Use of large-scale HRQoL datasets to generate individualised predictions and inform patients about the likely benefit of surgery.

Purpose: The English NHS has mandated the routine collection of health-related quality of life (HRQoL) data before and after surgery, giving prospective patient information about the likely benefit of surgery. Yet, the information is difficult to access and interpret because it is not presented in a...

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Publicado en:Quality of Life Research Vol. 26; no. 9; pp. 2497 - 2506
Autores principales: Gutacker, Nils, Street, Andrew
Formato: research Journal Article
Publicado: Springer Nature Sep2017
Acceso en línea:Ver este registro en EBSCOhost
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      place: New York, New York
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        atl: Use of large-scale HRQoL datasets to generate individualised predictions and inform patients about the likely benefit of surgery.
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          Gutacker, Nils
          Street, Andrew
        affil: Centre for Health Economics , University of York , Heslington YO10 5DD UK
      sug:
        subj:
          National Health Programs Standards
          Surgery, Operative Methods
          Quality of Life Psychosocial Factors
          Middle Age
          Aged
          Aged, 80 and Over
          Risk Factors
          Male
          Female
          Adolescence
          Adult
          Young Adult
          Human
          Funding Source
          Questionnaires
          Clinical Assessment Tools
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: Purpose: The English NHS has mandated the routine collection of health-related quality of life (HRQoL) data before and after surgery, giving prospective patient information about the likely benefit of surgery. Yet, the information is difficult to access and interpret because it is not presented in a lay-friendly format and does not reflect patients' individual circumstances. We set out a methodology to generate personalised information to help patients make informed decisions.Methods: We used anonymised, pre- and postoperative EuroQol-5D-3L (EQ-5D) data for over 490,000 English NHS patients who underwent primary hip or knee replacement surgery or groin hernia repair between April 2009 and March 2016. We estimated linear regression models to relate changes in EQ-5D utility scores to patients' own assessment of the success of surgery, and calculated from that minimally important differences for health improvements/deteriorations. Classification tree analysis was used to develop algorithms that sort patients into homogeneous groups that best predict postoperative EQ-5D utility scores.Results: Patients were classified into between 55 (hip replacement) to 60 (hernia repair) homogeneous groups. The classifications explained between 14 and 27% of variation in postoperative EQ-5D utility score.Conclusions: Patients are heterogeneous in their expected benefit from surgery, and decision aids should reflect this. Large administrative datasets on HRQoL can be used to generate the required individualised predictions to inform patients.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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