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A comparison of the responsiveness of different generic health status measures in patients with asthma

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Abstract

Generic health status has been recommended to be measured separately from disease-specific health status, because they can yield complementary information. In particular, generic health status can provide comprehensive health ratings across various disorders. However, the weakness with generic measures is that they may be less responsive to clinical changes than disease-specific ones. Therefore, when using generic health status as an endpoint in clinical trials, the instrument to be used is a problem with respect to responsiveness. In the present study, we investigated and compared the responsiveness of health status measures during asthma treatment using three different generic instruments: the Medical Outcomes Study Short Form 36-items Health Survey (SF-36), the Nottingham Health Profile (NHP) and the EQ5D (EuroQoL), as well as one disease-specific instrument, the Asthma Quality of Life Questionnaire (AQLQ). Fifty-four new patients with asthma who consulted our clinic were recruited. The health status measurements were performed on the initial visit, and at 3 and 6 months. All subscales of the SF-36 showed a significant improvement during the first 6 months. Each dimension of the EQ5D showed stronger ceiling effects than the SF-36. With respect to the responsiveness indices, the SF-36 was regarded as more responsive than the NHP or EQ5D utility. The changes in the SF-36 had a weak to moderate correlation with the changes in the AQLQ. In conclusion, the SF-36 had a higher responsiveness for asthma as a generic measure than the NHP or EQ5D, and evaluated different aspects from the AQLQ. The SF-36 can be used effectively in asthma clinical trials.

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References

  1. Patrick DL, Deyo RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989; 27: S217–S232.

    Google Scholar 

  2. Juniper EF. Health-related quality of life in asthma. Curr Opin Pulm Med 1999; 5: 105–110.

    Google Scholar 

  3. Ware JE, Sherbourne CD. The MOS 36-item short-from health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992; 30: 473–483.

    Google Scholar 

  4. Hunt SM, McKenna SP, McEwen J, Williams J, Papp E. The Nottingham Health Profile: Subjective health status and medical consultations. Soc Sci Med 1981; 15A: 221–229.

    Google Scholar 

  5. Bergner M, Bobbitt RA, Carter WB, Gilson BS. The sickness impact profile: Development and final revision of a health status measure. Med Care 1981; 19: 787–805.

    Google Scholar 

  6. The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy 1990; 16: 199–208.

    Google Scholar 

  7. Brooks R, with the EuroQol Group. EuroQoL: The current state of play. Health Policy 1996; 37: 53–72.

    Google Scholar 

  8. Kaplan RM, Anderson JP, Wu AW, Matthews WC, Kozin F, Orenstein D. The Quality of Well-being Scale: Application in AIDS, cystic fibrosis and arthritis. Med Care 1989; 27: S27–S43.

    Google Scholar 

  9. van der Molen T, Postma DS, Schreurs AJM, Bosveld HEP, Sears MR, Meyboom de Jong B. Discriminative aspects of two generic and two asthma-specific instruments: Relation with symptoms, bronchodilator use and lung function in patients with mild asthma. Qual Life Res 1997; 6: 353–361.

    Google Scholar 

  10. Mancuso CA, Peterson MGE, Charlson ME. Comparing discriminative validity between a disease-specific and a general health scale in patients with moderate asthma. J Clin Epidemiol 2001; 54: 263–274.

    Google Scholar 

  11. Juniper EF, Guyatt GH, Epstein RS, Ferrie PJ, Jaeschke R, Hiller TK. Evaluation of impairment of health related quality of life in asthma: Development of a questionnaire for use in clinical trials. Thorax 1992; 47: 76–83.

    Google Scholar 

  12. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis 1987; 136: 225–244.

    Google Scholar 

  13. Chai H, Farr RS, Froehlich LA, et al. Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol 1975; 56: 323–327.

    Google Scholar 

  14. British Thoracic Society. The British Guidelines on Asthma Management 1995 Review and Position Statement. Thorax 1997; 52: S1–S21.

    Google Scholar 

  15. Medical Section of the American Lung Association. Standardization of spirometry: 1994 update. Am Rev Respir Dis 1994; 152: 1107–1136.

