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QUALITY OF LIFE MEASURING INSTRUMENTS IN CHRONIC VENOUS DISEASE What’s the best option?

QUALITY OF LIFE MEASURING INSTRUMENTS IN CHRONIC VENOUS DISEASE What’s the best option?. Class 05 Introdução à Medicina II - 2010/2011. Chronic Venous Disease. Definition.

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QUALITY OF LIFE MEASURING INSTRUMENTS IN CHRONIC VENOUS DISEASE What’s the best option?

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  1. QUALITY OF LIFE MEASURING INSTRUMENTS IN CHRONIC VENOUS DISEASE What’s the best option? • Class 05 • Introdução à Medicina II - 2010/2011

  2. Chronic Venous Disease • Definition “Impaired venous blood flow or venous return (venous stasis), usually caused by inadequate venous valves. Venous insufficiency often occurs in the legs, and is associated with EDEMA and sometimes with VENOUS STASIS ULCERS at the ankle.” Source: http://www.ncbi.nlm.nih.gov/mesh

  3. Video ricardo

  4. CEAP Classification

  5. Clinical signs (CEAP) C0 No visible or touchable symptoms C1 Reticular veins C2 Varicose veins C6 Skin ulceration C5 Healed ulcers C3 Edema C4 Trophic skin alterations

  6. QualityofLife “It is a generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.” Source: http://www.ncbi.nlm.nih.gov/mesh?term=life%20quality

  7. QualityofLife Health-related quality of life (HRQOL) Mortality, Morbidity, or Cure Mortality, Morbidity, or Cure

  8. Health-Related Quality of Life … a multidimensional concept… Psychological Domain Social Domain Physical Domain

  9. Questions • Which are the most used instruments to measure QOL in CVD? • Which is the best instrument used to measure QOL in CVD?

  10. Aimsofthework

  11. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  12. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  13. Type of Study Type of study Synthesis study Systematic Review and Meta-Analysis Bibliographic Review

  14. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  15. Query Selection Pubmed’s Query: measuring[All Fields] AND("quality of life"[MeSH Terms] OR ("quality"[All Fields] AND "life"[All Fields]) OR "quality of life"[All Fields]) AND chronic[All Fields] AND ("veins"[MeSH Terms] OR "veins"[All Fields] OR "venous"[All Fields]) AND ("disease"[MeSH Terms] OR "disease"[All Fields]) AND insufficiency[All Fields]

  16. Query Selection measuring quality of life in chronic venous insufficiency measuring measurement evaluating evaluation

  17. Query Selection Isi, Cochrane and Scopus’ Query: Topic=((evaluating OR measuring OR assessing)) ANDTopic=(quality of life) ANDTopic=((chronic venous insufficiency OR chronic venous disease))

  18. Query Selection

  19. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  20. Searchin: PubMed, Google Scholar, Isi, Cochrane, Scopus Selection Criteria

  21. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  22. Articles Selection Stage 1: Search in Pubmed U GoogleScholar U Isi U Cochrane U Scopus 821 Selected Articles Stage 2: First Selection • Title • Abstract 82 Articles Stage 3: Second Selection • Full Text • Abstract (if Full Text was not available) 27 Articles

  23. Articles Selection 22 articles 19 articles ISI Web of Knowledge Cochrane Scoopus Google Schoolar Pubmed • 1article 0 articles 0 articles 0 articles 0 articles 10 articles 17 articles

  24. Articles Selection (stage 3) Reader nº. 3 if there is no consensus

  25. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  26. Data Extraction Extracted Data About the Study About the Measuring Instrument * * • Articles Identification • Authors/Country • Publication date • Study design • Impact Factor (of the journal) • Number of Quotes • Instrument used to measure QoL • Questionnaires Language * * * * * *

  27. Data Extraction Measuring instruments found in the selected article Impact Factor, used as a proxy for the relative importance of the article

  28. Data Extraction

  29. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  30. Data Management SPSS v.19 was used to… Data Storage Data Analysis

  31. Our database...

  32. Our database...

  33. Our database...

  34. Methodology • Type of study • Query selection • Selection criteria • Articles’ selection • Data extraction • Data management • Data analysis

  35. Data Analysis • Instruments with the highest frequecies will be described and analysed in terms of: • Reliability • Validation Specificity • Practicability

  36. Results • Graphic1– Frequency of use of QoL measurements

  37. Results Generic Specific p= 0,756 • Graphic2– Frequency of use of QoL measurements

  38. Results Generic Specific • Graphic 3– Impact factor by QoL measurement

  39. Results Generic Specific • Graphic 4– Mean of the number of quotes by measurement of QoL

  40. Results Spearman’s correlation coeficient= 0,667 • Graphic 5– Comparison between the mean of the impact factor and the mean of the number of quotes

