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Published in: BMC Geriatrics 1/2014

Open Access 01-12-2014 | Research article

Establishing a composite endpoint for measuring the effectiveness of geriatric interventions based on older persons’ and informal caregivers’ preference weights: a vignette study

Authors: Cynthia S Hofman, Peter Makai, Han Boter, Bianca M Buurman, Anton JM de Craen, Marcel GM Olde Rikkert, Rogier ART Donders, René JF Melis

Published in: BMC Geriatrics | Issue 1/2014

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Abstract

Background

The Older Persons and Informal Caregivers Survey Minimal Dataset’s (TOPICS-MDS) questionnaire which measures relevant outcomes for elderly people was successfully incorporated into over 60 research projects of the Dutch National Care for the Elderly Programme. A composite endpoint (CEP) for this instrument would be helpful to compare effectiveness of the various intervention projects. Therefore, our aim is to establish a CEP for the TOPICS-MDS questionnaire, based on the preferences of elderly persons and informal caregivers.

Methods

A vignette study was conducted with 200 persons (124 elderly and 76 informal caregivers) as raters. The vignettes described eight TOPICS-MDS outcomes of older persons (morbidity, functional limitations, emotional well-being, pain experience, cognitive functioning, social functioning, self-perceived health and self-perceived quality of life) and the raters assessed the general well-being (GWB) of these vignette cases on a numeric rating scale (0–10). Mixed linear regression analyses were used to derive the preference weights of the TOPICS-MDS outcomes (dependent variable: GWB scores; fixed factors: the eight outcomes; unstandardized coefficients: preference weights).

Results

The mixed regression model that combined the eight outcomes showed that the weights varied from 0.01 for social functioning to 0.16 for self-perceived health. A model that included “informal caregiver” showed that the interactions between this variable and each of the eight outcomes were not significant (p > 0.05).

