Quality of life: An important endpoint both in surgical practice and research

Troidl, H.; Kusche, J; Vestweber, Karl-Heinz; Eypasch, E.; Koeppen, Ludwig; Bouillon, Bertil

doi:10.1016/0021-9681(87)90009-9

Cited by 108 publications

(62 citation statements)

References 12 publications

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“…Since the success of an intervention is not anymore related to medical progress alone, patient’s QoL should also be considered [3,4]. Although this factor has not been thoroughly considered in surgery for several years [4,5], the situation has changed and QoL after intervention has become an important parameter which determines the success. Therefore, several previous studies assessed the factors affecting QoL of patients following valvular surgery [3,4,5].…”

Section: Discussionmentioning

confidence: 99%

“…The goal is not only to achieve survival, but also health, well-being and some reasonably good quality of living as well [21]. Since the success of an intervention is not anymore related to medical progress alone, patient’s QoL should also be considered [3,4]. Although this factor has not been thoroughly considered in surgery for several years [4,5], the situation has changed and QoL after intervention has become an important parameter which determines the success.…”

Section: Discussionmentioning

confidence: 99%

“…However, once the symptoms appear, they bring about problems in QoL of this relatively younger population. Although recent studies have assessed the factors affecting QoL of patients following valvular surgery [3,4,5], limited data are available on the assessment of QoL in patients during the follow-up period before an intervention. Furthermore, gender differences in the QoL during the preoperative period are solely based on studies about coronary artery bypass surgery, since studies with valvular patients exclusively are lacking [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

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The Relationship between Mean Pulmonary Artery Pressure and Quality of Life in Patients with Mitral Stenosis

Zorlu¹,

Amioglu²,

Yılmaz

et al. 2011

Cardiology

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Objectives: We aimed to evaluate echocardiography-guided hemodynamic determinants of quality of life (QoL) via the Medical Outcomes Study Short Form (SF-36) questionnaire in patients with mild to moderate mitral stenosis (MS). Methods: Eighty consecutive patients with rheumatic MS, who were admitted to the outpatient department, were enrolled into the study upon obtaining informed consent. Forty age-sex-matched healthy individuals were enrolled as a control group. Results: All subscale scores and total SF-36 scores were significantly lower in the patient group representing a worse QoL. In multivariable logistic regression analysis, only mean pulmonary artery pressure (OR 1.138, 95% CI 1.049–1.234, p = 0.002) was found to be an independent predictor of poor QoL in patients with mild to moderate MS. Conclusion: During follow-up of MS patients before intervention, physicians should consider that mean pulmonary artery pressure is the main factor which influences the patients’ QoL. In patients with MS, it seems that referral to intervention should consider components and derivatives of QoL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Relationship between Mean Pulmonary Artery Pressure and Quality of Life in Patients with Mitral Stenosis

Zorlu¹,

Amioglu²,

Yılmaz

et al. 2011

Cardiology

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“…La previsione dell'insorgenza di effetti collaterali verosimilmente in grado di influire negativamente sulla qualità della vita dei soggetti è una delle condizioni che esige necessariamente delle valutazioni sulla qualità della vita nell'ambito della sperimentazione clinica, tanto più se si tratta di patologie croniche o di effetti a lungo termine [23].…”

Section: Criteri Per Determinare La Ne-cessità DI Valutazioni Sulla Qunclassified

