1 Does it make a difference for the patient? Survival & Quality of life Jan J. v. Busschbach, Ph.D. Erasmus MC Institute for Medical Psychology and Psychotherapy Viersprong Institute for studies on Personality Disorders Presentations can be found at:
2 Most simple recipe.. Count the survival days SF-36 EuroQol EQ-5D
3 Outcome research SF-36 EQ-5D
4 Sensitivity Generic instruments Like SF-36 and EQ-5D Not necessarily sensitive for intervention Disease specific quality of life instruments More sensitive But comparisons with other disease difficult Not sensible in outcome research and health economics
5 Outcome research SF-36 EQ-5D Specific
6 Specific instruments Last option Develop it your self…. Desperate option Find one on the internet, PubMed etc…. To many, non at all or just not what you want… THE way to do it: Ask the opinion leaders What is used most on congresses? What would be a good translation of the effect for the clinicians?
7 Examples MMSE The Mini Mental State Examination IPSS International Prostate Symptom Score They have a horrible psychometric make up But they communicate your messages Clinicians ‘know’ the score by heart
8 A full, but simple recipe... Count the survival days SF-36 EuroQol EQ-5D To calculate QALYs A disease specific measure Ask the physician
9 Alternatives for SF-36 Other ‘hot’ generic list WHOQOL Domain specific offspring of the SF-36 EORTC C30 FACT Cancer, have additional disease specific modules Can be expected to be more sensitive than generic lists Reduces the need for specific measures
10 Alternatives for EQ-5D Must be able to generate QALYs Health Utility Index Own valuation of health states Increase of sensitivity Make sure that these are societal values… Otherwise no QALY from societal perspective Other instruments or adaptations EQ-5D+cog SF-6D (derived from SF-36) AQoL
11 A simple menu Count the survival days SF-36, WHOQOL or domain specific instruments like EORTC C30 EQ-5D, HUI, own validation EQ-5D+, SF-6D, AQoL A disease specific measure Ask the physician