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Responsiveness and Minimal Clinically Important Differences after Cholecystectomy: GIQLI Versus SF-36

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

To compare responsiveness and minimal clinically important differences (MCID) between the Gastrointestinal Quality of Life (GIQLI) and the Short Form 36 (SF-36), we prospectively analyze 159 patients undergoing cholecystectomy at two tertiary academic hospitals.

Patients and Methods

All patients completed the disease-specific GIQLI and the generic SF-36 before and 3 months after surgery. Scores using these instruments were interpreted by generalized estimating equation before and after cholecystectomy. The bootstrap estimation was used to derive 95% confidence intervals for differences in the responsiveness estimates.

Results and Discussion

Mean changes in all GIQLI and the SF-36 subscales were statistically significant (p < 0.05). Comparisons of effect size (ES), standardized response means (SRM), and relative efficiency (>1) indicated that the responsiveness of the GIQLI was superior to that of the SF-36. In the equivalence test, all lower or upper confidence limits presented no equivalence (>5), indicating good MCID. The ES and SRM for emotions and physical function in the GIQLI significantly differed from those of the SF-36 (p < 0.05).

Conclusion

The data in this study indicate that clinicians and health researchers should weight disease-specific measures more heavily than generic measures when evaluating treatment outcomes.

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References

  1. Sanders G, Kingsnorth AN. Gallstones. BMJ 2007;335:295–299. DOI 10.1136/bmj.39267.452257.AD.

    Article  PubMed  Google Scholar 

  2. Livingston EH, Miller JA, Coan B, Rege RV. Costs and utilization of intraoperative cholangiography. J Gastrointest Surg 2007;11(9):1162–1167. DOI 10.1007/s11605-007-0209-9.

    Article  PubMed  Google Scholar 

  3. de Reuver PR, Sprangers MA, Gouma DJ. Quality of life in bile duct injury patients. Ann Surg 2007;246:161–163. DOI 10.1097/SLA.0b013e318070cble.

    Article  PubMed  Google Scholar 

  4. Gurusamy K, Junnarkar S, Farouk M, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of day-case laparoscopic cholecystectomy. Br J Surg 2008;95(2):161–168. DOI 10.1002/bjs.6105.

    Article  PubMed  CAS  Google Scholar 

  5. Quintana JM, Cabriada J, Aróstegui I, Oribe V, Perdigo L, Varona M et al. Health-related quality of life and appropriateness of cholecystectomy. Ann Surg 2005;241:110–118.

    PubMed  Google Scholar 

  6. Fryback DG, Dunham NC, Palta M, Hanmer J, Buechner J, Cherepanov D et al. US norms for six generic health-related quality-of-life indexes from the national health measurement study. Med Care 2007;45:1162–1170.

    Article  PubMed  Google Scholar 

  7. Escobar A, Quintana JM, Bilbao A, Aróstegui I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthr Cartil 2007;15:273–280. DOI 10.1016/j.jclinepi.2004.02.007.

    Article  PubMed  CAS  Google Scholar 

  8. Turner D, Otley AR, Mack D, Hyams J, de Bruijne J, Uusoue K et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology 2007;133:423–432. DOI 10.1053/j.gastro.2007.05.029.

    Article  PubMed  Google Scholar 

  9. Schmitt JS, Di Fabio RP. Reliable change and minimum important difference (MID) proportions facilitated group responsiveness comparisons using individual threshold criteria. J Clin Epidemiol 2004;57:1008–1018. DOI 10.1016/j.jclinepi.2004.02.007.

    Article  PubMed  Google Scholar 

  10. Huang IC, Wu AW, Frangakis C. Do the SF-36 and WHOQOL-BREF measure the same constructs? Evidence from the Taiwan population. Qual Life Res 2006;15:15–24. DOI 10.1007/s11136-005-8486-9.

    Article  PubMed  CAS  Google Scholar 

  11. Yeung SM, Shiu AT, Martin CR, Chu KM. Translation and validation of the Chinese version of the Gastrointestinal Quality of Life Index in patients with gastric tumor. J Psychosom Res 2006;61:469–477. DOI 10.1016/j.jpsychores.2006.03.049.

    Article  PubMed  Google Scholar 

  12. Tang B, Cuschieri A. Conversions during laparoscopic cholecystectomy: risk factors and effects on patient outcome. J Gastrointest Surg 2006;10(7):1081–1097. DOI 10:1016/j.gassur.2005.12.001.

    Article  PubMed  Google Scholar 

  13. Giger UF, Michel JM, Opitz I, Th Inderbitzin D, Kocher T, Krähenbühl L. Swiss Association of Laparoscopic and Thoracoscopic Surgery (SALTS) Study Group. Risk factors for perioperative complications in patients undergoing laparoscopic cholecystectomy: analysis of 22,953 consecutive cases from the Swiss Association of Laparoscopic and Thoracoscopic Surgery database. J Am Coll Surg 2006;203(5):723–728. DOI 10.1016/j.jamcollsurg.2006.07.018.

