Challenges in Using Recommended Quality of Life Measures to Assess Fluctuating Health:A Think-Aloud Study to Understand How Recall and Timing of Assessment Influence Patient Responses

BACKGROUND: It can be challenging to measure quality of life to calculate quality-adjusted life-years in recurrent fluctuating health states, as quality of life can constantly change. It is not clear how patients who experience fluctuations complete measures and how assessment timing and recall influence responses. OBJECTIVE: We aimed to understand how patients with fluctuating health complete widely recommended and commonly used measures (EQ-5D-5L, EORTC QLQ-C30 and SF-12) and the extent to which the recall period (‘health today’, ‘past week’ and ‘past 4 weeks’) and timing of assessment influence the way that patients complete these questionnaires. METHODS: Twenty-four adult patients undergoing chemotherapy for urological, gynaecological or bowel cancers in the UK participated in think-aloud interviews, while completing the measures, completed a pictorial task illustrating how quality of life changed during the chemotherapy cycle and took part in semi-structured interviews. Transcripts were analysed using constant comparison. RESULTS: Patients were consistent in describing their quality of life as changing considerably throughout a chemotherapy cycle. The shorter recall period of ‘health today’ does not adequately represent patients’ quality of life because of fluctuations, patients remarked they could give a different answer depending on the timing of assessment, and many struggled to combine the “ups and downs” to answer measures with longer recall (‘past week’ and ‘past 4 weeks’). Across all measures, patients attempted to provide averages, adopt the peak-end rule or focus on the best part of their experience. Patients commonly used more than one approach when completing a given questionnaire as well as across questionnaires. CONCLUSIONS: Patients who experience recurrent fluctuations in health are unable to provide meaningful responses about their quality of life when completing quality-of-life measures due to the recall period and timing of assessment. The use of such responses to calculate health state values in economic evaluations to inform resource allocation decisions in fluctuating conditions must be questioned. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40271-021-00555-7

Scoring the ICECAP - a capability instrument : estimation of a UK general population tariff

This paper reports the results of a best–worst scaling (BWS) study to value the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A), a new capability measure among adults, in a UK setting. A main effects plan plus its foldover was used to estimate weights for each of the four levels of all five attributes. The BWS study was administered to 413 randomly sampled individuals, together with sociodemographic and other questions. Scale-adjusted latent class analyses identified two preference and two (variance) scale classes. Ability to characterize preference and scale heterogeneity was limited, but data quality was good, and the final model exhibited a high pseudo-r-squared. After adjusting for heterogeneity, a population tariff was estimated. This showed that ‘attachment’ and ‘stability’ each account for around 22% of the space, and ‘autonomy’, ‘achievement’ and ‘enjoyment’ account for around 18% each. Across all attributes, greater value was placed on the difference between the lowest levels of capability than between the highest. This tariff will enable ICECAP-A to be used in economic evaluation both within the field of health and across public policy generally. © 2013 The Authors. Health Economics published by John Wiley & Sons Ltd

Scoring the ICECAP-A capability instrument. Estimation of a UK general population tariff

This paper reports the results of a best–worst scaling (BWS) study to value the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A), a new capability measure among adults, in a UK setting. A main effects plan plus its foldover was used to estimate weights for each of the four levels of all five attributes. The BWS study was administered to 413 randomly sampled individuals, together with sociodemographic and other questions. Scale-adjusted latent class analyses identified two preference and two (variance) scale classes. Ability to characterize preference and scale heterogene-ity was limited, but data quality was good, and the final model exhibited a high pseudo-r-squared. After adjusting for heterogeneity, a population tariff was estimated. This showed that ‘attachment ’ and ‘stability ’ each account for around 22 % of the space, and ‘autonomy’, ‘achievement ’ and ‘enjoyment ’ account for around 18 % each. Across all attributes, greater value was placed on the difference between the lowest levels of capability than between the highest. This tariff will enable ICECAP-A to be used in economic evaluation both within the field of health and across public policy generally. © 2013 The Authors. Health Economics published by John Wiley & Sons Ltd

Value priorities in hearing-impaired adolescents

Hearing impairment is regarded to be a barrier to the psychological development and language skills of deaf students. In understanding and establishing what comprises the value priorities amongst adolescents, certain deviations can be expected amongst teenagers who are deaf or who have hearing impairment. The article describes and compares the value priorities of 246 adolescents who are deaf or with hearing impairment from Poland and the Czech Republic with hearing peers. The Schwartz Portrait Values Questionnaire is used to measure the value priorities of the respective groups of participants. In comparison to peers responses the results indicate that hearing status impacts upon an individuals’ values of conformity, tradition as well as achievement, however, other value priorities are shown to be infl uenced by gender and country of domicile

Emerging reporting and verification needs under the Paris Agreement : how can the research community effectively contribute?