Conclusion

A preference-weighted CEP for TOPICS-MDS questionnaire was established based on the preferences of older persons and informal caregivers. With this CEP optimal comparing the effectiveness of interventions in older persons can be realized.
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Literature
1.
go back to reference Humphreys G: The health-care challenges posed by population ageing. Bull World Health Organ. 2012, 90 (2): 82-83.CrossRefPubMed Humphreys G: The health-care challenges posed by population ageing. Bull World Health Organ. 2012, 90 (2): 82-83.CrossRefPubMed
3.
go back to reference Basu A, Philipson TJ: The impact of comparative effectiveness research on health and health care spending. 2010, Cambridge: Mass. National Bureau of Economic ResearchCrossRef Basu A, Philipson TJ: The impact of comparative effectiveness research on health and health care spending. 2010, Cambridge: Mass. National Bureau of Economic ResearchCrossRef
4.
go back to reference Porter ME: What is value in health care?. N Engl J Med. 2010, 363 (26): 2477-2481. 10.1056/NEJMp1011024.CrossRefPubMed Porter ME: What is value in health care?. N Engl J Med. 2010, 363 (26): 2477-2481. 10.1056/NEJMp1011024.CrossRefPubMed
5.
go back to reference Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G: Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004, 59 (3): 255-263. 10.1093/gerona/59.3.M255.CrossRefPubMed Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G: Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004, 59 (3): 255-263. 10.1093/gerona/59.3.M255.CrossRefPubMed
6.
go back to reference Lutomski JE, Baars MA, Schalk BW, Boter H, Buurman BM, den Elzen WP, Jansen AP, Kempen GI, Steunenberg B, Steyerberg EW, Olde Rikkert MG, Melis RJ, Topics-Mds Consortium: The Development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): A Large-Scale Data Sharing Initiative. PLoS One. 2013, 8 (12): e81673-10.1371/journal.pone.0081673.CrossRefPubMedPubMedCentral Lutomski JE, Baars MA, Schalk BW, Boter H, Buurman BM, den Elzen WP, Jansen AP, Kempen GI, Steunenberg B, Steyerberg EW, Olde Rikkert MG, Melis RJ, Topics-Mds Consortium: The Development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): A Large-Scale Data Sharing Initiative. PLoS One. 2013, 8 (12): e81673-10.1371/journal.pone.0081673.CrossRefPubMedPubMedCentral
8.
go back to reference Neuhauser M: How to deal with multiple endpoints in clinical trials. Fund Clinical Pharma. 2006, 20 (6): 515-523. 10.1111/j.1472-8206.2006.00437.x.CrossRef Neuhauser M: How to deal with multiple endpoints in clinical trials. Fund Clinical Pharma. 2006, 20 (6): 515-523. 10.1111/j.1472-8206.2006.00437.x.CrossRef
9.
go back to reference Veit CT, Ware JE: Measuring health state and health care outcomes: Issues and recommendations. Values and Long Term Care. Edited by: Kane RL, Kane RA. 1982, Lexington MA: Lexington Books, 233-259. Veit CT, Ware JE: Measuring health state and health care outcomes: Issues and recommendations. Values and Long Term Care. Edited by: Kane RL, Kane RA. 1982, Lexington MA: Lexington Books, 233-259.
10.
go back to reference Sackett DL, Torrance GW: The utility of different health states as perceived by the general public. J Chron Dis. 1978, 31 (11): 697-704. 10.1016/0021-9681(78)90072-3.CrossRefPubMed Sackett DL, Torrance GW: The utility of different health states as perceived by the general public. J Chron Dis. 1978, 31 (11): 697-704. 10.1016/0021-9681(78)90072-3.CrossRefPubMed
11.
go back to reference Gerteis M, Picker/Commonwealth Program for Patient-Centered Care: Through the patient's eyes: understanding and promoting patient-centered care. 1993, San Francisco: Jossey-Bass, 1 Gerteis M, Picker/Commonwealth Program for Patient-Centered Care: Through the patient's eyes: understanding and promoting patient-centered care. 1993, San Francisco: Jossey-Bass, 1
12.
go back to reference Say RE, Thomson R: The importance of patient preferences in treatment decisions–challenges for doctors. BMJ. 2003, 327 (7414): 542-545. 10.1136/bmj.327.7414.542.CrossRefPubMedPubMedCentral Say RE, Thomson R: The importance of patient preferences in treatment decisions–challenges for doctors. BMJ. 2003, 327 (7414): 542-545. 10.1136/bmj.327.7414.542.CrossRefPubMedPubMedCentral
13.
go back to reference Van Houtven CH, Norton EC: Informal care and health care use of older adults. J Health Econ. 2004, 23 (6): 1159-1180. 10.1016/j.jhealeco.2004.04.008.CrossRefPubMed Van Houtven CH, Norton EC: Informal care and health care use of older adults. J Health Econ. 2004, 23 (6): 1159-1180. 10.1016/j.jhealeco.2004.04.008.CrossRefPubMed
