77 research outputs found
On-sky tests of the CuReD and HWR fast wavefront reconstruction algorithms with CANARY
CuReD (Cumulative Reconstructor with domain Decomposition) and HWR (Hierarchical Wavefront Reconstructor) are novel wavefront reconstruction algorithms for the ShackβHartmann wavefront sensor, used in the single-conjugate adaptive optics. For a high-order system they are much faster than the traditional matrixβvector-multiplication method. We have developed three methods for mapping the reconstructed phase into the deformable mirror actuator commands and have tested both reconstructors with the CANARY instrument. We find out that the CuReD reconstructor runs stably only if the feedback loop is operated as a leaky integrator, whereas HWR runs stably with the conventional integrator control. Using the CANARY telescope simulator we find that the Strehl ratio (SR) obtained with CuReD is slightly higher than that of the traditional least-squares estimator (LSE). We demonstrate that this is because the CuReD algorithm has a smoothing effect on the output wavefront. The SR of HWR is slightly lower than that of LSE. We have tested both reconstructors extensively on-sky. They perform well and CuReD achieves a similar SR as LSE. We compare the CANARY results with those from a computer simulation and find good agreement between the two
Cross-sectional and longitudinal associations between psychotic and depressive symptoms in depressed adolescents
Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depressed adolescents aged 11β17 with and without psychotic symptoms were compared on depression severity scores at baseline and at 28- or 42-week follow-up in two large UK cohorts. Psychotic symptoms were weakly associated with more severe depression at baseline in both cohorts. At follow-up, baseline psychotic symptoms were only associated with depressive symptoms in one sample; in the other, the effect size was close to zero. This supports the DSM5 system of psychotic symptoms being a separate code to severity rather than the ICD10 system which only allows the diagnosis of psychotic depression with severe depression. There was no clear support for psychotic symptoms being a baseline marker of treatment response
ΠΡΠ΅Π½ΠΊΠ° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΎΡΠ³Π°Π½ΠΎΠ² Π³ΡΡΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅ΡΠΊΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ Π±ΠΈΠΎΠΏΡΠΈΠΈ ΠΏΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ΠΌ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ
Computed tomography (CT) guided percutaneous procedures like the fine needle aspiration cytology (FNAC) and fine needle aspiration biopsy (FNAB) are reliable techniques for diagnosing various thoracic diseases. These modalities are used for diagnosis in suspicious lung, pleural, mediastinal and vertebral and pulmonary lesions.The aim. We conducted a study in a Pulmonary Medicine Department of tertiary care hospital to study the efficacy and safety of CT guided FNCA/FNAB in thoracic diseases.Methods. A retrospective study was conducted at a tertiary care center with Information and Ethics committee permission within a total duration of two years. The study included patients presenting with following: 1) mediastinal mass lesions, 2) pulmonary solitary pulmonary nodules/masses, 3) pulmonary cavity, cyst and consolidation of undiagnosed etiology, 4) pleural mass, nodules, loculated collections, 5) extra-pulmonary and spinal tuberculosis suspects with pre/paravertebral abscess. Procedure details, radiological images and pathological