Health Related QoL

Question 1

How can we measure health?

Answer 1

Mortality, morbidity or patient-based outcomes

Question 2

Give three examples of patient based outcomes

Answer 2

Health-related QoL, health status, PROMs

Question 3

What are PROMs?

Answer 3

Patient reported outcome measures to directly measure health by comparing scores before and after treatment

Question 4

Give some pros and cons of PROMs

Answer 4

Pros: patient concerns, improve management of patient, compare hospitals to improve quality, published for patients to see

Cons: takes time and money to collect, analyse and present data, patient participation is difficult

Question 5

Define QoL

Answer 5

Individuals perception of position in life in context of culture and value system in relation to goals, expectation, standards and concerns

Question 6

Define health related QoL

Answer 6

Sense of physical, social and emotional wellbeing in context of clinical medicine which represents functional effect of illness and therapies as perceived by the patient

Question 7

Which two types of quantitative methods are used?

Answer 7

Generic-common, any population, overall health perceptions and pain
Specific-evaluates series of health dimensions specific to disease, site or dimension

Question 8

What are the pros and cons of specific questionnaires?

Answer 8

Pros: relevant content, acceptable to patients, sensitive to intervention change
Cons: can’t use with healthy people, limited comparisons, doesn’t see unexpected effects

Question 9

What are the pros and cons of generic questionnaires?

Answer 9

Pros: range of health problems, don’t need disease-specific tool, compare treatment groups, assess population health
Cons: less detailed and loss of relevance, no patient concerns heard, less sensitive to intervention changes

Question 10

Give two examples of generic instruments

Answer 10

SF-36

EQ-5D

Question 11

Describe SF-36

Answer 11

36 items in 8 dimensions:
Physical function and role, social role, emotional role, pain, health, vitality, mental health

Measures general health, patient management and resource allocation

Question 12

Describe EQ-5D

Answer 12

5 dimensions:
Mobility, self-care, pain, activities, anxiety
with 3 levels for each dimension:
No problems, some problems, extreme

Question 13

How do you decide which instrument to use?

Answer 13

Published?
Reliable and valid?
Suitable for every area of interest?
Acceptable to patients?
Reflect patient concerns?
Sensitive to change?
Easy to use and analyse?

Question 14

Why do we measure health?

Answer 14

Monitor patients progress
Target resources
Cost effective
Indicates need for care
Assess quality and effectiveness of care/services