14.
go back to reference Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002, 21 (2): 271-292. 10.1016/S0167-6296(01)00130-8.CrossRefPubMed Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002, 21 (2): 271-292. 10.1016/S0167-6296(01)00130-8.CrossRefPubMed
15.
go back to reference Atzmuller C, Steiner PM: Experimental Vignette Studies in Survey Research. Methodol-Eur. 2010, 6 (3): 128-138. Atzmuller C, Steiner PM: Experimental Vignette Studies in Survey Research. Methodol-Eur. 2010, 6 (3): 128-138.
16.
go back to reference Alexander CS, Becker HJ: The use of vignettes in survey research. Public Opin Q. 1978, 42 (1): 93-104. 10.1086/268432.CrossRef Alexander CS, Becker HJ: The use of vignettes in survey research. Public Opin Q. 1978, 42 (1): 93-104. 10.1086/268432.CrossRef
17.
go back to reference Ludwick R, Zeller RA: The factorial survey: an experimental method to replicate real world problems. Nurs Res. 2001, 50 (2): 129-133. 10.1097/00006199-200103000-00009.CrossRefPubMed Ludwick R, Zeller RA: The factorial survey: an experimental method to replicate real world problems. Nurs Res. 2001, 50 (2): 129-133. 10.1097/00006199-200103000-00009.CrossRefPubMed
18.
go back to reference Farshad M, Gerber C, Szucs T, Meyer DC: Determining utility values in patients with anterior cruciate ligament tears using clinical scoring systems. BMC Health Serv Res. 2011, 11: 182-10.1186/1472-6963-11-182.CrossRefPubMedPubMedCentral Farshad M, Gerber C, Szucs T, Meyer DC: Determining utility values in patients with anterior cruciate ligament tears using clinical scoring systems. BMC Health Serv Res. 2011, 11: 182-10.1186/1472-6963-11-182.CrossRefPubMedPubMedCentral
19.
go back to reference Muller-Engelmann M, Krones T, Keller H, Donner-Banzhoff N: Decision making preferences in the medical encounter–a factorial survey design. BMC Health Serv Res. 2008, 8: 260-10.1186/1472-6963-8-260.CrossRefPubMedPubMedCentral Muller-Engelmann M, Krones T, Keller H, Donner-Banzhoff N: Decision making preferences in the medical encounter–a factorial survey design. BMC Health Serv Res. 2008, 8: 260-10.1186/1472-6963-8-260.CrossRefPubMedPubMedCentral
22.
go back to reference Weinberger M, Samsa GP, Schmader K, Greenberg SM, Carr DB, Wildman DS: Comparing proxy and patients’ perceptions of patients’ functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc. 1992, 40 (6): 585-588.CrossRefPubMed Weinberger M, Samsa GP, Schmader K, Greenberg SM, Carr DB, Wildman DS: Comparing proxy and patients’ perceptions of patients’ functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc. 1992, 40 (6): 585-588.CrossRefPubMed
23.
go back to reference VanderZee KI, Sanderman R, Heyink JW, de Haes H: Psychometric qualities of the RAND 36-Item Health Survey 1.0: a multidimensional measure of general health status. Int J Behav Med. 1996, 3 (2): 104-122. 10.1207/s15327558ijbm0302_2.CrossRefPubMed VanderZee KI, Sanderman R, Heyink JW, de Haes H: Psychometric qualities of the RAND 36-Item Health Survey 1.0: a multidimensional measure of general health status. Int J Behav Med. 1996, 3 (2): 104-122. 10.1207/s15327558ijbm0302_2.CrossRefPubMed
24.
go back to reference Krabbe PF, Stouthard ME, Essink-Bot ML, Bonsel GJ: The effect of adding a cognitive dimension to the Euro Qol multiattribute health-status classification system. J Clin Epidemiol. 1999, 52 (4): 293-301. 10.1016/S0895-4356(98)00163-2.CrossRefPubMed Krabbe PF, Stouthard ME, Essink-Bot ML, Bonsel GJ: The effect of adding a cognitive dimension to the Euro Qol multiattribute health-status classification system. J Clin Epidemiol. 1999, 52 (4): 293-301. 10.1016/S0895-4356(98)00163-2.CrossRefPubMed
25.
go back to reference Gomez-Gallego M, Gomez-Amor J, Gomez-Garcia J: Determinants of quality of life in Alzheimer's disease: perspective of patients, informal caregivers, and professional caregivers. Int Psychogeriatr. 2012, 24 (11): 1805-1815. 10.1017/S1041610212001081.CrossRefPubMed Gomez-Gallego M, Gomez-Amor J, Gomez-Garcia J: Determinants of quality of life in Alzheimer's disease: perspective of patients, informal caregivers, and professional caregivers. Int Psychogeriatr. 2012, 24 (11): 1805-1815. 10.1017/S1041610212001081.CrossRefPubMed
26.
go back to reference Huang HL, Chang MY, Tang JS, Chiu YC, Weng LC: Determinants of the discrepancy in patient- and caregiver-rated quality of life for persons with dementia. J Clin Nurs. 2009, 18 (22): 3107-3118. 10.1111/j.1365-2702.2008.02537.x.CrossRefPubMed Huang HL, Chang MY, Tang JS, Chiu YC, Weng LC: Determinants of the discrepancy in patient- and caregiver-rated quality of life for persons with dementia. J Clin Nurs. 2009, 18 (22): 3107-3118. 10.1111/j.1365-2702.2008.02537.x.CrossRefPubMed