Farmacoeconomia ed etica: cure sostenibili e rispetto della persona

Spagnolo

Minacori

2004

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The scarcity of economic resources today is a fundamental problem in public healthcare. The importance of making well-founded choices for optimal resources allocation concerns also pharmacological treatments and is justified also on ethical grounds, besides the economic, political and/or medical considerations. In fact, a better management, also in economic sense, of the patient and sickness involves the possibility of offering an efficient treatment to all the sick, or at least to as many of them as possible. However, these considerations should always be subordinated to the ethical centrality of the patient, to the protection of his life, his health and his personal dignity, to the extent that life and health are priceless. The goal of ethics in pharmacoeconomics can be summarised in respect for the person, which must remain the end and reference of every therapeutic choice as well as every healthcare policy. The indispensable instruments for the realisation of the above objectives are, amongst others, those already highlighted but which demand further explanation: a) a suitable standard background/training and a multidisciplinary approach for optimising the evaluation procedures and increasing accuracy and verifiableness of the data; b) measures to contrast and disclose the conflict of interest for more transparency and credibility; c) a coherent evaluation of the ethical quality and humanness of the pharmacoeconomic analysis which requires a correct consideration of quality of life and a real respect for persons. Farmeconomia e percorsi terapeutici 2004; 5 (4): 251-263 INTRODUZIONEScarsità o limitatezza delle risorse -che si tratti di personale, di tempo, di strutture, di finanziamenti -costituiscono, a fronte delle grandi prospettive di sviluppo della ricerca e della disponibilità di tecnologie medico-scientifiche sempre più all'avanguardia, la questione fondamentale, anzi il vero, grande, problema della sanità. Ciò comporta, e sarà così anche in futuro, per i "decision makers", a livello sia di macro-allocazione sia di microallocazione, il confronto con scelte operative relative alla distribuzione e alla migliore gestione possibile delle risorse disponibili. Fino a pochi anni fa, tali decisioni erano soprattutto il frutto di esperienze precedenti o di pareri raccolti da esperti, se non di puro istinto. La responsabilità di un'adeguata distribuzione delle limitate risorse di cui si dispone richiama, dunque, la necessità di analisi strutturate e sistematiche delle alternative e delle opzioni, prima di assumere decisioni operative in sanità.L'importanza di operare tali scelte riguarda anche -e costituisce uno degli ambiti principali nella "razionalizzazione delle risorse in sanità" -i trattamenti farmacologici: gli esperti già da qualche tempo ammoniscono su tale esigenza di razionalizzazione, prevedendo per il futuro che non sarà possibile garantire a tutti ogni tipo di farmaco, soprattutto nel caso di farmaci che offrono benefici generici.Tale necessità di una migliore distribuzione di risorse, qui...

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“…Adoption of this position has been influenced primarily by the work of Ware and his associates (31,32,(37)(38)(39), Aaronson (7), and Aaronson and his co-workers (29). Inclusion of a global measure of quality of life is highly recommended if resources permit, because it is important that overall patient distress be measured (40). Najman and Levine (20) suggested that measures of quality of life that are focused on disease or treatment can miss critical aspects of quality of life for a particular patient.…”

Section: Operational Definition Of Quality Of Lifementioning

confidence: 99%

Quality of Life End Points in Cancer Clinical Trials: Review and Recommendations

Moinpour

Feigl

Metch

et al. 1989

JNCI Journal of the National Cancer Institute

370

129

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In this presentation, issues that influenced the development of policies for inclusion of quality of life end points in cer-In this review, we address issues and methods associated with measurement of quality of life in clinical trials and recommend specific instruments appropriate for clinical trials research. Our review was initiated in November 1987 at the request of the Southwest Oncology Group Cancer Control Research Committee. One motivation for the assessment of quality of life was the increased attention to cancer control research, both at the National Cancer Institute and in the Southwest Oncology Group. We circulated a position paper among the leaders of the Southwest Oncology Group recommending how and to what extent quality of life end points should be included in the group's clinical trials. Our recommendations were adopted by the Cancer Control Research Committee in October 1988. The policies we developed for assessing quality of life in selected trials are potentially relevant, with appropriate modifications, to other multi-institution clinical trials.The Southwest Oncology Group was organized in 1956 with the objectives of reducing mortality from cancer and improving care of patients with malignant disease. Participating medical institutions work together to conduct cancer clinical trials that evaluate the efficacy of cancer therapies. In the last 12 months, approximately 4,000 cancer patients were registered in 130 studies; 69% were in randomized comparative phase HI trials.The benefits of a cancer treatment regimen should outweigh its cost in patient suffering (7,2). By adding quality of life end points to the traditional end points of overall survival, disease-free survival, and tumor response, medical researchers can make more informed decisions about risk-benefit trade-offs; for example, two types of survival-quality of life trade-offs can be described. In one case, two treatments are associated with similar survival rates, but one treatment produces more severe toxic effects; in another case, one of two treatments demonstrates a better survival rate but has more severe toxic effects (3). Quality of life data can add to medical knowledge obtained in the conduct of clinical trials; such data do not supplant existing traditional end points, nor do they replace data on toxic effects based on physician reports.Received October 24, 1988; revised January 3, 1989; accepted January 4, 1989. Supported by Public Health Service grant CA-37429 from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services. Based in part on work completed by Dr. C. M. Moinpour while she was a National Research Service Award postdoctoral fellow Barofsky (4) argued that many clinical trials have paid at least implicit attention to quality of life issues, e.g., the focus of the National Surgical Adjuvant Breast and Bowel Project on the survival time associated with different degrees of surgery. Other trials (5-70) with breast cancer patients address quality of life issues expl...

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Quality of life: An important endpoint both in surgical practice and research

Cited by 108 publications

References 12 publications

The Relationship between Mean Pulmonary Artery Pressure and Quality of Life in Patients with Mitral Stenosis

The Relationship between Mean Pulmonary Artery Pressure and Quality of Life in Patients with Mitral Stenosis

Farmacoeconomia ed etica: cure sostenibili e rispetto della persona

Quality of Life End Points in Cancer Clinical Trials: Review and Recommendations

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