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Does it make a difference for the patient? Survival & Quality of life

Does it make a difference for the patient? Survival & Quality of life. Jan J. v. Busschbach, Ph.D. Erasmus MC Institute for Medical Psychology and Psychotherapy Viersprong Institute for studies on Personality Disorders Presentations can be found at: www.xs4all.nl/~jannetvb/busschbach/.

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Does it make a difference for the patient? Survival & Quality of life

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  1. Does it make a difference for the patient?Survival & Quality of life • Jan J. v. Busschbach, Ph.D. • Erasmus MC • Institute for Medical Psychology and Psychotherapy • Viersprong Institute for studies on Personality Disorders • Presentations can be found at: • www.xs4all.nl/~jannetvb/busschbach/

  2. Most simple recipe.. • Count the survival days • SF-36 • EuroQol EQ-5D

  3. Outcome research SF-36 EQ-5D

  4. Sensitivity • Generic instruments • Like SF-36 and EQ-5D • Not necessarily sensitive for intervention • Disease specific quality of life instruments • More sensitive • But comparisons with other disease difficult • Not sensible in outcome research and health economics

  5. Outcome research Specific SF-36 EQ-5D

  6. Specific instruments • Last option • Develop it your self…. • Desperate option • Find one on the internet, PubMed etc…. • To many, non at all or just not what you want… • THE way to do it: • Ask the opinion leaders • What is used most on congresses? • What would be a good translation of the effect for the clinicians?

  7. Examples • MMSE • The Mini Mental State Examination • IPSS • International Prostate Symptom Score • They have a horrible psychometric make up • But they communicate your messages • Clinicians ‘know’ the score by heart

  8. A full, but simple recipe... • Count the survival days • SF-36 • EuroQol EQ-5D • To calculate QALYs • A disease specific measure • Ask the physician

  9. Alternatives for SF-36 • Other ‘hot’ generic list • WHOQOL • Domain specific offspring of the SF-36 • EORTC C30 • FACT • Cancer, have additional disease specific modules • Can be expected to be more sensitive than generic lists • Reduces the need for specific measures

  10. Alternatives for EQ-5D • Must be able to generate QALYs • Health Utility Index • Own valuation of health states • Increase of sensitivity • Make sure that these are societal values… • Otherwise no QALY from societal perspective • Other instruments or adaptations • EQ-5D+cog • SF-6D (derived from SF-36) • AQoL

  11. A simple menu • Count the survival days • SF-36, WHOQOL • or domain specific instruments like EORTC C30 • EQ-5D, HUI, own validation • EQ-5D+, SF-6D, AQoL • A disease specific measure • Ask the physician

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