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Patient-centered measures for achalasia

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Abstract

Background

Various instruments may be used to measure health-related quality of life in patients with achalasia.

Methods

We administered four patient-centered measures used for evaluation of achalasia severity [an achalasia severity questionnaire we developed previously, an achalasia symptom checklist, the Gastrointestinal Quality-of-Life Index (GIQLI), and the Medical Outcomes Study 36-item Short-Form survey (SF-36)] to 25 subjects enrolled in a randomized controlled trial comparing pneumatic dilatation and laparoscopic Heller myotomy. We estimated correlations between the different measures.

Results

Twenty-five patients (13 male, 12 female) were studied; 12 were treated by pneumatic dilatation and 13 by laparoscopic myotomy. The average age of patients was 48.5 [range 25–69, standard deviation (SD) 13.7] years. Baseline scores demonstrated a substantial burden of impairment. The mean (SD) score on the achalasia severity measure [ranges from 0 (best) to 100 (worst)] was 62.3 (13.4). The mean (SD) symptom checklist score [ranges from 0 (best) to 36 (worst)] was 23.2 (6.6). The mean (SD) GIQLI [ranges from 0 (worst) to 144 (best)] was 77.04 (19.4). The SF-36 mean (SD) for the physical component score (PCS) was 45.29 (9.21) and the mean for the mental component score (MCS) was 37.61 (14.97). The achalasia severity measure correlated highly with the GIQLI (r = −0.57, p = 0.01), and the symptom checklist (r = 0.65, p = 0.004). The achalasia severity measure correlated well with the SF-36 PCS (r = −0.42, p = 0.039), but not with the MCS (r = −0.14, p = 0.501).

Conclusion

Subjects recruited to a randomized controlled trial of achalasia treatment demonstrated impairment in both generic quality-of-life and disease-specific measures. Scores on achalasia-specific measures correlated well with each other, but less well with measures of generic quality-of-life and mental health scales. Because of the multidimensional nature of achalasia, disease-specific measures should be combined with generic health measures for the best assessment of patient outcome.

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Acknowledgements

This research was supported in part by the Canadian Institutes of Health Research. Dr. Urbach is the Tyco Chair of Minimally Invasive Surgery at the University Health Network.

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Authors and Affiliations

  1. Division of Clinical Decision Making, Toronto General Hospital Research Institute, 200 Elizabeth Street, 13-EN-232B, M5G 2C4, Toronto, Ontario, Canada

    Julie L. Harnish, George A. Tomlinson & David R. Urbach

  2. Department of Surgery, University Health Network, Toronto, Ontario, Canada

    Gail E. Darling & David R. Urbach

  3. Department of Medicine, University Health Network, Toronto, Ontario, Canada

    Nicholas E. Diamant & George A. Tomlinson

  4. Division of Gastroenterology, Department of Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada

    Paul P. Kortan

  5. Department of Medical Imaging, St. Michael’s Hospital, Toronto, Ontario, Canada

    Wayne Deitel

  6. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    Audrey Laporte & David R. Urbach

Authors
  1. Julie L. Harnish
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  2. Gail E. Darling
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  3. Nicholas E. Diamant
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  4. Paul P. Kortan
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  5. George A. Tomlinson
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  6. Wayne Deitel
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  7. Audrey Laporte
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  8. David R. Urbach
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Corresponding author

Correspondence to Julie L. Harnish.

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Harnish, J.L., Darling, G.E., Diamant, N.E. et al. Patient-centered measures for achalasia. Surg Endosc 22, 1290–1293 (2008). https://doi.org/10.1007/s00464-007-9612-2

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  • DOI: https://doi.org/10.1007/s00464-007-9612-2

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