Health related quality of life

Esteban A, Anzueto A, Alia I, et al. How is mechanieal ventilation employed in the intensive care unit An inteinational utilization review. Am J Respir Crit Care Med 2000 161(5) 1450-1458. 

Carson SS, Cox CE, Holmes GM, et al. The changing epidemiology of meehanieal ventilation a population-based study. J Intensive Care Med 2006 21(3) 173-182. 

Needham DM, Bronskill SE, Sibbald WJ, et al. Mechanical ventilation in Ontario, 1992-2000 incidence, survival, and hospital bed utiUzation of noncaidiac surgery adult patients. Crit Care Med 2004 32(7) 1504-1509. 

Broehard L, Rauss A, Benito S, et al. Comparison of three methods of gradual withdrawal from ventilatory supptnt during weaning from meehanieal ventilation. Am J Respir Crit Care Med 1994 150(4) 896-903. 

Esteban A, Alia I, Gordo F, et al. Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation. The Spanish Lung Failure Collaborative Group. Am J Respir Crit Care Med 1997 156(2 pt 1) 459 5. 

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The most commonly used measure of utility in the health economics literature is the quality-adjusted life year (QALY), which weights longevity by life quality. The most commonly used preference-weighted measure of health-related quality of life in the UK is the EuroQol or EQ-5D (EuroQpl Group, 1990), but there are various other such measures. Utility scores can now be obtained from the 36-item Short Form (SF-36) quality-of-life scale, for example. Also in use are healthy-year equivalents (Mehrez and Gafni, 1989) and disability-adjusted life years (WHO, 2000), although both these measures are different in aim and construction from the QALY and are used less often in evaluations. 

The symptoms of bipolar disorder and the side effects associated with its treatment have implications for the patient s health-related quality of life. The disorder itself has an impact upon mental and emotional wellbeing. Bipolar disorder also affects areas of life such as employment, social partnerships and independence. The side effects of treatment may further impair the quality of life. 

A number of economic studies have been published that assess the economic impact of the introduction of anticholinesterase drugs on the care for people with dementia. Overall, they suggest that the introduction of the new drugs might be cost-neutral, while leading to modest improvements in the health-related quality of life of patients and carers. However, the reliability and robustness of the economic evidence need to be considered before concluding that any additional benefits of the new dmgs for dementia are indeed worth the cost. 

Economic studies should cover the full period over which the interventions could be expected to have an effect on resource use, survival and health-related quality of life. However, the economic evaluations of donepezil were based on effectiveness data from a limited number of trials, which were short in duration. This has a number of implications. First, the analysis can be limited to the effect of the drug during the period for which effectiveness data were available. In this case, it may be assumed that the treatment effect ceased after 6 months (Stewart et al, 1998). This assumption would only be valid if the donepezil were also discontinued at 6 months. If this is not the case, then the overall costs of the dmg may be underestimated and the benefits overestimated. 

One study used quality-adjusted life years to capture the range of health-related dimensions that may affect the quality of life of patients. This measure also provides an estimate of the value or preferences for changes in health status (Neumann et al, 1999). The study used the Health Utility Index Mark II in a sample of patients and carers, which is a generic measure of the value of health-related quality of life. However, it is clear that further research is needed to explore (a) the key determinants or dimensions of quality of life that are important to people with dementia and their carers (b) whether existing instmments to measure and value health-related quality of life are able to detect differences in quality of life that are important to people with cognitive disability and their carers and (c) whether the assessment and... 

Bullectomy, lung volume reduction surgery, and lung transplantation are surgical options for very severe COPD. These procedures may result in improved spirometry, lung volumes, exercise capacity, dyspnea, health-related quality of life, and possibly survival. Patient selection is critical because not all patients benefit. Refer to the ATS/ERS COPD standards for a detailed discussion of appropriate selection of surgical candidates.1... 

Changes in FEVj should not be the main outcome assessed. FEVi changes are weakly related to symptoms, exacerbations, and health-related quality of life (outcomes that are important to patients). 

Wood RH, Reyes-Alvarez R, Maral B, Metoyer KL and Welsch MA (1999). Physical fitness, cognitive function, and health-related quality of life in older adults. Journal of Aging and Physical Activity, 1, 217-230. 

Osteoporosis is currently defined as a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. Bone strength reflects the integration of two main features bone density and bone quality (NIH Consensus 2001). Thus, osteoporosis is a debilitating condition of the skeleton that propends to fractures and is associated with advanced age. The disease has a high prevalence in western countries, as it is a condition associated with advanced age, and it is on the rise since fife expectancy has risen dramatically in the last several decades. It is, therefore, a major public health problem because it not only induces morbidity (fractures and chronic sequelae) with a substantial impact on health-related quality of life, but is also associated with increased mortality (Badia et al. 2001, 2004). 

Badia X, Diez-Perez A, Lahoz R, Lizan L, Nogues X, Iborra J (2004) The ECOS-16 questionnaire for the evaluation of health related quality of life in post-menopausal women with osteoporosis. Health Qual Life Outcomes 2(1) 41... 

