Estimation of Minimal Clinically Important Difference in EQ-5D Visual Analog Scale Score After Pulmonary Rehabilitation in Subjects With COPD

Zanini, Andrea; Aiello, Marina; Adamo, Daniela; Casale, Silvia; Cherubino, Francesca; Patrona, S. Della; Raimondi, Eleonora; Zampogna, Elisabetta; Chetta, Alfredo; Spanevello, Antonio

doi:10.4187/respcare.03272

Cited by 114 publications

(84 citation statements)

References 43 publications

(50 reference statements)

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“…Similar evidence has been reported in patients with COPD [24,31,32] . As well as for patients with COPD, it is conceivable that even patients with non-CF bronchiectasis and a poor baseline lung function are at risk of entering a downward spiral of dyspnea, sedentariness, demotivation, and, finally, deconditioning [33] .…”

Section: Discussionsupporting

confidence: 74%

“…In this regard, given the variety of instruments used for the measurement of quality of life, a comparison with previous studies is not easy to perform: St. George's Respiratory Questionnaire [12,13] , Chronic Respiratory Disease Questionnaire [9,14] , and parameters without rating [15] . Notably, the magnitude of improvement in the EQ-VAS score observed in our study is similar to that obtained from a large cohort of patients with COPD, exceeding the minimal clinically important difference proposed for COPD [24] . However, this finding has not yet been defined for non-CF bronchiectasis and needs further study.…”

Section: Discussionsupporting

confidence: 70%

“…We adopted the VAS component of the EQ-5D, a simple instrument which has been demonstrated to be responsive to PR in COPD patients [24,25] . In this regard, given the variety of instruments used for the measurement of quality of life, a comparison with previous studies is not easy to perform: St. George's Respiratory Questionnaire [12,13] , Chronic Respiratory Disease Questionnaire [9,14] , and parameters without rating [15] .…”

Section: Discussionmentioning

confidence: 99%

“…Both univariate and multivariate logistic analyses were performed to evaluate the presence of independent predictors of efficacy of PR, which was expressed by a significant increase in 6MWD ( ≥ 30 m) [22] , by a significant increase in TDI ( ≥ 1 point) [23] , or by a significant increase in EQ-VAS score ( ≥ 8 points) [24] .…”

Section: Discussionmentioning

confidence: 99%

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Effects of Pulmonary Rehabilitation in Patients with Non-Cystic Fibrosis Bronchiectasis: A Retrospective Analysis of Clinical and Functional Predictors of Efficacy

et al. 2015

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sures after PR was assessed. Both univariate and multiple logistic analyses were performed to evaluate the presence of independent predictors of the efficacy of PR. Results: One hundred and eight patients [49 males, mean age 71 years, mean forced expiratory volume in 1 s (FEV 1 ) 76% predicted] were included. After PR, there was a significant improvement in 6MWD, TDI, and EQ-VAS score (p < 0.001). Changes in 6MWD and EQ-VAS score correlated with baseline FEV 1 , FEV 1 /vital capacity (VC), residual volume, transfer factor of the lung for carbon monoxide, and the number of exacerbations in the previous year. Both univariate and multivariate logistic regression analyses showed that male gender, baseline FEV 1 /VC <70%, and >2 exacerbations in the previous year were independent predictors of PR efficacy in terms of an improvement in 6MWD. Conclusions: Our study supports the inclusion of patients with bronchiectasis in PR programs. Clinical and functional baseline findings partially predict the response to PR in terms of exercise tolerance. Further prospective, randomized, controlled trials are needed. © 2015 S. Karger AG, Basel Key Words Bronchiectasis · Pulmonary rehabilitation · Predictors of efficacy Abstract Background:International guidelines recommend the inclusion of patients with bronchiectasis in pulmonary rehabilitation (PR) to improve exercise capacity and health-related quality of life (HRQoL). At present, the effect of PR in these patients has been poorly investigated. Objective: The aim of our retrospective analysis was to evaluate the effects and predictors of success for a PR program in patients with bronchiectasis not related to cystic fibrosis (non-CF bronchiectasis). Methods: One hundred and thirty-five non-CF bronchiectasis inpatients, allocated to a 3-week PR program, were retrospectively evaluated. Exercise capacity (6-min walk distance, 6MWD), dyspnea (Baseline/Transition Dyspnea Index, BDI/TDI), and HRQoL [EuroQol visual analogue scale (EQ-VAS)] were assessed before and after PR. The relationship between baseline parameters and changes in outcome mea-

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Section: Discussionsupporting

confidence: 74%

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Pulmonary Rehabilitation in Patients with Non-Cystic Fibrosis Bronchiectasis: A Retrospective Analysis of Clinical and Functional Predictors of Efficacy

et al. 2015

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“…The German Time Trade Off tariff was used to calculate utility scores ranging from 0 to 1, with higher values indicating better health (28). The MCID of 8 points for the EQ-5D VAS has been proposed for patients with moderate to severe COPD (29). A MCID for the EQ-5D-3L utility score is not yet established, but may range between 0.08 and 0.10 according to studies in patients without COPD (30)(31)(32).…”