    Article  PubMed  Google Scholar 

  14. Terwee CB, Dekker FW, Wiersinga WM, Prummel MF, Bossuyt PM. On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res 2003;12:349–362. DOI 10.1023/A:1023499322593.

    Article  PubMed  CAS  Google Scholar 

  15. Simon R, Maitournam A. Evaluating the efficiency of targeted designs for randomized clinical trials. Clin Cancer Res 2004;10:6759–6763. DOI 10.1158/1078-0432.CCR-04-0496.

    Article  PubMed  CAS  Google Scholar 

  16. Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989;10:407–415. DOI 10.1016/0197-2456(89)90005-6.

    Article  PubMed  CAS  Google Scholar 

  17. Tsong Y, Shen M. An alternative approach to assess exchangeability of a test treatment and the standard treatment with normally distributed response. J Biopharm Stat 2007;17:329–338. DOI 10.1080/10543400601177301.

    Article  PubMed  Google Scholar 

  18. Chang E, Abrahamowicz M, Ferland D, Fortin PR, CaNIOS Investigators. Comparison of the responsiveness of lupus disease activity measures to changes in systemic lupus erythematosus activity relevant to patients and physicians. J Clin Epidemiol 2002;55:488–497. DOI 10.1016/S0895-4356(01)00509-1.

    Article  PubMed  Google Scholar 

  19. Wyrwich KW, Tierney WM, Wolinsky FD. Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 1999;52:861–873. DOI 10.1016/S0895-4356(99)00071-2.

    Article  PubMed  CAS  Google Scholar 

  20. Cohen J. Statistical power analysis for the behavioural sciences. New York: Academic, 1977.

    Google Scholar 

  21. Zou GY. Quantifying responsiveness of quality of life measures without an external criterion. Qual Life Res 2005;14:1545–1552. DOI 10.1007/s11136-004-0027-4.

    Article  PubMed  Google Scholar 

  22. Pichel F, Zamarrón C, Magán F et al. Health-related quality of life in patients with obstructive sleep apnea: effects of long-term positive airway pressure treatment. Respir Med 2004;98:968–976.

    Article  PubMed  CAS  Google Scholar 

  23. Wells G, Li T, Maxwell L, MacLean R, Tugwell P. Determining the minimal clinically important differences in activity, fatigue, and sleep quality in patients with rheumatoid arthritis. J Rheumatol 2007;34:280–289.

    PubMed  Google Scholar 

  24. Rabeneck L, Davila JA, Thompson M, El-Serag HB. Surgical volume and long-term survival following surgery for colorectal cancer in the Veterans Affairs Health-Care System. Am J Gastroenterol 2004;99:668–675. DOI 10.1111/j.1572-0241.2004.04135.x.

    Article  PubMed  Google Scholar 

  25. Solomon DH, Losina E, Baron JA, Fossel AH, Guadagnoli E, Lingard EA et al. Contribution of hospital characteristics to the volume–outcome relationship: Dislocation and infection following total hip replacement surgery. Arthritis Rheum 2002;46:2436–2444. DOI 10.1002/art.10478.

    Article  PubMed  Google Scholar 

  26. Drossman D, Morris CB, Hu Y, Toner BB, Diamant N, Whitehead WE et al. Characterization of health related quality of life (HRQOL) for patients with functional bowel disorder (FBD) and its response to treatment. Am J Gastroenterol 2007;102:1442–1453. DOI 10.1111/j.1572-0241.2007.01283.x.

    Article  PubMed  Google Scholar 

  27. Finan KR, Leeth RR, Whitley BM, Klapow JC, Hawn MT. Improvement in gastrointestinal symptoms and quality of life after cholecystectomy. Am J Surg 2006;192:196–202. DOI 10.1016/j.amjsurg.2006.01.020.

    Article  PubMed  Google Scholar 

  28. Quintana JM, Cabriada J, López de Tejada I, Varona M, Oribe V, Barrios B, Perdigo L, Bilbao A. Translation and validation of the gastrointestinal Quality of Life Index (GIQLI). Rev Esp Enferm Dig 2001;93:693–706.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 100-Shih-Chun 1st Road, Kaohsiung, Taiwan

    Hon-Yi Shi, Herng-Chia Chiu & King-Teh Lee

  2. Department of Surgery, Chi Mei Medical Center, Liou Ying Campus, Tainan, Taiwan

    Hao-Hsien Lee, Chong-Chi Chiu & Yih-Huei Uen

  3. Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    King-Teh Lee

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  1. Hon-Yi Shi
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Correspondence to King-Teh Lee.

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Shi, HY., Lee, HH., Chiu, CC. et al. Responsiveness and Minimal Clinically Important Differences after Cholecystectomy: GIQLI Versus SF-36. J Gastrointest Surg 12, 1275–1282 (2008). https://doi.org/10.1007/s11605-008-0526-7

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