and microbiological reports were retrieved from case record book of patients available in department.Results. Study population consisted of 108 patients. Neoplastic diseases were 85 (78.70%) and Non- neoplastic diseases 23 (21.29%). In neoplastic diseases 78.82% patients had lung Cancer of which 85.07% non small cell carcinoma and 14.92% small cell lung cancer. Out of non small cell lung cancer adenocarcinoma of lung was the commonest. The most common non neoplastic diseases was tuberculosis. CT guided biopsy procedure was performed without any complications in 61.11%. The most common complication was pneumothorax (27.77%). The yield of CT guided biopsy was 98.14%.Conclusion. Percutaneous CT-guided lung biopsy is an effective, highly accurate, and safe method of obtaining tissue for the diagnosis of indeterminate pulmonary lesions especially in neoplastic diseases and tuberculosis.Π§ΡΠ΅ΡΠΊΠΎΠΆΠ½ΡΠ΅ ΠΏΡΠΎΡΠ΅Π΄ΡΡΡ ΠΏΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ΠΌ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ’), ΡΠ°ΠΊΠΈΠ΅ ΠΊΠ°ΠΊ ΡΠΎΠ½ΠΊΠΎΠΈΠ³ΠΎΠ»ΡΠ½Π°Ρ Π°ΡΠΏΠΈΡΠ°ΡΠΈΠΎΠ½Π½Π°Ρ ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡ (fine needle aspiration cytology β FNAC) ΠΈ ΡΠΎΠ½ΠΊΠΎΠΈΠ³ΠΎΠ»ΡΠ½Π°Ρ Π°ΡΠΏΠΈΡΠ°ΡΠΈΠΎΠ½Π½Π°Ρ Π±ΠΈΠΎΠΏΡΠΈΡ (fine needle aspiration biopsy β FNAB), ΡΠ²Π»ΡΡΡΡΡ Π½Π°Π΄Π΅ΠΆΠ½ΡΠΌΠΈ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΎΡΠ³Π°Π½ΠΎΠ² Π³ΡΡΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅ΡΠΊΠΈ. ΠΡΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡΡΡΡ Π΄Π»Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠΉ Π»Π΅Π³ΠΊΠΈΡ
, ΠΏΠ»Π΅Π²ΡΡ, ΡΡΠ΅Π΄ΠΎΡΡΠ΅Π½ΠΈΡ, ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° ΠΈ Π»Π΅Π³ΠΊΠΈΡ
.Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ³ΠΎ Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΏΡΠ»ΡΠΌΠΎΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΠΈΡΡ ΡΡΠ΅ΡΠΈΡΠ½ΠΎΠ³ΠΎ ΡΡΠΎΠ²Π½Ρ, ΡΠ²ΠΈΠ»ΠΎΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ FNCA / FNAB ΠΏΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ΠΌ ΠΠ’ ΠΏΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΡ
ΠΎΡΠ³Π°Π½ΠΎΠ² Π³ΡΡΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅ΡΠΊΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 2 Π»Π΅Ρ Π² ΡΠ΅Π½ΡΡΠ΅ ΡΡΠ΅ΡΠΈΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Ρ ΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΠΎΠΌΠΈΡΠ΅ΡΠ° ΠΏΠΎ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ ΡΡΠΈΠΊΠ΅. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ ΡΠ»Π΅Π΄ΡΡΡΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ: 1) Ρ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ ΡΡΠ΅Π΄ΠΎΡΡΠ΅Π½ΠΈΡ; 2) Ρ Π»Π΅Π³ΠΎΡΠ½ΡΠΌΠΈ ΡΠΎΠ»ΠΈΡΠ°ΡΠ½ΡΠΌΠΈ ΡΠ·Π»Π°ΠΌΠΈ / Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ; 3) Ρ ΠΏΠΎΠ»ΠΎΡΡΡΠΌΠΈ, ΠΊΠΈΡΡΠ°ΠΌΠΈ ΠΈ ΠΊΠΎΠ½ΡΠΎΠ»ΠΈΠ΄Π°ΡΠΈΠ΅ΠΉ Π² Π»Π΅Π³ΠΊΠΈΡ
Π½Π΅Π²ΡΡΡΠ½Π΅Π½Π½ΠΎΠΉ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ; 4) Ρ ΠΏΠ»Π΅Π²ΡΠ°Π»ΡΠ½ΡΠΌΠΈ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ, ΡΠ·Π΅Π»ΠΊΠ°ΠΌΠΈ, ΠΎΡΡΠΌΠΊΠΎΠ²Π°Π½Π½ΡΠΌΠΈ ΡΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡΠΌΠΈ; 5) Ρ ΠΏΠ»Π΅Π²ΡΠ°Π»ΡΠ½ΡΠΌΠΈ ΠΌΠ°ΡΡΠ°ΠΌΠΈ, ΡΠ·Π΅Π»ΠΊΠ°ΠΌΠΈ, ΠΎΡΡΠΌΠΊΠΎΠ²Π°Π½Π½ΡΠΌΠΈ ΡΠΊΠΎΠΏΠ»Π΅Π½ΠΈΡΠΌΠΈ, ΠΏΠΎΠ΄ΠΎΠ·ΡΠ΅Π½ΠΈΠ΅ΠΌ Π½Π° Π²Π½Π΅Π»Π΅Π³ΠΎΡΠ½ΡΠΉ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π· ΠΈ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π· ΠΏΠΎΠ·Π²ΠΎΠ½ΠΎΡΠ½ΠΈΠΊΠ° Ρ ΠΏΡΠ΅-, ΠΏΠ°ΡΠ°Π²Π΅ΡΡΠ΅Π±ΡΠ°Π»ΡΠ½ΡΠΌ Π°Π±ΡΡΠ΅ΡΡΠΎΠΌ. ΠΠ°Π½Π½ΡΠ΅ ΠΎ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠΉ ΠΏΡΠΎΡΠ΅Π΄ΡΡΠ΅, ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ²ΡΠΊΠΈΠ΅ ΡΠ½ΠΈΠΌΠΊΠΈ, ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΡΠ΅ΡΡ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ ΠΈΠ· ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΠΈΠΌΠ΅ΡΡΠΈΡ
