TY - JOUR
T1 - Comparison of three generic quality-of-life metrics in peripheral arterial disease patients undergoing conservative and invasive treatments
AU - Petersohn, Svenja
AU - Ramaekers, Bram L. T.
AU - Olie, Renske H.
AU - ten Cate-Hoek, Arina J.
AU - Daemen, Jan-Willem H. C.
AU - ten Cate, Hugo
AU - Joore, Manuela A.
N1 - Publisher Copyright:
© 2019, The Author(s).
PY - 2019/8
Y1 - 2019/8
N2 - Purpose To determine the effect of revascularisation for peripheral arterial disease (PAD) on QoL in the first and second year following diagnosis, to compare the effect depicted by Short Form Six Dimensions (SF-6D) and EuroQoL five Dimensions (EQ-5D) utilities, and Visual Analogue Scale (VAS) scores and to analyse heterogeneity in treatment response.Methods Longitudinal data from 229 PAD patients were obtained in an observational study in southern Netherlands. Utility scores were calculated with the international (SF-6D) and Dutch (EQ-5D) tariffs. We analysed treatment effect at years 1 and 2 through propensity score-matched ANCOVAs. Thereby, we estimated the marginal means (EMMs) of revascularisation and conservative treatment, and identified covariates of revascularisation effect.Results A year after diagnosis, 70 patients had been revascularised; the EMMs of revascularisation were 0.038, 0.077 and 0.019 for SF-6D, EQ-5D and VAS, respectively (always in this order). For conservative treatment these were -0.017, 0.038 and 0.021. At 2-year follow-up, the EMMs of revascularisation were 0.015, 0.077 and 0.027, for conservative treatment these were -0.020, 0.013 and -0.004. Baseline QoL (and rest pain in year 2) were covariates of treatment effect.Conclusions We measured positive effects of revascularisation and conservative treatment on QoL a year after diagnosis, the effect of revascularisation was sustained over 2 years. The magnitude of effect varied between the metrics and was largest for the EQ-5D, which may be most suitable for QoL measurement in PAD patients. Baseline QoL influenced revascularisation effect, in clinical practice this may inform expected QoL gain in individual patients.
AB - Purpose To determine the effect of revascularisation for peripheral arterial disease (PAD) on QoL in the first and second year following diagnosis, to compare the effect depicted by Short Form Six Dimensions (SF-6D) and EuroQoL five Dimensions (EQ-5D) utilities, and Visual Analogue Scale (VAS) scores and to analyse heterogeneity in treatment response.Methods Longitudinal data from 229 PAD patients were obtained in an observational study in southern Netherlands. Utility scores were calculated with the international (SF-6D) and Dutch (EQ-5D) tariffs. We analysed treatment effect at years 1 and 2 through propensity score-matched ANCOVAs. Thereby, we estimated the marginal means (EMMs) of revascularisation and conservative treatment, and identified covariates of revascularisation effect.Results A year after diagnosis, 70 patients had been revascularised; the EMMs of revascularisation were 0.038, 0.077 and 0.019 for SF-6D, EQ-5D and VAS, respectively (always in this order). For conservative treatment these were -0.017, 0.038 and 0.021. At 2-year follow-up, the EMMs of revascularisation were 0.015, 0.077 and 0.027, for conservative treatment these were -0.020, 0.013 and -0.004. Baseline QoL (and rest pain in year 2) were covariates of treatment effect.Conclusions We measured positive effects of revascularisation and conservative treatment on QoL a year after diagnosis, the effect of revascularisation was sustained over 2 years. The magnitude of effect varied between the metrics and was largest for the EQ-5D, which may be most suitable for QoL measurement in PAD patients. Baseline QoL influenced revascularisation effect, in clinical practice this may inform expected QoL gain in individual patients.
KW - ATRIAL-FIBRILLATION
KW - EQ-5D
KW - EuroQol EQ-5D (EQ-5D)
KW - HEALTH-STATUS
KW - INTERMITTENT CLAUDICATION
KW - MANAGEMENT
KW - Peripheral arterial disease
KW - Peripheral revascularisation
KW - REVASCULARIZATION
KW - RISK-FACTORS
KW - SF-6D
KW - UTILITIES
KW - Utility
KW - VALUATION
KW - TASK-FORCE
U2 - 10.1007/s11136-019-02166-0
DO - 10.1007/s11136-019-02166-0
M3 - Article
C2 - 30929124
SN - 0962-9343
VL - 28
SP - 2257
EP - 2279
JO - Quality of Life Research
JF - Quality of Life Research
IS - 8
ER -