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  • Title: Specific HRQL instruments and symptom scores were more responsive than preference-based generic instruments in patients with GERD.
    Author: Brozek JL, Guyatt GH, Heels-Ansdell D, Degl'Innocenti A, Armstrong D, Fallone CA, Wiklund I, van Zanten SV, Chiba N, Barkun AN, Akl EA, Schünemann HJ.
    Journal: J Clin Epidemiol; 2009 Jan; 62(1):102-10. PubMed ID: 18619804.
    Abstract:
    OBJECTIVE: To determine relative responsiveness of disease-specific and generic preference-based health-related quality of life instruments in gastroesophageal reflux disease (GERD). STUDY DESIGN AND SETTING: We compared standardized response means (SRM) of disease-specific and preference-based instruments in 217 outpatients with GERD. RESULTS: Quality of Life in Reflux and Dyspepsia and symptom scores were responsive across all domains, whereas global rating of change and Work Productivity and Activity Impairment-GERD only in single domains. The most responsive were Quality of Life in Reflux and Dyspepsia food/drink problems (SRM: 1.90, 95% confidence interval [CI]: 1.76-2.03) and vitality (SRM: 1.68, 95% CI 1.55-1.82) domains, Work Productivity and Activity Impairment-GERD workdays with reflux symptoms (SRM: 2.02, 95% CI 1.84-2.19), symptoms of heartburn (SRM: 1.83, 95% CI 1.69-1.96) and acid reflux (SRM: 1.48, 95% CI 1.35-1.62), and global rating of change in stomach problems (SRM: 2.19, 95% CI 2.05-2.32). The least responsive were Work Productivity and Activity Impairment-GERD domains related to hours absent at work (SRM: 0.22, 95% CI 0.05-0.38), reduced productivity at work (SRM: 0.66, 95% CI 0.48-0.83) and during other activities (SRM: 0.78, 95% CI 0.65-0.92), as well as emotional global rating of change (SRM: 0.72, 95% CI 0.58-0.85), and the standard gamble (SRM: 0.35, 95% CI 0.21-0.48), which was less responsive than the feeling thermometer (SRM: 0.92, 95% CI 0.78-1.05). CONCLUSIONS: In patients with GERD, disease-specific health-related quality of life instruments and symptom scores showed greater responsiveness than preference-based generic instruments. The feeling thermometer proved more responsive than the standard gamble.
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