    Google Scholar 

  16. Japan Society of Chest Diseases. The predicted values of pulmonary function testing in Japanese (in Japanese). Jpn J Thoracic Dis 1993; 31: Appendix.

  17. Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K. Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 1998; 51: 1037–1044.

    Google Scholar 

  18. Tsukino M, Nishimura K, Ikeda A, Koyama H, Mishima M, Izumi T. Physiologic factors that determine the healthrelated quality of life in patients with COPD. Chest 1996; 110: 896–903.

    Google Scholar 

  19. Ikeda S, Ikegami N on behalf of the Japanese EuroQol Tariff Project. Health status in Japanese population (in Japanese). Iryou to Syakai 1999; 9: 83–92.

    Google Scholar 

  20. Stahl E, Green J, Hashimoto H, Mear I, Juniper EF. Cultural adaptation of the asthma quality of life questionnaire into Japanese. Qual Life Res 1998; 7: 665–666.

    Google Scholar 

  21. Ikeda S, Ikegami N. Preference-based measure, EQ-5D: Quality of Life Evaluation Handbook for Clinicians (in Japanese). Tokyo: Igaku-shoin, 2001; pp. 14–18.

  22. Wright JG, Young NL. A comparison of different indices of responsiveness. J Clin Epidemiol 1997; 50: 239–246.

    Google Scholar 

  23. Jans MP, Schellevis FG, van Eijk J. The Nottingham Health Profile: Score distribution, internal consistency and validity in asthma and COPD patients. Qual Life Res 1999; 8: 501–507.

    Google Scholar 

  24. Essink-Bot M-L, Krabbe PFM, Bonsel GJ, Aaronson NK. An empirical comparison of four generic health status measures. Med Care 1997; 35: 522–537.

    Google Scholar 

  25. Beaton DE, Hogg-Johnson S, Bombardier C. Evaluating changes in health status: Reliability and responsiveness of five generic health status measures in workers with musculoskeletal disorders. J Clin Epidemiol 1997; 50: 79–93.

    Google Scholar 

  26. Hagen KB, Smedstad LM, Uhlig T, Kvien TK. The responsiveness of health status measures in patients with rheumatoid arthritis: Comparison of disease-specific and generic instruments. J Rheumatol 1999; 26: 1474–1480.

    Google Scholar 

  27. Jones PW, Bosch TK. Quality of life changes in COPD patients treated with salmeterol. Am J Respir Crit Care Med 1997; 155: 1283–1289.

    Google Scholar 

  28. Freeman JA, Hobart JC, Langdon DW, Thompson AJ. Clinical appropriateness: A key factor in outcome measure selection: The 36 item short form health survey in multiple sclerosis. J Neurol Neurosurg Psychiat 2000; 68: 150–156.

    Google Scholar 

  29. Suarez-Almazor ME, Kendall C, Johnson JA, Skeith K, Vincent D. Use of health status measures in patients with low back pain in clinical settings. Comparison of specific, generic and preference-based instruments. Rheumatology 2000; 39: 783–790.

    Google Scholar 

  30. Curtis RJ, Deyo RA, Hudson LD. Health-related quality of life among patients with chronic obstructive pulmonary disease. Thorax 1994; 49: 162–170.

    Google Scholar 

  31. Crockett AJ, Cranston JM, Moss JR, Alpers JH. The MOS SF-36 health survey questionnaire in severe chronic airflow limitation: Comparison with the Nottingham Health Profile. Qual Life Res 1996; 5: 330–338.

    Google Scholar 

  32. Garratt AM, Hutchinson A, Russell I. Patient-assessed measures of health outcome in asthma: A comparison of four approaches. Respir Med 2000; 94: 597–606.

    Google Scholar 

  33. Fayers PM, Machin D. Quality of Life: Assessment, Analysis and Interpretation. Chichester: Wiley, 2000.

    Google Scholar 

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Oga, T., Nishimura, K., Tsukino, M. et al. A comparison of the responsiveness of different generic health status measures in patients with asthma. Qual Life Res 12, 555–563 (2003). https://doi.org/10.1023/A:1025051829223

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