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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2003

Open Access 01-12-2003 | Research

The development and preliminary validation of a Preference-Based Stroke Index (PBSI)

Authors: Lise Poissant, Nancy E Mayo, Sharon Wood-Dauphinee, Ann E Clarke

Published in: Health and Quality of Life Outcomes | Issue 1/2003

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Abstract

Background

Health-related quality of life (HRQL) is a key issue in disabling conditions like stroke. Unfortunately, HRQL is often difficult to quantify in a comprehensive measure that can be used in cost analyses. Preference-based HRQL measures meet this challenge. To date, there are no existing preference-based HRQL measure for stroke that could be used as an outcome in clinical and economic studies of stroke. The aim of this study was to develop the first stroke-specific health index, the Preference-based Stroke Index (PBSI).

Methods

The PBSI includes 10 items; walking, climbing stairs, physical activities/sports, recreational activities, work, driving, speech, memory, coping and self-esteem. Each item has a 3-point response scale. Items known to be impacted by a stroke were selected. Scaling properties and preference-weights obtained from individuals with stroke and their caregivers were used to develop a cumulative score.

Results

Compared to the EQ-5D, the PBSI showed no ceiling effect in a high-functioning stroke population. Moderately high correlations were found between the physical function (r = 0.78), vitality (r = 0.67), social functioning (r = 0.64) scales of the SF-36 and the PBSI. The lowest correlation was with the role emotional scale of the SF-36 (r = 0.32). Our results indicated that the PBSI can differentiate patients by severity of stroke (p < 0.05) and level of functional independence (p < 0.0001).