27.
go back to reference Crespo M, Bernaldo de Quiros M, Gomez MM, Hornillos C: Quality of life of nursing home residents with dementia: a comparison of perspectives of residents, family, and staff. Gerontol. 2012, 52 (1): 56-65. 10.1093/geront/gnr080.CrossRef Crespo M, Bernaldo de Quiros M, Gomez MM, Hornillos C: Quality of life of nursing home residents with dementia: a comparison of perspectives of residents, family, and staff. Gerontol. 2012, 52 (1): 56-65. 10.1093/geront/gnr080.CrossRef
28.
go back to reference Moyle W, Murfield JE, Griffiths SG, Venturato L: Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts. J Adv Nurs. 2012, 68 (10): 2237-2246. 10.1111/j.1365-2648.2011.05912.x.CrossRefPubMed Moyle W, Murfield JE, Griffiths SG, Venturato L: Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts. J Adv Nurs. 2012, 68 (10): 2237-2246. 10.1111/j.1365-2648.2011.05912.x.CrossRefPubMed
29.
go back to reference Schwartz CE, Sprangers MA: Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Soc Sci Med. 1999, 48 (11): 1531-1548. 10.1016/S0277-9536(99)00047-7.CrossRefPubMed Schwartz CE, Sprangers MA: Methodological approaches for assessing response shift in longitudinal health-related quality-of-life research. Soc Sci Med. 1999, 48 (11): 1531-1548. 10.1016/S0277-9536(99)00047-7.CrossRefPubMed
30.
go back to reference Rapkin BD, Schwartz CE: Toward a theoretical model of quality-of-life appraisal: Implications of findings from studies of response shift. Health Qual Life Outcomes. 2004, 2: 14-10.1186/1477-7525-2-14.CrossRefPubMedPubMedCentral Rapkin BD, Schwartz CE: Toward a theoretical model of quality-of-life appraisal: Implications of findings from studies of response shift. Health Qual Life Outcomes. 2004, 2: 14-10.1186/1477-7525-2-14.CrossRefPubMedPubMedCentral
31.
go back to reference Neumann PJ, Araki SS, Gutterman EM: The use of proxy respondents in studies of older adults: lessons, challenges, and opportunities. J Am Geriatr Soc. 2000, 48 (12): 1646-1654.CrossRefPubMed Neumann PJ, Araki SS, Gutterman EM: The use of proxy respondents in studies of older adults: lessons, challenges, and opportunities. J Am Geriatr Soc. 2000, 48 (12): 1646-1654.CrossRefPubMed
33.
go back to reference Dolan P: Effect of age on health state valuations. J Health Serv Res Policy. 2000, 5 (1): 17-21.PubMed Dolan P: Effect of age on health state valuations. J Health Serv Res Policy. 2000, 5 (1): 17-21.PubMed
34.
go back to reference Wittenberg E, Halpern E, Divi N, Prosser LA, Araki SS, Weeks JC: The effect of age, race and gender on preference scores for hypothetical health states. Qual Life Res. 2006, 15 (4): 645-653. 10.1007/s11136-005-3514-3.CrossRefPubMed Wittenberg E, Halpern E, Divi N, Prosser LA, Araki SS, Weeks JC: The effect of age, race and gender on preference scores for hypothetical health states. Qual Life Res. 2006, 15 (4): 645-653. 10.1007/s11136-005-3514-3.CrossRefPubMed
35.
go back to reference van der Heijde DM, van't Hof MA, van Riel PL, van Leeuwen MA, van Rijswijk MH, van de Putte LB: Validity of single variables and composite indices for measuring disease activity in rheumatoid arthritis. Ann Rheum Dis. 1992, 51 (2): 177-181. 10.1136/ard.51.2.177.CrossRefPubMedPubMedCentral van der Heijde DM, van't Hof MA, van Riel PL, van Leeuwen MA, van Rijswijk MH, van de Putte LB: Validity of single variables and composite indices for measuring disease activity in rheumatoid arthritis. Ann Rheum Dis. 1992, 51 (2): 177-181. 10.1136/ard.51.2.177.CrossRefPubMedPubMedCentral
36.
go back to reference Fuchs HA: The Use of the Disease-Activity Score in the Analysis of Clinical-Trials in Rheumatoid-Arthritis. Br J Rheumatol. 1993, 20 (11): 1863-1866. Fuchs HA: The Use of the Disease-Activity Score in the Analysis of Clinical-Trials in Rheumatoid-Arthritis. Br J Rheumatol. 1993, 20 (11): 1863-1866.
Metadata
Title
Establishing a composite endpoint for measuring the effectiveness of geriatric interventions based on older persons’ and informal caregivers’ preference weights: a vignette study
Authors
Cynthia S Hofman
Peter Makai
Han Boter
Bianca M Buurman
Anton JM de Craen
Marcel GM Olde Rikkert
Rogier ART Donders
René JF Melis
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2014
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/1471-2318-14-51

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