Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items

The use of global health items permits an efficient way of gathering general perceptions of health. These items provide useful summary information about health and are predictive of health care utilization and subsequent mortality. Analyses of 10 self-reported global health items obtained from an internet survey as part of the Patient-Reported Outcome Measurement Information System (PROMIS) project. We derived summary scores from the global health items. We estimated the associations of the summary scores with the EQ-5D index score and the PROMIS physical function, pain, fatigue, emotional distress, and social health domain scores. Exploratory and confirmatory factor analyses supported a two-factor model. Global physical health (GPH; 4 items on overall physical health, physical function, pain, and fatigue) and global mental health (GMH; 4 items on quality of life, mental health, satisfaction with social activities, and emotional problems) scales were created. The scales had internal consistency reliability coefficients of 0.81 and 0.86, respectively. GPH correlated more strongly with the EQ-5D than did GMH (r = 0.76 vs. 0.59). GPH correlated most strongly with pain impact (r = −0.75) whereas GMH correlated most strongly with depressive symptoms (r = −0.71). Two dimensions representing physical and mental health underlie the global health items in PROMIS. These global health scales can be used to efficiently summarize physical and mental health in patient-reported outcome studies

Minimal important differences for interpreting health-related quality of life scores from the EORTC QLQ-C30 in lung cancer patients participating in randomized controlled trials

The aim of this study was to determine the smallest changes in health-related quality of life (HRQOL) scores in a subset of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) scales, which could be considered as clinically meaningful in patients with non-small-cell lung cancer (NSCLC). WHO performance status (PS) and weight change were used as clinical anchors to determine minimal important differences (MIDs) in HRQOL change scores (range, 0-100) in the EORTC QLQ-C30 scales. Selected distribution-based methods were used for comparison. In a pooled dataset of 812 NSCLC patients undergoing treatment, the values determined to represent the MID depended on whether patients were improving or deteriorating. MID estimates for improvement (based on a one-category change in PS, 5 -aEuro parts per thousand < 20% weight gain) were physical functioning (9, 5); role functioning (14, 7); social functioning (5, 7); global health status (9, 4); fatigue (14, 5); and pain (16, 2). The respective MID estimates for deterioration (based on PS, weight loss) were physical (4, 6); role (5, 5); social (7, 9); global health status (4, 4); fatigue (6, 11); and pain (3, 7). Based on the selected QLQ-C30 scales, the MID may depend upon whether the patients' PS is improving or worsening, but our results are not definitive. The MID estimates for the specified scales can help clinicians and researchers evaluate the significance of changes in HRQOL and assess the value of a health care intervention or compare treatments. The estimates also can be useful in determining sample sizes in the design of future clinical trials

Attention and vigilance : a large scale workplace study

Many previous studies have examined the effect of working environment on job performance. However, these are usually site-specific experiments examining office workers, concentrating on self-report measures and peer assessments. An area of particular interest is whether computerised tests could be used to identify deficits in performance and associate these with specific environmental problems. We recruited over four hundred participants from several companies in Singapore, spanning a range of job types requiring different levels of visual attention, broadly grouped as technical workshop staff, office staff, and operational control room workers. Where possible, job types were matched across companies. Participants were given a series of psychological, environmental, and health-related questionnaires and computerised tests examining various aspects of visual attention (psychomotor vigilance task, go-nogo task and global-local change detection) as analogues of work performance. Mixed effect models were used to examine the workers’ performance, taking into account work-related, environmental, and health related factors. Results indicate variability across companies and job types, effects of shift work, and some effects of environment on vigilant and selective attention

Health-related quality of life in the elderly three years after percutaneous coronary intervention

Aims: Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (=70 years) with younger patients (0.05). By 36 months, the HRQOL for the older patients worsened in five of the eight subdomains (all p-values>0.05). Younger patients did not experience enduring changes in HRQOL, with the exception of role physical functioning. Predictors of impaired HRQOL were generally different for the elderly (diabetes, previous PCI) compared to younger cohorts (smoking, previous bypass surgery, ACE inhibitors), although poor six-month HRQOL, anxiety and depression were common predictors for both groups. Conclusions: Elderly PCI patients experience a deteriorating and poorer HRQOL than younger patients across three years. Contrary to younger patients, three-year HRQOL of elderly patients is irrespective of adverse events during outcomes