How can quality of life researchers make their work more useful to health workers and their patients?
- 301 Downloads
To make optimal use of data from randomized trials in clinical decision-making, clinicians require knowledge of the magnitude of treatment effects. Reports of trials including quality of life data often fail to report results that provide interpretable estimates of magnitude of effect. Strategies that investigators could use to remedy this problem include reporting mean differences between groups in relation to the minimal important difference and reporting the proportion of patients who benefit from treatment and the associated number needed to treat. Techniques are available that allow investigators to use the same strategies in reporting pooled estimates from meta-analyses, even when studies use different instruments to measure the same construct. These reporting approaches, as well as ensuring access to data from individual items, will also help those developing decision aids to use quality of life data.
KeywordsMinimal important difference Number needed to treat Systematic reviews Decision aids
We are grateful for the very helpful advice that Dr. Tim Whelan gave us regarding making quality of life data helpful for those developing decision aids.
- 1.Guyatt, G., Gutterman, D., Baumann, M. H., Addrizzo-Harris, D., Hylek, E. M., Phillips, B., Raskob, G., Lewis, S. Z., & Schunemann, H. (2006). Grading strength of recommendations and quality of evidence in clinical guidelines: Report from an American college of chest physicians task force. Chest, 129, 174–181.PubMedCrossRefGoogle Scholar
- 5.Gary, R. (2006). Exercise self-efficacy in older women with diastolic heart failure: results of a walking program and education intervention. J Gerontol Nurs, 32, 31–39, quiz 40-1.Google Scholar
- 6.Naunheim, K. S., Wood, D. E., Mohsenifar, Z., Sternberg, A. L., Criner, G. J., DeCamp, M. M., Deschamps, C. C., Martinez, F. J., Sciurba, F. C., Tonascia, J., & Fishman, A. P. (2006). Long-term follow-up of patients receiving lung-volume-reduction surgery versus medical therapy for severe emphysema by the National Emphysema Treatment Trial Research Group. Ann Thorac Surg, 82, 431–443.PubMedCrossRefGoogle Scholar
- 10.Wong, R. K., Paul, N., Ding, K., Whitehead, M., Brundage, M., Fyles, A., Wilke, D., Nabid, A., Fortin, A., Wilson, D., McKenzie, M., Ackerman, I., Souhami, L., Chabot, P., & Pater, J. (2006). 5-Hydroxytryptamine-3 receptor antagonist with or without short-course dexamethasone in the prophylaxis of radiation induced emesis: A placebo-controlled randomized trial of the National Cancer Institute of Canada Clinical Trials Group (SC19). J Clin Oncol, 24, 3458–3464.PubMedCrossRefGoogle Scholar
- 12.Bacigalupo, A., Lamparelli, T., Barisione, G., Bruzzi, P., Guidi, S., Alessandrino, P. E., di Bartolomeo, P., Oneto, R., Bruno, B., Sacchi, N., van Lint, M. T., & Bosi, A. (2006). Thymoglobulin prevents chronic graft-versus-host disease, chronic lung dysfunction, and late transplant-related mortality: Long-term follow-up of a randomized trial in patients undergoing unrelated donor transplantation. Biol Blood Marrow Transplant, 12, 560–565.PubMedCrossRefGoogle Scholar
- 16.Kosinski, M., Zhao, S. Z., Dedhiya, S., Osterhaus, J. T., & Ware, J. E. Jr. (2000). Determining minimally important changes in generic and disease-specific health-related quality of life questionnaires in clinical trials of rheumatoid arthritis. Arthritis Rheum, 43, 1478–1487.PubMedCrossRefGoogle Scholar
- 31.Brook, R. H., Ware, J. E. Jr., Rogers, W. H., Keeler, E. B., Davies, A. R., Donald, C. A., Goldberg, G. A., Lohr, K. N., Masthay, P. C., & Newhouse, J. P. (1983). Does free care improve adults’ health? Results from a randomized controlled trial. N Engl J Med, 309, 1426–1434.PubMedCrossRefGoogle Scholar
- 32.Goldstein, R. S., Todd, T. R., Guyatt, G., Keshavjee, S., Dolmage, T. E., van Rooy, S., Krip, B., Maltais, F., LeBlanc, P., Pakhale, S., & Waddell, T. K. (2003). Influence of lung volume reduction surgery (LVRS) on health related quality of life in patients with chronic obstructive pulmonary disease. Thorax, 58, 405–410.PubMedCrossRefGoogle Scholar
- 35.Derose, K., Kanouse, D., Weidmer, B., Weech-Maldonado, R., Garcia, R., & Hays, R. (in press). Developing a Spanish-language sample report for CAHPS. Joint Commission Journal on Quality and Patient Safety.Google Scholar
- 36.Burge, P. S., Calverley, P. M., Jones, P. W., Spencer, S., Anderson, J. A., & Maslen, T. K. (2000). Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: The ISOLDE trial. Bmj, 320, 1297–1303.PubMedCrossRefGoogle Scholar
- 40.Guyatt, G., Hayward, R., Richardson, W. S., Green, L., Wilson, M., Sinclair, J., Cook, D., Glasziou, P., Detsky, A., & Bass, E. (2002). Moving from evidence to action. In G. R. Guyatt & D. Rennie (Eds.), The Users’ Guides to the Medical Literature: A Manual for Evidence-based Clinical Practice. Chicago, Illinois: AMA publications.Google Scholar
- 41.Oxman, A., Guyatt, G., Jaeschke, R., Montori, V. (2002). Summarizing the evidence. In G. R. Guyatt & D. Rennie (Eds.), The Users’ Guides to the Medical Literature: A Manual for Evidence-based Clinical Practice. Chicago, Illinois: AMA publications.Google Scholar
- 42.Cohen, J. (1988). Statistical power analysis in the behavioral sciences. Hillsdale, NJ: Erlbaum.Google Scholar
- 45.Guyatt, G. H., Haynes, R. B., Jaeschke, R. Z., Cook, D. J., Green, L., Naylor, C. D., Wilson, M. C., & Richardson, W. S. (2000). Users’ Guides to the Medical Literature: XXV. Evidence-based medicine: Principles for applying the Users’ Guides to patient care. Evidence-based Medicine Working Group. Jama, 284, 1290–1296.PubMedCrossRefGoogle Scholar
- 48.Akl, E. A., Grant, B. J. B., Guyatt, G. H., Montori, V. M., & Schu¨nemann, H. J. (in press). A decision aid for COPD patients considering inhaled steroid therapy: development and before and after pilot testing. BMC Med Inform Decis Making.Google Scholar