Pmd34: Comparison of Sf-36 Summary and Preference-Based Utility Scores Across Groups Differing in Disease Severity: Results From the Medicare Health Outcomes Survey

Ware, JE; Bierman, AS; Gandek, Barbara; Sinclair, S.; Lawrence, WP

doi:10.1016/s1098-3015(10)64112-5

Cited by 5 publications

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“…Data on the health and wellbeing of junior doctors in Australia is limited and as such this study provides pertinent information in this area of interest. This study was designed to minimise any potential bias with the use of reliable and validated questionnaires [ 15 , 16 ]. Additionally, the surveys were conducted at the end of the clinical year so as to reduce the potential impact of stressors such as new clinical rotations, examinations and traditionally high-stress periods.…”

Section: Discussionmentioning

confidence: 99%

“…Participation was voluntary and anonymous. Two validated questionnaires, the Short Form 36 Health Questionnaire (SF36) [ 15 ] and the Perceived Stress Scale 14 (PSS14) [ 16 ], were used to assess the general wellbeing and stress amongst participants. Demographic data sought included variables such as age, gender, marital status, number of children and training related variables such as location and satisfaction with current posting.…”

Section: Methodsmentioning

confidence: 99%

“…The SF36 is a survey that was designed to provide information about the general health and wellbeing of the participant [ 15 ]. This survey is a concise version derived from a larger set of questions used in the Medical Outcomes Study in 1989 [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

“…This survey is a concise version derived from a larger set of questions used in the Medical Outcomes Study in 1989 [ 20 ]. It has been demonstrated to produce reliable and valid results in both the clinical and population setting and has been used internationally [ 15 , 19 ]. The SF-36 provides indicators across eight dimensions: Physical functioning: Indicative of the extent of limitation in performing daily activities due to the individual’s health.…”

Section: Methodsmentioning

confidence: 99%

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Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

Soares

Chan

2016

BMC Med Educ

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BackgroundStress in doctors adversely affects decision-making, memory, information-recall and attention, thereby negatively impacting upon the provision of safe and high quality patient care. As such, stress in doctors has been subject to increasing scientific scrutiny and has amassed greater public awareness in recent years. The aims of this study are to describe stress levels and the psychological wellbeing of current junior medical officers (JMOs), and to compare this to their predecessors, American surgical residents and population norms.MethodsPost graduate years 1 & 2 doctors at a single metropolitan tertiary referral center were surveyed in 2009 and 2014 using two reliable and validated psychometric questionnaires, the Short Form-36 (SF36) and Perceived Stress Scale-14 (PSS14), with additional questions pertaining to demographics and training. The results were compared with published data from American general surgical residents and Australian age-matched population norms.ResultsMean stress levels were lower in 2014 (23 ± 7.2) than in 2009 (27.2 ± 7.6) (p = 0.017). The mean PSS-14 score was lower than that of American surgical residents, both before (26.8 ± 7.3, p = 0.003) and after (26.7 ± 8.2, p = 0.004) implementation of the safe working hour policies but higher than societal controls (p < 0.0001). Whilst JMOs in 2014 reported better overall mental health compared to those in 2009 (p = 0.02), they were significantly worse than the general population (p = 0.009). Multivariate analysis showed that JMOs were more likely to have a high PSS-14 score or to have a low mental health score if they reported higher career anxiety (p < 0.05).ConclusionsDoctors are still at risk despite an improvement in their stress levels and overall mental health. They are less likely to be stressed and to have better mental health if they have less career-related anxiety. This has implications for the medical education and training of our junior doctors.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

Soares

Chan

2016

BMC Med Educ

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“…Higher scores reflect better quality of life, with a scale range of 0 to 100 for each domain and summary score. Because outcomes for patients with both AF and heart failure resemble those with heart failure, the minimal clinically important difference (MCID) for the SF-36 PCS is between 4.1 and 9.2 (anchored to mortality) . Further detail on outcome derivation and MCIDs for patients with AF are presented in the eMethods in Supplement 3.…”