ΡΡ Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠ±ΠΎΡΠΊΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 108 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π²ΡΡΠ²Π»Π΅Π½Ρ Ρ 85 (78,70 %), Π½Π΅ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠ΅ β Ρ 23 (21,29 %) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². Π£ 78,82 % ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ Π²ΡΡΠ²Π»Π΅Π½ ΡΠ°ΠΊ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ, Ρ 85,07 % ΠΈΠ· Π½ΠΈΡ
β Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΉ, Ρ 14,92 % β ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΉ ΡΠ°ΠΊ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ. Π£ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ Π²ΡΡΡΠ΅ΡΠ°Π»Π°ΡΡ Π°Π΄Π΅Π½ΠΎΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌ Π½Π΅ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ΠΌ ΡΠ²Π»ΡΠ»ΡΡ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·. ΠΠΈΠΎΠΏΡΠΈΡ ΠΏΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ΠΌ ΠΠ’ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° Π±Π΅Π· ΠΊΠ°ΠΊΠΈΡ
-Π»ΠΈΠ±ΠΎ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π² 61,11 % ΡΠ»ΡΡΠ°Π΅Π². ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΡΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠ΅ΠΌ (27,77 %) Π±ΡΠ» ΠΏΠ½Π΅Π²ΠΌΠΎΡΠΎΡΠ°ΠΊΡ. ΠΠΈΠΎΠΏΡΠΈΡ ΠΏΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ΠΌ ΠΠ’ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»Π° ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΠ· Π² 98,14 % ΡΠ»ΡΡΠ°Π΅Π².ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π§ΡΠ΅ΡΠΊΠΎΠΆΠ½Π°Ρ Π±ΠΈΠΎΠΏΡΠΈΡ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ΄ ΠΊΠΎΠ½ΡΡΠΎΠ»Π΅ΠΌ ΠΠ’ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ, Π²ΡΡΠΎΠΊΠΎΡΠΎΡΠ½ΡΠΌ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΈΡ ΡΠΊΠ°Π½ΠΈ Π΄Π»Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π½Π΅ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΡΡ
ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠΉ Π»Π΅Π³ΠΊΠΈΡ
, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎ ΠΏΡΠΈ ΠΎΠΏΡΡ
ΠΎΠ»Π΅Π²ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΡ
ΠΈ ΡΡΠ±Π΅ΡΠΊΡΠ»Π΅Π·Π΅
Recommended from our members
First stellar photons for an integrated optics discrete beam combiner at the William Herschel Telescope
We present the first on-sky results of a four-telescope integrated optics discrete beam combiner (DBC) tested at the 4.2mWilliamHerschel Telescope. The device consists of a four-input pupil remapper followed by a DBC and a 23-output reformatter. The whole device was written monolithically in a single alumino-borosilicate substrate using ultrafast laser inscription. The device was operated at astronomical H-band (1.6 ΞΌm), and a deformable mirror along with a microlens array was used to inject stellar photons into the device. We report the measured visibility amplitudes and closure phases obtained on Vega and Altair that are retrieved using the calibrated transfer matrix of the device. While the coherence function can be reconstructed, the on-sky results show significant dispersion from the expected values. Based on the analysis of comparable simulations, we find that such dispersion is largely caused by the limited signal-to-noise ratio of our observations. This constitutes a first step toward an improved validation of theDBCas a possible beam combination scheme for long-baseline interferometry. Β© 2021 Optical Society of America
