, it can be assumed that instruments developed prior to this date and still in use would show up in the literature identified with our search. For instance the Nottingham Health Profile was already published in 1981,[58] is still in use, and thus, was included in this study. This finding stresses the longstanding importance of participation as an outcome in rehabilitation.
Topical therapies for knee osteoarthritis
Published in Postgraduate Medicine, 2018
A study showed that topical nimesulide gel can have beneficial consequences and can ameliorate quality of life in patients with knee OA [10]. Seventy-four adult knee OA outpatients were enrolled in a double-blind, randomized, placebo-controlled study. Treatment group received topical nimesulide gel 1% on the knee skin three times a day, whereas placebo group received an identical-appearing gel for 30 days. There was a significant improvement in the nimesulide treatment group for all parameters studied. The overall Western Ontario and McMaster Universities OA (WOMAC) scores was significantly better than placebo, but physical functioning, stiffness, and pain scales did not reach statistical significance. For the Nottingham Health Profile (NHP) scores, there was an improvement at ‘energy level,’ ‘pain,’ ‘physical motion,’ and ‘NHP distress’ scores in the treatment group, whereas no improvement was found in the placebo group. Between-group differences were not significant. Both patient and physician satisfaction scores were significantly better in the treatment group.
Quality of life for post-polio syndrome: a patient derived, Rasch standard scale
Published in Disability and Rehabilitation, 2018
Carolyn A. Young, Anne-Marie C. Quincey, Samantha M. Wong, Alan Tennant
The impact of PPS upon QoL has largely been restricted to the impact of aspects of health-related quality of life (HRQoL), mostly comprising impairment and activity limitations, as expressed by such scales as the Nottingham Health Profile [12] and the SF36. [13] Little or no work can be found which examines QoL as a unitary concept, such as subjective well-being.[14] In such an approach, QoL is seen as distinct from health status (HRQoL), and consequently enables a consideration of what might mediate between health status and QoL.[15] The availability of a post-polio disease-specific QoL scale, with items derived from the patients’ lived experience, would offer the ability to model the impact of health status (e.g., fatigue and mobility limitations) upon QoL. Consequently, this study is set out to develop a disease–specific QoL scale for PPS.