tailieunhanh - báo cáo khoa học:" Minimal important differences and response shift in health-related quality of life; a longitudinal study in patients with multiple myeloma"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Minimal important differences and response shift in health-related quality of life; a longitudinal study in patients with multiple myeloma | Kvam et al. Health and Quality of Life Outcomes 2010 8 79 http content 8 1 79 HEALTH AND QUALITY OF LIFE OUTCOMES RESEARCH Open Access Minimal important differences and response shift in health-related quality of life a longitudinal study in patients with multiple myeloma Ann K Kvam1 2 Finn Wisloff1 2 Peter M Fayers3 4 Abstract Background We previously reported that changes of 6-17 percent in the EORTC QLQ-C30 scores are regarded important by patients with multiple myeloma and thus may be considered as Minimal Important Differences MIDs . However patients internal standard of measurement may have changed over time response shift RS . In the present work we evaluated whether myeloma patients experience RS and if this could affect the MIDestimates. Methods Between 2006 and 2008 239 patients with multiple myeloma completed the EORTC QLQ-C30 at baseline T1 and after three months T2 . At T2 patients were asked if they had noticed any change in the domains pain fatigue physical function and global quality of life. They were also asked to give a retrospective judgment of their baseline values on all the four domains. Results We found clear evidence of RS in myeloma patients. However there were differences in both magnitude and direction between patients who stated that they improved and those who deteriorated. Deteriorating patients retrospectively reported better health-related quality of life at T1 for the domains pain fatigue and physical function. In these patients MIDs adjusted for RS were observed to increase up to 12 percentage points. In contrast for patients stating that they improved we only found evidence of statistically significant RS in the domain global quality of life. Conclusions MIDs estimated from pre-test post-test data appeared to be robust against RS in patients reporting improvement over 3-months. This could indicate that RS has a minimal impact on the results in patients who respond to treatment and that RS may not have an important .