Section: Clinical Outcome Measuresmentioning

confidence: 99%

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences–Comorbidities Network Study

Houben-Wilke

Jörres

Bals

et al. 2017

Am J Respir Crit Care Med

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Rationale: Knowledge about the prevalence of objectively assessed peripheral artery disease (PAD) and its clinical relevance in patients with chronic obstructive pulmonary disease (COPD) is scarce.Objectives: We aimed to: (1) assess the prevalence of PAD in COPD compared with distinct control groups; and (2) study the association between PAD and functional capacity as well as health status.Methods: The ankle-brachial index was used to diagnose PAD (ankle-brachial index < 0.9). The 6-minute-walk distance, health status (St. George's Respiratory Questionnaire), COPD Assessment Test, and EuroQol-5-Dimensions were assessed in patients enrolled in the German COPD and Systemic Consequences-Comorbidities Network cohort study. Control groups were derived from the Study of Health in Pomerania. Conclusions: In a large cohort of patients with COPD, 8.8% were diagnosed with PAD, which is higher than the prevalence in control subjects without COPD. PAD was associated with a clinically relevant reduction in functional capacity and health status.

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Association Between Levothyroxine Treatment and Thyroid-Related Symptoms Among Adults Aged 80 Years and Older With Subclinical Hypothyroidism

Mooijaart

Puy

Stott

et al. 2019

JAMA

109

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IMPORTANCE It is unclear whether levothyroxine treatment provides clinically important benefits in adults aged 80 years and older with subclinical hypothyroidism. OBJECTIVE To determine the association of levothyroxine treatment for subclinical hypothyroidism with thyroid-related quality of life in adults aged 80 years and older. DESIGN, SETTING, AND PARTICIPANTS Prospectively planned combined analysis of data involving community-dwelling adults aged 80 years and older with subclinical hypothyroidism. Data from a randomized clinical trial were combined with a subgroup of participants aged 80 years and older from a second clinical trial. The trials were conducted between April 2013 and May 2018. Final follow-up was May 4, 2018. EXPOSURES Participants were randomly assigned to receive levothyroxine (n = 112; 52 participants from the first trial and 60 from the second trial) or placebo (n = 139; 53 participants from the first trial and 86 from the second trial). MAIN OUTCOMES AND MEASURES Co-primary outcomes were Thyroid-Related Quality of Life Patient-Reported Outcome (ThyPRO) questionnaire scores for the domains of hypothyroid symptoms and tiredness at 1 year (range, 0-100; higher scores indicate worse quality of life; minimal clinically important difference, 9). RESULTS Of 251 participants (mean age, 85 years; 118 [47%] women), 105 were included from the first clinical trial and 146 were included from the second clinical trial. A total of 212 participants (84%) completed the study. The hypothyroid symptoms score decreased from 21.7 at baseline to 19.3 at 12 months in the levothyroxine group vs from 19.8 at baseline to 17.4 at 12 months in the placebo group (adjusted between-group difference, 1.3 [95% CI, −2.7 to 5.2]; P = .53). The tiredness score increased from 25.5 at baseline to 28.2 at 12 months in the levothyroxine group vs from 25.1 at baseline to 28.7 at 12 months in the placebo group (adjusted between-group difference, −0.1 [95% CI, −4.5 to 4.3]; P = .96). At least 1 adverse event occurred in 33 participants (29.5%) in the levothyroxine group (the most common adverse event was cerebrovascular accident, which occurred in 3 participants [2.2%]) and 40 participants (28.8%) in the placebo group (the most common adverse event was pneumonia, which occurred in 4 [3.6%] participants). CONCLUSIONS AND RELEVANCE In this prospectively planned analysis of data from 2 clinical trials involving adults aged 80 years and older with subclinical hypothyroidism, treatment with levothyroxine, compared with placebo, was not significantly associated with improvement in hypothyroid symptoms or fatigue. These findings do not support routine use of levothyroxine for treatment of subclinical hypothyroidism in adults aged 80 years and older.

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Estimation of Minimal Clinically Important Difference in EQ-5D Visual Analog Scale Score After Pulmonary Rehabilitation in Subjects With COPD

Cited by 114 publications

References 43 publications

Effects of Pulmonary Rehabilitation in Patients with Non-Cystic Fibrosis Bronchiectasis: A Retrospective Analysis of Clinical and Functional Predictors of Efficacy

Effects of Pulmonary Rehabilitation in Patients with Non-Cystic Fibrosis Bronchiectasis: A Retrospective Analysis of Clinical and Functional Predictors of Efficacy

Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences–Comorbidities Network Study

Association Between Levothyroxine Treatment and Thyroid-Related Symptoms Among Adults Aged 80 Years and Older With Subclinical Hypothyroidism

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