  41. Results Generic Specific • Graphic 6– Number of years published of de QoL measurements

  42. Results • Graphic8– Percentage (%) of Questionnaires available in portuguese • Graphic 7– Percentage (%) of Validated Questionnaires

  43. Results • Table 1– Basic RequirementsofMeasuringInstruments

  44. Results • Table 2– Most frequentgeneric measuring instruments

  45. Results • Table 3– Most frequent specific measuring instruments

  46. Results SF-36 • Developed by Ware & Sherbourne 1992 • translated into various languages • all health conditions • physical functioning and social functioning • easy to administer (only requires 5-10 minutes)

  47. Results CIVIQ • - initially developed by Launois et al. • - 20-item questionnaire • - 4 different dimensions: physical, psichological, social e pain • sensitive to QoL dimensions, mainly the ones that are related to CVD.

  48. Conclusion • Our • Recommendation...

  49. References • Mirjam A. G. Sprangers, Carolyn E. Schwartz. Integrating response shift into health-related quality of life research: a theoretical model. Social Science & Medicine. Volume 48, Issue 11, June 1999. Pages 1507-1515 • R. D. Hays, R. Anderson and D. Revicki Psychometric considerations in evaluating health-related quality of life measures. Quality of Life Research. Volume 2, Number 6. Pages 441-449, DOI: 10.1007/BF00422218. • Susan R Kahn, Cyr E M'lan, Donna L Lamping, Xavier Kurz, AnickBérard, Lucien A Abenhaim. Relationship between clinical classification of chronic venous disease and patient-reported quality of life: results from an international cohort study. Journal of Vascular Surgery. VEINES Study Group. Volume 39, Issue 4, 2004 April . Pages 823-828, DOI: 10.1016/j.jvs.2003.12.007). • Donna L. Lamping.Donna L. Lamping. Measuring Health-Related Quality of Life in Venous Disease: Practical and Scientific Considerations. Angiology. January 1997 . Pages 48: 51-57. • Kahn SR, Milan CE, Lamping DL, Kurz X, Bérard A, Abenhaim . Relationship between clinical classification of chronic venous disease and patient-reported quality of life: results from an international cohort study. J Vasc Surg. LAVEINES Study Group. 2004. Pages 39:823–828. • Kahn SR, M’Lan CE, Lamping DL, Kurz X, Berard A, Abenhaim L. The influence of venous thromboembolism on quality of life and severity of chronic venous disease. J Thromb Haemost . 2004. Pages 2: 2146–51. • Callam, MJ. Epidemiology of varicose veins. Br J Surg. 1994. Pages 81-167. • http://www.ncbi.nlm.nih.gov/mesh

  50. References • Douglas, WS, Simpson, NB. Guidelines for the management of chronic venous leg ulceration. Report of a multidisciplinary workshop. British Association of Dermatologists and the Research Unit of the Royal College of Physicians. Br J Dermatol .1995. Pages 132-446. • Santos Raymundo, Porfírio Gustavo, Pitta Guilherme. Differencesinthequalityoflifeofpatientswithmildandseverechronicvenousdisease. J VascBras. 2009. Pages 8(2): 143-147. • G M Andreozzi, R Córdova, M A Scomparin, R Martini, A D’Eri, F Andreozzi. QualityofLifeinChronicVenousInsufficiency. IntAngiol. 2005. Pages 24: 272-7. • Nelson, EA, Bell-Syer, SE, Cullum, NA. Compression for preventing recurrence of venous ulcers. Cochrane Database Syst Rev . 2000. CD002303. • Mani, R, Vowden, K, Nelson, EA. Intermittent pneumatic compression for treating venous leg ulcers (Coochrane Review). Cochrane Database Syst Rev .2001. 4:CD001899. • Jeffrey L. Ballard and John J. Bergan. Chronic venous insufficiency: diagnosis and treatment. 2nd ed .Springer-Verlag London Limited. 2000. • Kathleenn. Lohr. Rating the strength of scientific evidence: relevance for quality improvementprograms. International Journal for Quality in Health Care .2004. Volume 16. Number 1. Pages 9–18. 10.1093/intqhc/mzh005 • C. Rutishauser; S.M. Sawyer; L. Bond; C. Coffey; G. Bowes. DevelopmentandvalidationoftheAdolescentAsthmaQualityofLifeQuestionnaire (AAQOL). ERS JournalsLtd. Availablefrom http://erj.ersjournals.com/content/17/1/52.full. • http://www.ncbi.nlm.nih.gov/mesh?term=life%20quality

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