Conclusions

Content validity and preliminary evidence of construct validity has been demonstrated. Further work is needed to develop a multiattribute utility function to gather information on psychometric properties of the PBSI.
Appendix
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Literature
1.
Patrick DL, Deyo RA: Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989, 27: S217-S232.PubMedCrossRef
2.
Rubenstein LV: Quality of life for patients: diagnosis or screening, or to evaluate treatment. Quality of Life and Pharmacoeconomics in Clinical trials. Lippincott-Raven 1996, 363–373.
3.
Whiteneck GG: Measuring what matters: key rehabilitation outcomes. Arch Phys Med Rehabil 1994, 75: 1073–1076.PubMedCrossRef
4.
Nunes JF: Economic evaluation of rehabilitation: The quality of life approach using EuroQol. Int Adv Econ Res 1998, 4: 192–201.CrossRef
5.
Ware JE Jr, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30: 473–483.PubMedCrossRef
6.
Duncan PW, Wallace D, Lai SM, et al.: The Stroke Impact Scale Version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke 1999, 30: 2131–2140.PubMedCrossRef
7.
Saladin LK: Measuring quality of life post-stroke. Neur Rep 2000, 24: 133–139.CrossRef
8.
Duncan PW, Horner RD, Reker DA, et al.: Adherence to postacute rehabilitation guidelines is associated with functional recovery in stroke. Stroke 2002, 33: 167–177. 10.1161/hs0102.101014PubMedCrossRef
9.
Dorman PJ, Slattery J, Farrell B, et al.: A randomised comparison of the EuroQol and Short Form-36 after stroke. Br Med J 1997, 23: 461.CrossRef
10.
Dorman PJ, Waddell F, Slattery J, et al.: Is the EuroQol a valid measure of health-related quality of life after stroke? Stroke 1997, 28: 1876–1882.PubMedCrossRef
11.
Dorman PJ, Dennis M, Sandercock P: How do scores on the EuroQol relate to scores on the SF-36 after stroke? Stroke 1999, 30: 2146–2151.PubMedCrossRef
12.
Cella DF: Quality of Life: Concepts and definition. J PainSymptom Manage 1994, 9: 186–192.CrossRef
13.
Torrance GW, Furlong W, Feeny D, et al.: Multi-attribute preference functions – Health Utilities Index. PharmaEcon 1995, 7: 503–520.CrossRef
14.
Boyle MH, Furlong W, Feeny D, et al.: Reliability of the Health Utilities Index – Mark III used in the 1991 cycle 6 Canadian general social survey health questionnaire. Qual Life Res 1995, 4: 249–257.PubMedCrossRef
15.
EuroQol Group: EuroQol – a new facility for the measurement of health-related quality of life. Health Pol 1990, 16: 199–208.CrossRef
16.
Kind P: The EuroQol Instrument: An index of health-related quality of life. Quality of Life and Pharmacoeconomics in Clinical trials. Lippincott-Raven 1996, 191–201.
17.
Kaplan RM, Bush JW, Berry CC: Health status: Types of validity and the index of well-being. Health Serv Res 1976, 11: 478–507.PubMedCentralPubMed
18.
Brazier J, Jones N, Kind P: Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Qual Life Res 1993, 2: 169–180.PubMedCrossRef
19.
Dorman P, Slattery J, Farrell B, et al.: Qualitative comparison of the reliability of health status assessments with the EuroQol and SF-36 questionnaires after stroke. Stroke 1998, 29: 63–68.PubMedCrossRef
20.
Dorman PJ, Waddell F, Slattery J, et al.: Are proxy assessments of health status after stroke with the EuroQol questionnaire feasible, accurate, and unbiased? Stroke 1997, 28: 1883–1887.PubMedCrossRef
21.
Grootendorst P, Feeny D, Furlong W: Health Utilities Index Mark 3: evidence of construct validity for stroke and arthritis in a population health survey. Med Care 2000, 38: 290–299. 10.1097/00005650-200003000-00006PubMedCrossRef
22.
Mathias SD, Bates MM, Pasta DJ, et al.: Use of the Health Utilities Index with stroke patients and their caregivers. Stroke 1997, 28: 1888–1893.PubMedCrossRef
23.
ICIDH-2: International Classification of Functioning and Disability. Beta-2 draft 1999.
24.
Pedersen PM, Jorgensen HS, Nakayama H, et al.: Aphasia in acute stroke: Incidence, determinants and recovery. Ann Neur 1995, 38: 659–666.CrossRef
25.
Kotila M, Waltimo O, Niemi ML, et al.: The profile of recovery from stroke and factors influencing outcome. Stroke 1984, 15: 1039–1044.PubMedCrossRef
26.
Pohjasvaara T, Erkinjuntti T, Vataja R, et al.: Dementia three months after stroke. Baseline frequency and effect of different definitions of dementia in the helsinki stroke aging memory study (SAM) cohort. Stroke 1997, 28: 785–792.PubMedCrossRef
27.
Anderson CS, Linto J, Stewart-Wynne EG: A population-based assessment of the impact and burden of caregiving for long-term stroke survivors. Stroke 1995, 26: 843–849.PubMedCrossRef
28.
Revicki DA, Leidy NK, Brennan-Diemer F, et al.: Integrating patient preferences into health outcomes assessment. Chest 1998, 114: 998–1007.PubMedCrossRef
29.
Revicki DA, Leidy NK, Brennan-Diemer F, et al.: Development and preliminary validation of the multiattribute Rhinitis Symptom Utility Index. Qual Life Res 1998, 7: 693–702. 10.1023/A:1008860113818PubMedCrossRef
30.
Mayo NE: Hospitalization and case-fatality rates for stroke in Canada from 1982 through 1991. The Canadian collaborative study group of stroke hospitalizations. Stroke 1996, 27: 1215–1220.PubMedCrossRef
31.