Acknowledgments This work was supported by the European Union’s Horizon 2020 research and innovation programme project VERIFY [grant agreement No 776810]. A special thanks must be given to Sebastian Wunderlich (UBA, Germany), for his support on data interpretation. We also thank Paul Ruyssenaars (RVIM, Netherlands), Marina Vitullo (ISPRA, Italy), Colas Robert and Céline Gueguen (CITEPA, France), Maria Purzner (EAA, Austria), Rasmus Astrup (NIBIO, Norway), Ann Marie Ryan (EMPA, Ireland) and Margreet Van Zanten for their support in the terminology analysis and fruitful exchange during the course of the VERIFY project.Peer reviewedPublisher PD

How to Maximize the Usefulness of Behaviour Change Conversations with Patients during Routine Dental Consultations

Clinicians can use behaviour change techniques effectively in routine consultations in healthcare settings, including dentistry. Professional guidelines support their use for preventing and managing a range of dental diseases. Theory and evidence from behavioural science can inform effective behaviour change interventions. This article examines the relevance of these techniques to the whole dental team and how they can be implemented within routine dental consultations

Phaeoviral infections are present in macrocystis, ecklonia and undaria (laminariales) and are influenced by wave exposure in ectocarpales

Two sister orders of the brown macroalgae (class Phaeophyceae), the morphologically complex Laminariales (commonly referred to as kelp) and the morphologically simple Ectocarpales are natural hosts for the dsDNA phaeoviruses (family ) that persist as proviruses in the genomes of their hosts. We have previously shown that the major capsid protein (MCP) and DNA polymerase concatenated gene phylogeny splits phaeoviruses into two subgroups, A and B (both infecting Ectocarpales), while MCP-based phylogeny suggests that the kelp phaeoviruses form a distinct third subgroup C. Here we used MCP to better understand the host range of phaeoviruses by screening a further 96 and 909 samples representing 11 and 3 species of kelp and Ectocarpales, respectively. Sporophyte kelp samples were collected from their various natural coastal habitats spanning five continents: Africa, Asia, Australia, Europe, and South America. Our phylogenetic analyses showed that while most of the kelp phaeoviruses, including one from , belonged to the previously designated subgroup C, new lineages of in 3 kelp species, , , , grouped instead with subgroup A. In addition, we observed a prevalence of 26% and 63% in kelp and Ectocarpales, respectively. Although not common, multiple phaeoviral infections per individual were observed, with the Ectocarpales having both intra- and inter-subgroup phaeoviral infections. Only intra-subgroup phaeoviral infections were observed in kelp. Furthermore, prevalence of phaeoviral infections within the Ectocarpales is also linked to their exposure to waves. We conclude that phaeoviral infection is a widely occurring phenomenon in both lineages, and that phaeoviruses have diversified with their hosts at least since the divergence of the Laminariales and Ectocarpales

The Concise Guide to PHARMACOLOGY 2015/16:Ligand-gated ion channels

The Concise Guide to PHARMACOLOGY 2015/16 provides concise overviews of the key properties of over 1750 human drug targets with their pharmacology, plus links to an open access knowledgebase of drug targets and their ligands (www.guidetopharmacology.org), which provides more detailed views of target and ligand properties. The full contents can be found at http://onlinelibrary.wiley.com/doi/10.1111/bph.13349/full. Ligand-gated ion channels are one of the eight major pharmacological targets into which the Guide is divided, with the others being: ligand-gated ion channels, voltage-gated ion channels, other ion channels, nuclear hormone receptors, catalytic receptors, enzymes and transporters. These are presented with nomenclature guidance and summary information on the best available pharmacological tools, alongside key references and suggestions for further reading. The Concise Guide is published in landscape format in order to facilitate comparison of related targets. It is a condensed version of material contemporary to late 2015, which is presented in greater detail and constantly updated on the website www.guidetopharmacology.org, superseding data presented in the previous Guides to Receptors &amp; Channels and the Concise Guide to PHARMACOLOGY 2013/14. It is produced in conjunction with NC-IUPHAR and provides the official IUPHAR classification and nomenclature for human drug targets, where appropriate. It consolidates information previously curated and displayed separately in IUPHAR-DB and GRAC and provides a permanent, citable, point-in-time record that will survive database updates.</p