Week 7- HRQOL Instruments and Generic Instruments

Question 1

Breakthroughs in the conceptualization of HRQOL and Standardization of Measures From…

Answer 1

Function is the most important dimension of HRQOL and should include physical, social and role function

Question 2

Why are patient-based health surveys important?

Answer 2

improve risk prediction, service planning, and outcomes monitoring efforts, and ensure that program planning and evaluation efforts incorporate the patient’s perspective

Question 3

Three stages of the International QOL Assessment (IQOLA)

Answer 3

1. Rigorous translation and evaluation procedures to ensure conceptual equivalence and respondent acceptance
2. Formal psychometric tests of the assumptions underlying item scoring and construction of multi-item scales;
3. Examination of the validity of the scales and the accumulation of normative data and evaluating the equivalence of interpretation across countries.
   * 1 & 2= application to population concerned
   * 3= developing a reference norm for meaningful interpretation of data obtained from specific patient groups

Question 4

Barriers to Routine Clinical Use of HRQOL Measures…

Answer 4

• Concerns about cost
• Feasibility
• Clinical relevance

Question 5

Steps to discover which HRQOL should be used in the clinical setting?

Answer 5

Step 1: Questions to ask when choosing a measure for use in clinical practice

Step 2: Introducing an HRQOL measure into clinical practice

Question 6

Generic Instruments

Answer 6

Advantages of being applicable to all persons irrespective of their type or number of illness but they may not be sensitive to some problems unique to particular diseases

Question 7

Disease-specific Instruments

Answer 7

• make comparison between different patient groups difficult

Question 8

Criteria for QOL Instruments

Answer 8

• feasibility
• reliability
• validity
• responsiveness
• interpretability

Question 9

Instrument Development: Number of Items

Answer 9

• single item for single concept
• multiple items for a single concept
• multiple items for multiple domains within a concept

Question 10

Instrument Development: Intended Measurement

Answer 10

Generic vs specific (condition-specific or population-specific)

Question 11

Instrument Development: Data Collection Method

Answer 11

• interviewer-administered
• self-administered
• interactively administered (computer-assisted, web-based interactive voice response)

Question 12

Instrument Development: Timing

Answer 12

• defined intervals throughout a study

- timeframe: with the last “period”

Question 13

Instrument Development: Types of Scores

Answer 13

• single rating on a single concept
• index (single score combining multiple ratings of related domains or individual concepts)
• profile (multiple uncombined scores of multiple related domains)
• battery (multiple uncombined scores of independent concepts)
• composite (single rating, index, profile or battery)

Question 14

Instrument Development: Weighting of items or concepts

Answer 14

• all items and domains are equally weighted
• items are assigned variable weights
• domains are assigned variable weights

Question 15

Response Formats

Answer 15

• visual analog scale, likert scale, rating scale or checklist

Question 16

SF-36: What is it?

Answer 16

• A set of generic, coherent, and easily administered quality-of-life measures.
• Rely upon patient self-reporting and are now widely utilized by managed care organizations and for routine monitoring and assessment of care outcomes in adult patients.

Question 17

Sickness Impact Profile

Answer 17

A behaviorally-based measure of health status, is used to assess a person’s perception of their health status with respect to their disease impact

• all items are scored dichotomously (no= 0, yes= 1)
• higher scores indicate more health-related behavioural problems

Question 18

Sickness Impact Profile: 6 Subscales

Answer 18

• Somatic autonomy
• Mobility control
• Mobility range
• Social behavior
• Emotional stability
• Psychological autonomy/communication

Question 19

Nottingham Health Profile

Answer 19

Intended for primary health care, to provide a brief indication of a patient’s perceived emotional, social and physical health problems

Question 20

Nottingham Health Profile: Breakdown of Questionnaire

Answer 20

• Part I: 38 questions in 6 subareas, with each question assigned a weighted value; the sum of all weighted values in a given subarea adds up to 100
• energy level (EL): 3
• pain (P): 8
• emotional reaction (ER): 9
• sleep (S): 5
• social isolation (SI): 5
• physical abilities (PA): 8
• Part II: 7 life areas affected