tailieunhanh - báo cáo khoa học:" Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference units"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Improving the interpretation of quality of life evidence in meta-analyses: the application of minimal important difference units | Johnston et al. Health and Quality of Life Outcomes 2010 8 116 http content 8 1 116 HEALTH AND QUALITY of life outcomes RESEARCH Open Access Improving the interpretation of quality of life evidence in meta-analyses the application of minimal important difference units Bradley C Johnston1 Kristian Thorlund1 Holger J Schunemann1 2 Feng Xie1 3 Mohammad Hassan Murad4 Victor M Montori4 Gordon H Guyatt1 2 Abstract Systematic reviews of randomized trials that include measurements of health-related quality of life potentially provide critical information for patient and clinicians facing challenging health care decisions. When as is most often the case individual randomized trials use different measurement instruments for the same construct such as physical or emotional function authors typically report differences between intervention and control in standard deviation units so-called standardized mean difference or effect size . This approach has statistical limitations it is influenced by the heterogeneity of the population and is non-intuitive for decision makers. We suggest an alternative approach reporting results in minimal important difference units the smallest difference patients experience as important . This approach provides a potential solution to both the statistical and interpretational problems of existing methods. Introduction Health-related quality of life HRQL is increasingly recognized as an important outcome in randomized trials. Disease-specific HRQL instruments provide critical information because of their ability to detect small but important treatment effects 1 2 . Typically for specific conditions a number of disease-specific instruments are available. For example there are at least five instruments available to measure HRQL in patients with chronic obstructive respiratory disease COPD Chronic Respiratory Questionnaire Clinical COPD Questionnaire Pulmonary Functional Status Dyspnea Questionnaire Seattle Obstructive Lung Disease .