Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study

Pauli, Carla; Schwarzbold, Marcelo Libório; Diaz, Alexandre Paim; Thais, Maria Emília Rodrigues de Oliveira; Kondageski, Charles; Linhares, Marcelo Neves; Guarnieri, Ricardo; Zingano, Bianca de Lemos; Ben, Juliana; Nunes, Jean Costa; Markowitsch, Hans J.; Wolf, Peter; Wiebe, Samuel; Lin, Kátia; Walz, Roger

doi:10.1111/epi.13721

Cited by 47 publications

(53 citation statements)

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“…Many studies are retrospective and have limited follow‐up times or examine patients (and rarely controls) at a single point of time. There are few prospective longitudinal controlled studies of HRQOL after epilepsy surgery and none with a follow‐up of 10 years or more …”

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confidence: 99%

“…To address this, the concept of minimum clinically important difference (MCID) has been developed to describe the smallest change of scores in the domain of interest that patients perceive as beneficial . To date, only three studies have used this approach for analysis of HRQOL change after epilepsy surgery . Interpretation of HRQOL change scores needs to be related to other relevant indicators, such as regaining employment or being able to take part in societal activities that were not possible earlier.…”

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confidence: 99%

“…There are few prospective longitudinal controlled studies of HRQOL after epilepsy surgery and none with a follow-up of 10 years or more. 2,10,12,[15][16][17] Many studies of HRQOL after epilepsy surgery have focused on statistical significance in change of scores rather than interpreting data in terms of what patients would appreciate as meaningful change. Small changes in HRQOL scores may reach statistical significance, but may not reflect a magnitude of change that is clinically important.…”

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confidence: 99%

“…18 To date, only three studies have used this approach for analysis of HRQOL change after epilepsy surgery. 12,16,17 Interpretation of HRQOL change scores needs to be related to other relevant indicators, such as regaining employment or being able to take part in societal activities that were not possible earlier. Research in this field has been conducted for several HRQOL instruments, and relevant cutoffs for MCID are available for interpretation of the 36-item Short-Form Health Survey (SF-36) outcomes in general.…”

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Health‐related quality of life and emotional well‐being after epilepsy surgery: A prospective, controlled, long‐term follow‐up

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Health‐related quality of life and emotional well‐being after epilepsy surgery: A prospective, controlled, long‐term follow‐up

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“…Provavelmente, são reflexo da melhora em qualidade de vida promovida pela cirurgia, com menos efeitos colaterais de DAEs, menos sedação e maior independência (Pauli et al, 2017).…”

Section: Lobectomia Temporal Anterior Queixas Subjetivas De Memóriaunclassified

Impacto da cirurgia de epilepsia no desempenho cognitivo de pacientes com esclerose mesial temporal unilateral

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Factors Associated With Failure of Adult Strabismus–20 Questionnaire Scores to Improve Following Strabismus Surgery

2018

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IMPORTANCE Health-related quality of life (HRQOL) typically improves following strabismus surgery. Nevertheless, for some patients, HRQOL does not improve, and reasons for this are unknown.OBJECTIVE To identify factors associated with failure of adult strabismus-20 (AS-20) HRQOL scores to improve following strabismus surgery. DESIGN, SETTING, AND PARTICIPANTS Prospective observational case series at the Mayo Clinic, Rochester, Minnesota, comprising 276 adults, between July 2012 and August 2016. MAIN OUTCOMES AND MEASURESParticipants completed the AS-20 HRQOL questionnaire, diplopia questionnaire, Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) (depressive symptoms), and Type-D Scale 14 questionnaire (type-Distressed [type-D] personality) both preoperatively and 6 weeks postoperatively. To assess factors associated with failure of HRQOL to improve (no change or decrease in score), univariate and multiple logistic regression analyses were performed. Each of the 4 AS-20 domains (self-perception, interactions, reading function, and general function) were analyzed separately including only patients able to improve at least by the magnitude of previously defined 95% limits of agreement. Factors assessed were age (at onset and at surgery), sex, number of previous surgeries, presence of visually obtrusive facial anomaly, visual acuity, preoperative and postoperative diplopia questionnaire scores, alignment (as a vector), presence of esotropia, presence of a vertical deviation, CESD-R scores, and type-D personality. Stepwise multiple logistic regression analyses were performed to assess factors associated with failure of AS-20 scores to improve for each domain. RESULTSOf the 276 participants, the median age was 57 years (range, 18-91 years), 153 were women (55%), and 266 were white (96%). Failure to improve was associated with worse diplopia postoperatively on the self-perception (adjusted risk ratio [RR], 1.01; 95% CI, 1.00-1.02), reading function (adjusted RR, 1.02; 95% CI, 1.01-1.03), and general function domains (adjusted RR, 1.02; 95% CI, 1.01-1.03). In addition, failure to improve on the self-perception domain was associated with type-D personality postoperatively (adjusted RR, 4.26; 95% CI, 1.90-9.57) and failure to improve on the interactions domain was associated with postoperative depressive symptoms (adjusted RR, 1.04; 95% CI, 1.02-1.06) and coexisting visually obtrusive anomaly (adjusted RR, 2.12; 95% CI, 1.04-4.32).CONCLUSIONS AND RELEVANCE Postoperative diplopia, depressive symptoms, type-D personality, and visually obtrusive facial anomalies were associated with failure of AS-20 scores to improve (remaining the same or worsening) following strabismus surgery. The association of nonstrabismus factors may have implications for patient treatment and is worthy of continued study. 51 28. Mols F, Thong MSY, de Poll-Franse LVV, Roukema JA, Denollet J. Type-D (distressed) personality is associated with poor quality of life and mental health among 3080 cancer survivors. J Affect Disord. 2012;136(1...

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Predictors of meaningful improvement in quality of life after temporal lobe epilepsy surgery: A prospective study

Cited by 47 publications

References 37 publications

Health‐related quality of life and emotional well‐being after epilepsy surgery: A prospective, controlled, long‐term follow‐up

Health‐related quality of life and emotional well‐being after epilepsy surgery: A prospective, controlled, long‐term follow‐up

Impacto da cirurgia de epilepsia no desempenho cognitivo de pacientes com esclerose mesial temporal unilateral

Factors Associated With Failure of Adult Strabismus–20 Questionnaire Scores to Improve Following Strabismus Surgery

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