Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients

Kaarlola, Anne; Pettilä, Ville; Kekki, Pertti

doi:10.1007/s00134-004-2471-6

Cited by 55 publications

(38 citation statements)

References 30 publications

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“…HRQL was assessed using the EQ-5D, 42 which has been validated for use in the critical care patient group. 80 Surviving patients completed the EQ-5D at 3 and 12 months post cardiac arrest. The EQ-5D responses were converted to health-state utility values using the UK tariff.…”

Section: Quality-adjusted Life-yearsmentioning

confidence: 99%

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation

Gates

Lall

Quinn

et al. 2017

Health Technol Assess

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BackgroundMechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA).ObjectiveEvaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA.DesignPragmatic, cluster randomised trial including adults with non-traumatic OHCA. Ambulance dispatch staff and those collecting the primary outcome were blind to treatment allocation. Blinding of the ambulance staff who delivered the interventions and reported initial response to treatment was not possible. We also conducted a health economic evaluation and a systematic review of all trials of out-of-hospital mechanical chest compression.SettingFour UK ambulance services (West Midlands, North East England, Wales and South Central), comprising 91 urban and semiurban ambulance stations. Clusters were ambulance service vehicles, which were randomly assigned (approximately 1 : 2) to the LUCAS-2 device or manual CPR.ParticipantsPatients were included if they were in cardiac arrest in the out-of-hospital environment. Exclusions were patients with cardiac arrest as a result of trauma, with known or clinically apparent pregnancy, or aged < 18 years.InterventionsPatients received LUCAS-2 mechanical chest compression or manual chest compressions according to the first trial vehicle to arrive on scene.Main outcome measuresSurvival at 30 days following cardiac arrest; survival without significant neurological impairment [Cerebral Performance Category (CPC) score of 1 or 2].ResultsWe enrolled 4471 eligible patients (1652 assigned to the LUCAS-2 device and 2819 assigned to control) between 15 April 2010 and 10 June 2013. A total of 985 (60%) patients in the LUCAS-2 group received mechanical chest compression and 11 (< 1%) patients in the control group received LUCAS-2. In the intention-to-treat analysis, 30-day survival was similar in the LUCAS-2 (104/1652, 6.3%) and manual CPR groups [193/2819, 6.8%; adjusted odds ratio (OR) 0.86, 95% confidence interval (CI) 0.64 to 1.15]. Survival with a CPC score of 1 or 2 may have been worse in the LUCAS-2 group (adjusted OR 0.72, 95% CI 0.52 to 0.99). No serious adverse events were noted. The systematic review found no evidence of a survival advantage if mechanical chest compression was used. The health economic analysis showed that LUCAS-2 was dominated by manual chest compression.LimitationsThere was substantial non-compliance in the LUCAS-2 arm. For 272 out of 1652 patients (16.5%), mechanical chest compression was not used for reasons that would not occur in clinical practice. We addressed this issue by using complier average causal effect analyses. We attempted to measure CPR quality during the resuscitation attempts of trial participants, but were unable to do so.ConclusionsThere was no evidence of improvement in 30-day survival with LUCAS-2 compared with manual compressions. Our systematic review of recent randomised trials did not suggest that survival or survival without significant disability may be improved by the use of mechanical chest compression.Future workThe use of mechanical chest compression for in-hospital cardiac arrest, and in specific circumstances (e.g. transport), has not yet been evaluated.TriaI registrationCurrent Controlled Trials ISRCTN08233942.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 11. See the NIHR Journals Library website for further project information.

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Section: Quality-adjusted Life-yearsmentioning

confidence: 99%

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation

Gates

Lall

Quinn

et al. 2017

Health Technol Assess

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“…Even though the EQ-5D-3L is brief and easy to administer, it caused high ceiling effects [4][5][6][7][8][9][10]. Thus, to reduce the ceiling effects, the EuroQoL group developed a new version of EQ-5D, called EQ-5D-5L [11].…”

Section: Introductionmentioning

confidence: 99%

Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases

et al. 2015

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“…In other areas of health, however, the five dimensions may not fully capture the health-related impacts of certain conditions on affected patients. Such areas include vision and hearing [14,15], cognition [16], sexual function, incontinence [17] and severe mental health conditions such as schizophrenia [18]. The EQ-5D may not be psychometrically valid and sensitive to the impacts of a particular condition if changes in health are not reflected in the descriptive system.…”

Section: Introductionmentioning

confidence: 99%

Views of the UK General Public on Important Aspects of Health Not Captured by EQ-5D

Shah

Mulhern

Longworth

et al. 2017

Patient

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Introduction: The EQ-5D is a standardised instrument designed for use as a generic measure of health outcome. It was (and is) intended to provide information about a "common core" of dimensions known to be relevant across a range of conditions. However, the five dimensions may not fully capture the health-related impacts of certain conditions. This study analyses the views of the UK general public about important aspects of health considered to be missing from the instrument.Methods: Survey respondents were asked whether there are any aspects of health they consider to be important but are not captured by the EQ-5D, and if so, what these aspects of health are. The responses (text comments) were analysed using content analysis with analyst triangulation. Data were collected from a broadly representative sample of the general public via a paper questionnaire administered as part of face-toface interviews.Results: Data are available for 436 respondents, 179 of whom suggested aspects of health they considered important but not captured by the five EQ-5D dimensions. These were organised into 22 themes. Sensory deprivation and mental health were the aspects of health most commonly mentioned by respondents.Conclusions: Respondents identified several important aspects of health that are not covered by the EQ-5D descriptive system. The study can provide the basis for more detailed qualitative and quantitative research -in particular, to examine the views of different patient groups -to inform further review of the EQ-5D descriptive system. The results also have implications for the sensitivity of other generic measures.3 Key points for decision makersViews were sought from the UK general public about important aspects of health considered to be missing from the EQ-5D health outcome measure.Twenty-two themes emerged from the responses, reflecting the brief nature of the EQ-5D.Sensory deprivation and mental health were the aspects of health most commonly mentioned by respondents.

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Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients

Abstract: The EQ-5D and the RAND-36 correlated well, but when more precisely stated information is needed, especially regarding mobility, self-care, or low quality of life levels of previous critically ill patients, the profile-based RAND-36 may discriminate better.

Cited by 55 publications

References 30 publications

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation

Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases

Views of the UK General Public on Important Aspects of Health Not Captured by EQ-5D

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