A comparison of conventional and retrospective measures of change in symptoms after elective surgery
| Autor: | Alf Trojan, Rugzan Hussein, Stefan Nickel, Marco Petrucci, Christoph Lorenz, Hans Dörning, EM Bitzer |
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| Rok vydání: | 2011 |
| Předmět: |
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medicine.medical_specialty medicine.medical_treatment Observation lcsh:Computer applications to medicine. Medical informatics Patient satisfaction Bias Quality of life Surveys and Questionnaires Outcome Assessment Health Care medicine Humans Hernia Longitudinal Studies Postoperative Period Elective surgery Herniorrhaphy Retrospective Studies business.industry Research Public Health Environmental and Occupational Health Retrospective cohort study General Medicine Middle Aged Hernia repair medicine.disease Surgery Cholecystectomy Laparoscopic Elective Surgical Procedures Patient Satisfaction Mental Recall Preoperative Period lcsh:R858-859.7 Female Cholecystectomy sense organs Health Services Research Elective Surgical Procedure business |
| Zdroj: | Health and Quality of Life Outcomes Health and Quality of Life Outcomes, Vol 9, Iss 1, p 23 (2011) |
| ISSN: | 1477-7525 |
| DOI: | 10.1186/1477-7525-9-23 |
| Popis: | Background Measuring change is fundamental to evaluations, health services research and quality management. To date, the Gold-Standard is the prospective assessment of pre- to postoperative change. However, this is not always possible (e.g. in emergencies). Instead a retrospective approach to the measurement of change is one alternative of potential validity. In this study, the Gold-Standard 'conventional' method was compared with two variations of the retrospective approach: a perceived-change design (model A) and a design that featured observed follow-up minus baseline recall (model B). Methods In a prospective longitudinal observational study of 185 hernia patients and 130 laparoscopic cholecystectomy patients (T0: 7-8 days pre-operative; T1: 14 days post-operative and T2: 6 months post-operative) changes in symptoms (Hernia: 9 Items, Cholecystectomy: 8 Items) were assessed at the three time points by patients and the conventional method was compared to the two alternatives. Comparisons were made regarding the percentage of missing values per questionnaire item, correlation between conventional and retrospective measurements, and the degree to which retrospective measures either over- or underestimated changes and time-dependent effects. Results Single item missing values in model A were more frequent than in model B (e.g. Hernia repair at T1: model A: 23.5%, model B: 7.9%. In all items and at both postoperative points of measurement, correlation of change between the conventional method and model B was higher than between the conventional method and model A. For both models A and B, correlation with the change calculated with the conventional method was higher at T1 than at T2. Compared to the conventional model both models A and B also overestimated symptom-change (i.e. improvement) with similar frequency, but the overestimation was higher in model A than in model B. In both models, overestimation was lower at T1 than at T2 and lower after hernia repair than after cholecystectomy. Conclusions The retrospective method of measuring change was associated with a larger improvement in symptoms than was the conventional method. Retrospective assessment of change results in a more optimistic evaluation of improvement by patients than does the conventional method (at least for hernia repair and laparoscopic cholecystectomy). |
| Databáze: | OpenAIRE |
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