Changes in health-related quality of life Social and emotional well-being Life Satisfaction... 

Biological DMARDs are indicated when autoimmune inflammatory diseases are refractory to therapy with single traditional DMARDs or with combinations of oral or IV traditional DMARDs. Improvements of ACR 20 and ASAS 20 in over 70% of patients with refractory RA and AS do not mean much to the patients in terms of pain relief, improvement of function and health-related quality of life. The present biological DMARDs combined with MTX still cannot fully address the problems of the majority of patients with DMARDs refractory chronic progressive autoimmune inflammatory diseases. Those who are refractory to MTX - - biological DMARDs respond well to SBC-5-IMNs in over 80% of cases. 

EuroQol Group EuroQol - a new facility for the measurement of health-related quality of life. Healthy Policy 16(3), 199-208, 1990. 

Rondanelli, M., Giacosa, A., Opizzi, A., Pelucchi, C., La Vecchia, C., Montorfano, G., Negroni, M., Berra, B., Politi, P., and Rizzo, A. (2011). Long chain omega 3 polyunsaturated fatty acids supplementation in the treatment of elderly depression Effects on depressive symptoms, on phospholipids fatty acids profile and on health-related quality of life. J. Nutr. Health Aging 15, 37-44. 

In 192 adult offspring (mean age 31 years) of mothers who had taken part in a randomized controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (87 exposed to betamethasone two doses 24 hours apart, and 105 exposed to placebo) there were no alterations in cognitive functioning, working memory and attention, psychiatric morbidity, handedness, or health-related quality-of-life in adulthood (400). 

Dalziel SR, Lim VK, Lambert A, McCarthy D, Parag V, Rodgers A, Harding JE. Antenatal exposure to betamethasone psychological functioning and health related quality of life 31 years after inclusion in randomised controlled trial. BMJ 2005 331(7518) 665. 

Byrnes CA, Morton AS, Liss CL, Lippert MC, Gillenwater JY. Efficacy, tolerability, and effect on health-related quality of life of finasteride versus placebo in men with symptomatic benign prostatic hyperplasia a community based study. CUSP Investigators. Community based study of Proscar. Clin Ther 1995 17 956-69. 

Yuen K, Goldstein M, Pelayo R, Guilleminault C. Prospective study of health-related quality of life in obstructive sleep apnea before and after treatment. Sleep 2001 24(suppl) A284-285. 

Hays J, Ockene JK, Brunner RL, Kotchen JM, Manson JE, Patterson RE, Aragaki AK, Shumaker SA, Brzyski RG, LaCroix AZ et al (2003) Effects of estrogen plus progestin on health-related quality of life. NEJM 348 1839-1854... 

Cynthia s objectives are to reduce hospitalizations and emergency department visits by increasing compliance with heart failure medications and educating patients about their disease state and how to make diet and behavioral modifications, as well as improve patients health-related quality of life and satisfaction with care. 

Cynthia feels that health-related quality of life and patient satisfaction are important aspects of her clinic. She thinks that these outcomes can serve to complement the economic and clinical outcomes that she is reporting to the HMO and can further prove her case that the clinic is a valuable service to the heart failure patients. 

Regensteiner JG, WareJrJE, McCarthy WJ, etal. Effect of cilostazol on treadmill walking, community-based walking ability, and health-related quality of life in patients with intermittent claudication due to peripheral arterial disease meta-analysis of six randomized controlled trials. J Am Geriatr Soc 2002 50 1939-1946. 

More recently, there has a growing interest in the development of questionnaires to measure the impact of food allergy on health-related quality of life (De Blok et ah, 2007). Health related quality of life (HRQL) is a multidimensional construct, consisting of physical, psychological, and social components (Eiser and Morse, 2001). 

A developmental framework has the potential to link formerly disparate concepts such as health-related quality of life, the maturation of the immune system, and delineate mechanisms linking psychological stress, personality and emotion to neuroimmunoregulation as well as to increased risk of negative impact. Such a model may be used to explain both physiological and psychological phenomena, and their interaction,... 

Marklund, B., Ahlstead, B., and Nordstrom, G. (2004). Health-related quality of life among adolescents with allergy-like conditions—with emphasis on food hypersensitivity. Health Qual. Life Outcomes 2, 65-69. 

Although mania has been associated with olanzapine (SEDA-24, 68 SEDA-25, 68 SEDA-26, 62), it has also been used in the treatment of acute mania. In a 12-week, double-blind, double-dummy, randomized trial, 120 patients with bipolar disorder type I hospitalized for an acute manic episode were randomly assigned to either sodium valproate (n = 63) or olanzapine (n = 57) and were followed in hospital for up to 21 days (60). Valproate and olanzapine had similar short-term effects on clinical or health-related quality of life outcomes in bipolar disorder adverse effects that occurred in a higher percentage of olanzapine-treated than valproate-treated patients included somnolence (47% versus 29%), weight gain (25% versus 10%), rhinitis (14% versus 3%), edema (14% versus 0%), and slurred speech (7% versus 0%) no adverse events occurred significantly more often with valproate. 

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