Section: Methodsmentioning

confidence: 99%

Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life

Kotecha

Bunting

Gill

et al. 2020

JAMA

155

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for the Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) Team IMPORTANCE There is little evidence to support selection of heart rate control therapy in patients with permanent atrial fibrillation, in particular those with coexisting heart failure.OBJECTIVE To compare low-dose digoxin with bisoprolol (a β-blocker). DESIGN, SETTING, AND PARTICIPANTSRandomized, open-label, blinded end-point clinical trial including 160 patients aged 60 years or older with permanent atrial fibrillation (defined as no plan to restore sinus rhythm) and dyspnea classified as New York Heart Association class II or higher. Patients were recruited from 3 hospitals and primary care practices in England from 2016 through 2018; last follow-up occurred in October 2019. INTERVENTIONS Digoxin (n = 80; dose range, 62.5-250 μg/d; mean dose, 161 μg/d) or bisoprolol (n = 80; dose range, 1.25-15 mg/d; mean dose, 3.2 mg/d). MAIN OUTCOMES AND MEASURESThe primary end point was patient-reported quality of life using the 36-Item Short Form Health Survey physical component summary score (SF-36 PCS) at 6 months (higher scores are better; range, 0-100), with a minimal clinically important difference of 0.5 SD. There were 17 secondary end points (including resting heart rate, modified European Heart Rhythm Association [EHRA] symptom classification, and N-terminal pro-brain natriuretic peptide [NT-proBNP] level) at 6 months, 20 end points at 12 months, and adverse event (AE) reporting.RESULTS Among 160 patients (mean age, 76 [SD, 8] years; 74 [46%] women; mean baseline heart rate, 100/min [SD, 18/min]), 145 (91%) completed the trial and 150 (94%) were included in the analysis for the primary outcome. There was no significant difference in the primary outcome of normalized SF-36 PCS at 6 months (mean, 31.9 [SD, 11.7] for digoxin vs 29.7 [11.4] for bisoprolol; adjusted mean difference, 1.4 [95% CI, −1.1 to 3.8]; P = .28). Of the 17 secondary outcomes at 6 months, there were no significant between-group differences for 16 outcomes, including resting heart rate (a mean of 76.9/min [SD, 12.1/min] with digoxin vs a mean of 74.8/min [SD, 11.6/min] with bisoprolol; difference, 1.5/min [95% CI, −2.0 to 5.1/min]; P = .40). The modified EHRA class was significantly different between groups at 6 months; 53% of patients in the digoxin group reported a 2-class improvement vs 9% of patients in the bisoprolol group (adjusted odds ratio, 10.3 [95% CI, 4.0 to 26.6]; P < .001). At 12 months, 8 of 20 outcomes were significantly different (all favoring digoxin), with a median NT-proBNP level of 960 pg/mL (interquartile range, 626 to 1531 pg/mL) in the digoxin group vs 1250 pg/mL (interquartile range, 847 to 1890 pg/mL) in the bisoprolol group (ratio of geometric means, 0.77 [95% CI, 0.64 to 0.92]; P = .005). Adverse events were less common with digoxin; 20 patients (25%) in the digoxin group had at least 1 AE vs 51 patients (64%) in the bisoprolol group (P < .001). There were 29 treatment-related AEs and 16 serious AEs in the digoxin group vs 142 and 37, ...

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Quality of Life: Questionnaires and Questions

Mooney

2006

Journal of Health Communication

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Quality of life (QoL) is a phrase often used in health care settings at policy and administration levels, in clinical assessments of therapies, and in clinical management of individual cases. While QoL is a broad concept that covers such areas as social, environmental, economic, and health satisfaction, health-related quality of life (HRQL) is less wide ranging, including mental and physical health and their consequences. First, I question the singularity of HRQL, suggesting there are at least two distinct meanings of HRQL. Second, questionnaires designed to assess individual patients' HRQL allow a limited range of ways for patients to express their state of being. The Medical Outcomes Study Short Form (SF-36), which operationalises HRQL for a traditional clinical setting, is used to show in detail the restricted options that are available for patient respondents. The communications limitations of utility-based measures, designed as cost-effectiveness measures but often used as though they were HRQL instruments, are also discussed. For assessing the HRQL of individuals in a health setting, such questionnaires can provide only a starting point, which should be supplemented with good interaction and communication.

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Pmd34: Comparison of Sf-36 Summary and Preference-Based Utility Scores Across Groups Differing in Disease Severity: Results From the Medicare Health Outcomes Survey

Cited by 5 publications

References 0 publications

Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life

Quality of Life: Questionnaires and Questions

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