Hofman Cynthia S, Makai Peter, Boter Han, Buurman Bianca M, de Craen Anton J M, Olde Rikkert Marcel G M, Donders Rogier A R T, Melis René J F
Department of Geriatric Medicine (HP 925), Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Netherlands.
BMC Geriatr. 2014 Apr 18;14:51. doi: 10.1186/1471-2318-14-51.
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.
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).
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).
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.
老年人与非正式照料者调查最小数据集（TOPICS - MDS）问卷用于测量老年人的相关结局，已成功纳入荷兰国家老年护理计划的60多个研究项目中。该工具的综合终点（CEP）有助于比较各个干预项目的效果。因此，我们的目标是根据老年人和非正式照料者的偏好，为TOPICS - MDS问卷建立一个CEP。
对200人（124名老年人和76名非正式照料者）作为评分者进行了一项 vignette 研究。vignettes 描述了老年人的八项TOPICS - MDS结局（发病率、功能限制、情绪健康、疼痛体验、认知功能、社会功能、自我感知健康和自我感知生活质量），评分者在数字评分量表（0 - 10）上评估这些 vignette 案例的总体幸福感（GWB）。使用混合线性回归分析得出TOPICS - MDS结局的偏好权重（因变量：GWB分数；固定因素：八项结局；非标准化系数：偏好权重）。
结合八项结局的混合回归模型显示，权重从社会功能的0.01到自我感知健康的0.16不等。包含“非正式照料者”的模型显示，该变量与八项结局中每一项之间的交互作用不显著（p > 0.05）。
基于老年人和非正式照料者的偏好，为TOPICS - MDS问卷建立了一个偏好加权的CEP。利用这个CEP，可以实现对老年人干预效果的最佳比较。
