Hofman Cynthia S, Lutomski Jennifer E, Boter Han, Buurman Bianca M, de Craen Anton J M, Donders Rogier, Olde Rikkert Marcel G M, Makai Peter, Melis René J F
Department of Geriatric Medicine (HP 925), Radboud University Medical Center, Nijmegen, The Netherlands.
Department for Health Evidence (HP133), Radboud University Medical Center, Nijmegen, the Netherlands.
PLoS One. 2017 Mar 15;12(3):e0173081. doi: 10.1371/journal.pone.0173081. eCollection 2017.
Preference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey-Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating interventions in geriatric care as it combines multiple outcomes relevant to older persons in a single metric. The objective of this study was to validate TOPICS-CEP across different study settings (general population, primary care and hospital).
Data were extracted from TOPICS Minimum Dataset (MDS), a pooled public-access national database with information on older persons throughout the Netherlands. Data of 17,603 older persons were used. Meta-correlations were performed between TOPICS-CEP indexed scores, EuroQol5-D utility scores and Cantril's ladder life satisfaction scores. Mixed linear regression analyses were performed to compare TOPICS-CEP indexed scores between known groups, e.g. persons with versus without depression.
In the complete sample and when stratified by study setting TOPICS-CEP and Cantril's ladder were moderately correlated, whereas TOPICS-CEP and EQ-5D were highly correlated. Higher mean TOPICS-CEP scores were found in persons who were: married, lived independently and had an education at university level. Moreover, higher mean TOPICS-CEP scores were found in persons without dementia, depression, and dizziness with falls, respectively. Similar results were found when stratified by subgroup.
This study supports that TOPICS-CEP is a robust measure which can potentially be used in broad settings to identify the effect of intervention or of prevention in elderly care.
偏好加权的多维度终点指标有潜力推动纳入患者偏好的比较效果研究。老年人及非正式照料者调查综合终点指标(TOPICS-CEP)可能是评估老年护理干预措施的一项有价值的结局指标,因为它将与老年人相关的多个结局整合在一个单一指标中。本研究的目的是在不同研究环境(一般人群、初级保健和医院)中验证TOPICS-CEP。
数据从TOPICS最小数据集(MDS)中提取,MDS是一个汇集的可公开访问的国家数据库,包含荷兰各地老年人的信息。使用了17603名老年人的数据。对TOPICS-CEP索引分数、欧洲五维健康量表(EuroQol5-D)效用分数和坎特里尔阶梯式生活满意度分数进行了元相关性分析。进行混合线性回归分析以比较已知组之间的TOPICS-CEP索引分数,例如有抑郁症与无抑郁症的人群。
在完整样本中以及按研究环境分层时,TOPICS-CEP与坎特里尔阶梯式生活满意度分数呈中度相关,而TOPICS-CEP与EQ-5D呈高度相关。在已婚、独立生活且受过大学教育的人群中发现了较高的TOPICS-CEP平均分数。此外,在无痴呆症、无抑郁症以及无跌倒相关头晕的人群中分别发现了较高的TOPICS-CEP平均分数。按亚组分层时也发现了类似结果。
本研究支持TOPICS-CEP是一项可靠的指标,可潜在地用于广泛环境中以确定老年护理中干预或预防的效果。