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Health-related quality of life measures in coronary heart disease prevention and treatment

We performed a large (n = 878), multicenter, hospital-based, cross-sectional study to measure the health-related quality of life (HRQOL) of healthy participants treated for dyslipidemia and patients with coronary heart disease (CHD). The HRQOL measures included a nonpreference-based measure (SF-36 Health Survey) and three preference-based measures (Rating Scale (RS), Time Trade-off (TTO) and Standard Gamble (SG)). / The adjusted mean HRQOL, of healthy participants undergoing treatment for dyslipidemia was 2.8 (p = 0.02) and 3.3 (p = 0.02) points lower, when compared to a similar group of participants not being treated for dyslipidemia, on the RS and the SF-36 General Health Perception (GHP) subscale, respectively. These differences were unlikely to be due to confounding by comorbidity, age, gender and body mass index. No significant differences were detected on the TTO and SG scales. / For each preference-based scaling technique, the adjusted HRQOL mean scores obtained from patients diagnosed with angina, myocardial infarction, or angina and myocardial infarction were similar. Patients with congestive heart failure reported the worst HRQOL on all scales. / The test-retest reliability, over a 3 to 6 week period, was acceptable for all scaling techniques and the majority of participants reported consistent scores at the test and the retest assessments. Correlation between the preference-based measures and each of the SF-36 subscales varied from poor to moderate. Compared to the TTO and the SG, the RS was the most highly correlated with the different aspects of the HRQOL measured by the SF-36 Health Survey and had the highest ability to discriminate CHD patients with various physical disabilities and participants reporting specific number of health problems. / This study provides a complete set of preference-based measures for use in cost-effectiveness analysis of CHD primary prevention. It suggests that the impact of detecting and treating dyslipidemia on the participant's HRQOL may be small but significant from a public policy point of view. Further research should be done confirming these results and elucidating the causes and the consequences of this negative effect on HRQOL of healthy individuals treated for dyslipidemia.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.34992
Date January 1998
CreatorsLalonde, Lyne.
ContributorsGrover, Steven A. (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageDoctor of Philosophy (Department of Epidemiology and Biostatistics.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001605576, proquestno: NQ44484, Theses scanned by UMI/ProQuest.

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