The PANGAEA study design β a prospective, multicenter, non-interventional, long-term study on fingolimod for the treatment of multiple sclerosis in daily practice
Health status of the advanced elderly in six european countries: results from a representative survey using EQ-5D and SF-12
<p>Abstract</p> <p>Background</p> <p>Due to demographic change, the advanced elderly represent the fastest growing population group in Europe. Health problems tend to be frequent and increasing with age within this cohort.</p> <p>Aims of the study</p> <p>To describe and compare health status of the elderly population in six European countries and to analyze the impact of socio-demographic variables on health.</p> <p>Methods</p> <p>In the European Study of the Epidemiology of Mental Disorders (ESEMeD), representative non-institutionalized population samples completed the EQ-5D and Short Form-12 (SF-12) questionnaires as part of personal computer-based home interviews in 2001-2003. This study is based on a subsample of 1659 respondents aged β₯ 75 years from Belgium (n = 194), France (n = 168), Germany (n = 244), Italy (n = 317), the Netherlands (n = 164) and Spain (n = 572). Descriptive statistics, bivariate- (chi-square tests) and multivariate methods (linear regressions) were used to examine differences in population health.</p> <p>Results</p> <p>68.8% of respondents reported problems in one or more EQ-5D dimensions, most frequently pain/discomfort (55.2%), followed by mobility (50.0%), usual activities (36.6%), self-care (18.1%) and anxiety/depression (11.6%). The proportion of respondents reporting any problems increased significantly with age in bivariate analyses (age 75-79: 65.4%; age 80-84: 69.2%; age β₯ 85: 81.1%) and differed between countries, ranging from 58.7% in the Netherlands to 72.3% in Italy. The mean EQ VAS score was 61.9, decreasing with age (age 75-79: 64.1; age 80-84: 59.8; age β₯ 85: 56.7) and ranging from 60.0 in Italy to 72.9 in the Netherlands. SF-12 derived Physical Component Summary (PCS) and Mental Component Summary (MCS) scores varied little by age and country. Age and low educational level were associated with lower EQ VAS and PCS scores. After controlling for socio-demographic variables and reported EQ-5D health states, mean EQ VAS scores were significantly higher in the Netherlands and Belgium, and lower in Germany than the grand mean.</p> <p>Conclusions</p> <p>More than two thirds of the advanced elderly report impairment of health status. Impairment increases rapidly with age but differs considerably between countries. In all countries, health status is significantly associated with socio-demographic variables.</p
Whereβs WALY? : A proof of concept study of the βwellbeing adjusted life yearβ using secondary analysis of cross-sectional survey data
Background
The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE (https://www.nice.org.uk/process/pmg9/). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L.
Methods
Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearsonβs and Spearmanβs correlations, linear regression, and receiver operating characteristic curves.
Results
Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R2 being 0.104 for the index and 0.141 for the visual analogue scale).
Conclusion
The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure β a Wellbeing Adjusted Life Year β is needed
Measurement properties of the EQ-5D across four major geriatric conditions: Findings from TOPICS-MDS
Developing the Chinese version of the new 5-level EQ-5D descriptive system: the response scaling approach
- β¦