Mayo NE, Wood-Dauphinee S, Ahmed S, et al.: Disablement following stroke. Disabil Rehabil 1999, 21: 258–268. 10.1080/096382899297684PubMedCrossRef
32.
Mahoney FI, Barthel DW: Functional evaluation: The Barthel lndex. Maryland Med J 1965, 14: 61–65.PubMed
33.
McDowell I, Newell C: Measuring health: A guide to rating scales and Questionnaires. 1996.
34.
Wood-Dauphinee S, Williams JI: Reintegration to Normal Living as a proxy to quality of life. J Chronic Dis 1987, 40: 491–502.PubMedCrossRef
35.
Folstein MF, Folstein SE, McHugh PR: "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12: 189–198. 10.1016/0022-3956(75)90026-6PubMedCrossRef
36.
Fleiss JL: Statistical methods for rates and proportions. New York: Wiley 1981.
37.
Juniper EF, Guyatt GH, Streiner DL, et al.: Clinical impact versus factor analysis for quality of life questionnaire construction. J Clin Epid 1997, 50: 233–238. 10.1016/S0895-4356(96)00377-0CrossRef
38.
Langley GB, Shephard H: The visual analogue scale: Its use in pain measurement. Rheumatol Int 1985, 5: 145–148.PubMedCrossRef
39.
Nunnally J: Psychometric Theory. New York: McGraw-Hill 1978.
40.
Likert R: A technique for the measurement of attitudes. Arch Psy 1932, 140: 5–55.
41.
Mayo NE, Wood-Dauphinee S, Côté R, et al.: There's no place like home: An evaluation of early supported discharge for stroke. Stroke 2000, 31: 1016–1023.PubMedCrossRef
42.
Dolan P: Modelling valuations for health states: The effect of duration. Health Pol 1996, 38: 189–203. 10.1016/0168-8510(96)00853-6CrossRef
43.
Jorgensen HS, Nakayama H, Raaschou HO, et al.: Outcome and time course of recovery in stroke. Part II: Time course of recovery:The Copenhagen stroke study. Arch Phys Med Rehabil 1995, 76: 406–412.PubMedCrossRef
44.
Côté R, Battista RN, Wolfson C, et al.: The Canadian Neurological Scale: validation and reliability assessment. Neuro 1989, 39: 638–643.CrossRef
45.
Roy CW, Togneri J, Hay E, et al.: An inter-rater reliability study of the Barthel Index. Int J Rehabil Res 1988, 11: 67–70.CrossRef
46.
Desmond DW, Moroney JT, Sano M, et al.: Recovery of cognitive function after stroke. Stroke 1996, 27: 1798–1803.PubMedCrossRef
47.
Pohjasvaara T, Erkinjuntti T, Vataja R, et al.: Comparison of stroke features and disability in daily life in patients with ischemic stroke aged 55 to 70 and 71 to 85 years. Stroke 1997, 28: 729–735.PubMedCrossRef
48.
Montgomery H, Persson LO, Ryden A: Importance and attainment of life values among disabled and non-disabled people. Scand J Rehabil Med 1996, 28: 233–240.PubMed
49.
Fryback DG, Lawrence WF, Martin PA, et al.: Predicting quality of well-being scores form the SF-36: Results from the Beaver Dam Health Outcomes Study. Med Dec Making 1997, 17: 1–9.CrossRef
50.
Hobart JC, Williams LS, Moran K, et al.: Quality of life measurement after stroke: uses and abuses of the SF-36. Stroke 2002, 33: 1348–1356. 10.1161/01.STR.0000015030.59594.B3PubMedCrossRef
51.
Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D: Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark2. Pharmacoeconomics 1999, 15: 141–155.PubMedCrossRef
52.
Ruta DA, Garratt AM, Leng M, et al.: A new approach to the measurement of quality of life. The Patient-Generated Index. Med Care 1994, 32: 1109–1126.PubMedCrossRef
53.
Williams LS, Weinberger M, Harris LE, et al.: Development of a stroke-specific quality of life scale. Stroke 1999, 30: 1362–1369.PubMedCrossRef
54.
Wolfe F, Hawley DJ: Measurement of the quality of life in rheumatic disorders using the EuroQol. Bri J Rheumatol 1997, 36: 786–793. 10.1093/rheumatology/36.7.786CrossRef
55.
Fransen M, Edmonds J: Reliability and validity of the EuroQol in patients with osteoarthritis of the knee. Rheumatol (Oxford) 1999, 38: 807–813. 10.1093/rheumatology/38.9.807CrossRef
56.
Duncan PW, Samsa GP, Weinberger M, et al.: Health status of individuals with mild stroke. Stroke 1997, 28: 740–745.PubMedCrossRef
57.
Shin AY, Porter PJ, Wallace MC, et al.: Quality of life of stroke in younger individuals. Utility assessment in patients with arteriovenous malformations. Stroke 1997, 28: 2395–2399.PubMedCrossRef
58.
Samsa GP, Matchar DB, Goldstein L, et al.: Utilities for major stroke: Results from a survey of preferences among persons at increased risk for stroke. Am Heart J 1980, 136: 1703–713.
59.
Gage BF, Cardinalli AB, Owens DK: The effect of stroke and stroke prophylaxis with aspirin or warfarin on quality of life. Arch Int Med 1996, 156: 1829–1836. 10.1001/archinte.156.16.1829CrossRef
60.
Post PN, Stiggelbout AM, Wakker PP: The utility of health states after stroke – A systematic review of the literature. Stroke 2001, 32: 1425–1429.PubMedCrossRef
61.
62.
Kaplan RM, Ganiats T, Sieber W, et al.: The Quality of Well-Being scale: critical similarities and differences with SF-36. Int J Qual Health Care 1998, 10: 509–520. 10.1093/intqhc/10.6.509PubMedCrossRef
Metadata
Title
The development and preliminary validation of a Preference-Based Stroke Index (PBSI)
Authors
Lise Poissant
Nancy E Mayo
Sharon Wood-Dauphinee
Ann E Clarke
Publication date
01-12-2003
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2003
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-1-43

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