TY - JOUR
T1 - Changes in quality of life after elective surgery
T2 - an observational study comparing two measures
AU - Kronzer, Vanessa L.
AU - Jerry, Michelle R.
AU - Ben Abdallah, Arbi
AU - Wildes, Troy S.
AU - McKinnon, Sherry L.
AU - Sharma, Anshuman
AU - Avidan, Michael S.
N1 - Funding Information:
VLK was supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) [Grant UL1TR000448, subaward TL1TR000449]. MSA was supported by the National Institute on Aging [Grant 1UH2AG050312-01] and the Barnes Jewish Hospital Foundation [Grant BJHF#7937-77]. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH. The funding sources provided infrastructure and financial support but had no role in the design or conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.
Publisher Copyright:
© 2017, Springer International Publishing Switzerland.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Purpose: Our main objective was to compare the change in a validated quality of life measure to a global assessment measure. The secondary objectives were to estimate the minimum clinically important difference (MCID) and to describe the change in quality of life by surgical specialty. Methods: This prospective cohort study included 7902 adult patients undergoing elective surgery. Changes in the Veterans RAND 12-Item Health Survey (VR-12), composed of a physical component summary (PCS) and a mental component summary (MCS), were calculated using preoperative and postoperative questionnaires. The latter also contained a global assessment question for quality of life. We compared PCS and MCS to the global assessment using descriptive statistics and weighted kappa. MCID was calculated using an anchor-based approach. Analyses were pre-specified and registered (NCT02771964). Results: By the change in VR-12 scores, an equal proportion of patients experienced improvement and deterioration in quality of life (28% for PCS, 25% for MCS). In contrast, by the global assessment measure, 61% reported improvement, while only 10% reported deterioration. Agreement with the global assessment was slight for both PCS (kappa = 0.20, 57% matched) and MCS (kappa = 0.10, 54% matched). The MCID for the overall VR-12 score was approximately 2.5 points. Patients undergoing orthopedic surgery showed the most improvement in quality of life measures, while patients undergoing gastrointestinal/hepatobiliary or urologic surgery showed the most deterioration. Conclusions: Subjective global quality of life report does not agree well with a validated quality of life instrument, perhaps due to patient over-optimism.
AB - Purpose: Our main objective was to compare the change in a validated quality of life measure to a global assessment measure. The secondary objectives were to estimate the minimum clinically important difference (MCID) and to describe the change in quality of life by surgical specialty. Methods: This prospective cohort study included 7902 adult patients undergoing elective surgery. Changes in the Veterans RAND 12-Item Health Survey (VR-12), composed of a physical component summary (PCS) and a mental component summary (MCS), were calculated using preoperative and postoperative questionnaires. The latter also contained a global assessment question for quality of life. We compared PCS and MCS to the global assessment using descriptive statistics and weighted kappa. MCID was calculated using an anchor-based approach. Analyses were pre-specified and registered (NCT02771964). Results: By the change in VR-12 scores, an equal proportion of patients experienced improvement and deterioration in quality of life (28% for PCS, 25% for MCS). In contrast, by the global assessment measure, 61% reported improvement, while only 10% reported deterioration. Agreement with the global assessment was slight for both PCS (kappa = 0.20, 57% matched) and MCS (kappa = 0.10, 54% matched). The MCID for the overall VR-12 score was approximately 2.5 points. Patients undergoing orthopedic surgery showed the most improvement in quality of life measures, while patients undergoing gastrointestinal/hepatobiliary or urologic surgery showed the most deterioration. Conclusions: Subjective global quality of life report does not agree well with a validated quality of life instrument, perhaps due to patient over-optimism.
KW - Elective surgical procedures
KW - Minimum clinically important difference (MCID)
KW - Outcome assessment
KW - Patient-reported outcomes
KW - Quality of life
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U2 - 10.1007/s11136-017-1560-2
DO - 10.1007/s11136-017-1560-2
M3 - Article
C2 - 28357679
AN - SCOPUS:85016438907
SN - 0962-9343
VL - 26
SP - 2093
EP - 2102
JO - Quality of Life Research
JF - Quality of Life Research
IS - 8
ER -