The Relationship between Cardiac Functional Capacity and Patients' Symptom-specific Utilities for Angina
| Autor: | Hilary A. Llewellyn-Thomas, Graham Nichol, C. David Naylor, Elaine C. Thiel |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Psychometrics Health Status Comorbidity Coronary disease Severity of Illness Index Angina Pectoris Angina 03 medical and health sciences 0302 clinical medicine Activities of Daily Living Humans Medicine 030212 general & internal medicine Exercise Tolerance business.industry 030503 health policy & services Health Policy Confounding Factors Epidemiologic Middle Aged medicine.disease Emergency medicine Quality of Life Physical therapy Female 0305 other medical science business Attitude to Health |
| Zdroj: | Medical Decision Making. 16:78-85 |
| ISSN: | 1552-681X 0272-989X |
| Popis: | Forty-one angina patients with coronary disease were interviewed to examine the correlation between prespecified and individualized weights for disease-specific measures of the effects of angina on the patients' well-being. Modifications of the Canadian Cardiovascular Society (CCS) scale for angina and the Duke Activity Specific Index (DASI) were used to rate functional capacity with prespecified items. Disease-specific utilities based on descriptions of functional status were obtained directly, and again indirectly with different anchoring conditions to control for noncardiac comorbidity. Correlations between the functional-capacity measures and the derived utilities were not strong, ranging from -0 25 (p > 0.1) to -0.35 (p = 0.02). Correlation between the two prespecified measures was higher (r = -0.51 or -0.69, both p < 0.01, for DASI versus CCS graded from walking and stair-climbing, re spectively). The direct and indirect disease-specific utility scores were similar (r = 0.92, p < 0.01). The method described provides an approach to measuring disease-specific utilities by adapting existing scales for use in a standard gamble. It confirms that prespecified functional status scores inconsistently reflect patients' valuations of functional states. Further investigation should address whether the observed null effect of comorbidity on disease- specific utilities arose from inadequate coverage of the comorbidity issues in patient inter views or from lack of power given the small size of the feasibility study. Key words: cardiac patients' utilities; cardiac functional capacity; utilities for angina; comorbidity. (Med Decis Making 1996;16:78-85) |
| Databáze: | OpenAIRE |
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