Development of a self-reporting tool to obtain a Combined Index of Severity of Fibrom

[leelaplay]

Bernice A. Melsky posted this to co-cure Jan 11

(if: for some reason I find this study a bit ominous. I hope I'm wrong and mis-reading and/or mis-inferring. I haven't read the whole thing - just the abstract here. a) I'm not sure I agree that a self-reporting tool should make up for inadequacies of the clinical setting. b) the 'assessment' sounds subjective dressed-up as objective, c) they say the 'Emotional Factor" explains 33.7% of variance !? d) "statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs." !? e) "The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a self-assessment questionnaire based on elements from well known tests." !? I wonder what happens when one picks and chooses elements from different tests?

Cliches float to my mind. mutton dressed up as lamb, massage the data, ........................ Wish I had a science-background and could read the whole thing. I would like to be wrong in my fears about what this is.

[B]Development of a self-reporting tool to obtain a Combined Index of Severity of Fibromyalgia (ICAF).[/B]

Health Qual Life Outcomes. 2010 Jan 7;8(1):2. [Epub ahead of print]

Vallejo MA, Rivera J, Esteve-Vives J, Icaf G.

PMID: 20055985


ABSTRACT:
BACKGROUND: Fibromyalgia is a syndrome with heterogeneous symptoms. The evaluation in the clinical setting usually fails to cover the complexity of the syndrome. This study aims to determine how different aspects of fibromyalgia are inter-related when measured by means of a self-reporting tool. The objective is to develop a more complete evaluation model adjusted to the complexity and multi-dimensional nature of the syndrome.

METHODS: Application was made of the Fibromyalgia Impact Questionnaire, the Hospital Anxiety and Depression Scale, the Brief Pain Inventory, the Fatigue Assessment Scale, the Health Assessment Questionnaire, the General Health Questionnaire (GHQ-28), the Chronic Pain Coping Inventory, the Arthritis Self-efficacy Scale and the Sleep Quality Scale. An assessment was made, on the basis of clinical interviews, case histories and specific tests, of the patient sociodemographic data, comorbidity, physical exploration and other clinical indexes. An exploratory factor analysis was made, with comparisons of the clinical index scores in extreme groups of patients.

RESULTS: The ICAF composed of 59 items was obtained, offering four factors that explain 64% of the variance, and referred to as Emotional Factor (33.7%), Physical-Activity (15%), Active Coping (9%) and Passive Coping (6.3%). A t-test between the extreme scores of these factors in the 301 patients revealed statistically significant differences in occupational status, medically unexplained syndromes, number of tender points, the six-minutes walk test, comorbidity and health care costs.

CONCLUSIONS: This study offers a tool allowing more complete and rapid evaluation of patients with fibromyalgia. The test intrinsically evaluates the emotional aspects: anxiety and depression, and their impact upon social aspects. It also evaluates patient functional capacity, fatigue, sleep quality, pain, and the way in which the patient copes with the disease. This is achieved by means of a self-assessment questionnaire based on elements from well known tests.

 

[JT1024]

It seems like there are so many different tools used to measure the impact of illnesses and for this reason, it is difficult to compare one illness against another.

I used to work for a healthcare software vendor and one client wanted to include the SF-36 to be able to measure patient outcomes. See excerpts from three different websites below. The first is from RAND, the originators of the tool.


http://www.rand.org/health/surveys_tools/mos/mos_core_36item.html

Medical Outcomes Study: 36-Item Short Form Survey

As part of the Medical Outcomes Study (MOS) a multi-year, multi-site study to explain variations in patient outcomes RAND developed the 36-Item Short Form Health Survey (SF-36). SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting and are now widely utilized by managed care organizations and by Medicare for routine monitoring and assessment of care outcomes in adult patients.

From Wikipedia:

The Short Form (36) Health Survey is a survey of patient health. The SF-36 is commonly used in health economics as a variable in the quality-adjusted life year calculation to determine the cost-effectiveness of a health treatment. The original SF-36 came out from the Medical Outcome Study, MOS, done by the RAND Corporation. Since then a group of researchers from the original study went ahead and released a commercial version of SF-36 while the original SF-36 is available in public domain license free from RAND.

The SF-36 and RAND-36 include the same set of items that were developed in the Medical Outcomes Study. Scoring of the general health and pain scales is different, however. The differences in scoring are summarized by Hays, Sherbourne, and Mazel (Health Economics, 2: 217-227, 1993)
[edit]Scoring

[1] The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight.
The eight sections are:

• vitality
• physical functioning
• bodily pain
• general health perceptions
• physical role functioning
• emotional role functioning
• social role functioning
• mental health

From an MS website:

Health Status Questionnaire (SF-36)

The Short Form-36 was derived from the General Health Survey of the Medical Outcomes Study by Stewart and colleagues (1988). It is one of the most widely used generic measures of health-related quality of life and has been shown to discriminate between subjects with different chronic conditions and between subjects with different severity levels of the same disease. The SF-36 has also demonstrated sensitivity to significant treatment effects in a variety of patient populations. Population-based normative data on the SF-36 is available for the United States and some other countries as well.

Hope this is worthwhile!