Measurements of analysis Flashcards
Is distribution considered when deciding a treatment?
No, focuses on total maximum benefit regardless of the distribution e.g. 50yrs of life for 1 person = 10yrs of life for 5 people
What are clinical outcomes measured in?
Natural units e.g. life years gained
What is a proxy outcome?
An outcome which goes on to change further outcomes e.g. increased detection, increases survival
What is used when considering a condition specific outcome?
Questionnaires.
What are the advantages and disadvantages of using clinical outcomes?
+ measure within a clinical study
+ easy to understand
- lack comparability as different diseases have different outcomes
- more than one outcome could be considered
What is a QALY?
Quality adjusted life years. Combines length and quality of life. It is the QoL for each additional year gained. Used by NICE to make a decision to maximise health gain.
What is the calculation for a QALY?
= Sum (length of life x QoL)
How is the QALY calculation used to determine which treatment is better?
Uses the total gain of QALYs:
QALY of A - QALY of B
Where is life year data obtained from?
Life tables, long term follow up, deaths recorded.
How is QoL determined?
Uses judgement from expert consultants, questionnaires, public description and published values from studies
Give an example of a questionnaire used for QoL.
EQ-5D - regarding mobility, self care, activities, discomfort, anxiety/depression at 5 different levels
What are the advantages of using QALYs?
+ consider the impact of both quantity and quality
+ can be used as a common unit to compare between diseases
+ convenient measurement tools
What are the disadvantages of using QALYs?
- valued at the same level but individuals may have a different opinion on what a good QALY is for them
- Public decides the values
- insensitivity of the results using questionnaires with restricted options
- valued more at the end of life
- family and carer benefits and other pt benefits not considered
What may a direct cost on health or social include?
Interventions and medications required, primary and secondary care use, social services use, time, transport, paid carers, prescription charges, private care
What may an indirect cost include?
Lost production = time off, unemployment, reduced productivity
