Health-related quality-of-life and health-utility reporting in critical care

查看全文 作　　者：Vincent Issac [1]Lau;Jeffrey A [2]Johnson;Sean M [1]Bagshaw;Oleksa G [1]Rewa;John [3]Basmaji;Kimberley A [4]Lewis;M Elizabeth [5]Wilcox;Kali [5]Barrett;Francois [6]Lamontagne;Francois [7]Lauzier;Niall D [8]Ferguson;Simon J W [9]Oczkowski;Kirsten M [10]Fiest;Daniel J [11]Niven;Henry T [12]Stelfox;Waleed [13]Alhazzani;Margaret [14]Herridge;Robert [15]Fowler;Deborah J [13]Cook;Bram [13]Rochwerg;Feng [16]Xie 机构地区：[1]Department of Critical Care Medicine,University of Alberta,Edmonton T6G 2B7,AB,Canada;[2]School of Public Health,Inst Hlth Econ,University of Alberta,Edmonton T6G 2B7,AB,Canada;[3]Department of Medicine,Division of Critical Care,Western University,London N6A 5W9,Canada;[4]Division of Critical Care,McMaster University,Hamilton L8N 4A6,Canada;[5]Interdepartmental Division of Critical Care,University of Toronto,Toronto M5T 2S8,Canada;[6]Department of Medicine,University Sherbrooke,Sherbrooke J1H 5N4,Canada;[7]Departments of Medicine and Anesthesiology,University Laval,Laval G1V 4G2,Canada;[8]Department Critical Care Medicine,University of Toronto,Toronto M5G 2C4,Canada;[9]Department of Medicine,McMaster Clin,Hamilton Gen Hosp,McMaster University,Hamilton L8N 4A6,Canada;[10]Department of Community Health Sciences&Institute for Public Health,University of Calgary,Calgary T2N 2T9,Canada;[11]Department of Critical Care Medicine,University Calgary,Calgary T2N 2T9,Canada;[12]Department of Community Health Sciences,University of Calgary,Calgary T2N 2T9,Canada;[13]Department of Medicine,McMaster University,Hamilton L8N 4A6,Canada;[14]Indepartmental Division of Critical Care,University Health Network,Toronto M5G 2C4,Canada;[15]Departments of Medicine and Critical Care Medicine,Sunnybrook Health Sciences Center,Institute of Health Policy Management and Evaluation,University of Toronto,Toronto M4N 3M5,Canada;[16]Health Research Methods,Evidence and Impact,McMaster University,Hamilton L8N 3Z5,Canada 出　　处：《World Journal of Critical Care Medicine》索引2022年第11卷第4期,共10页 基　　金：Supported by the EuroQol Research Foundation,No. 299-RA 摘　　要：Mortality is a well-established patient-important outcome in critical care studies.In contrast,morbidity is less uniformly reported(given the myriad of critical care illnesses and complications of each)but may have a common end-impact on a patient’s functional capacity and health-related quality-of-life(HRQoL).Survival with a poor quality-of-life may not be acceptable depending on individual patient values and preferences.Hence,as mortality decreases within critical care,it becomes increasingly important to measure intensive care unit(ICU)survivor HRQoL.HRQoL measurements with a preference-based scoring algorithm can be converted into health utilities on a scale anchored at 0(representing death)and 1(representing full health).They can be combined with survival to calculate quality-adjusted life-years(QALY),which are one of the most widely used methods of combining morbidity and mortality into a composite outcome.Although QALYs have been use for health-technology assessment decision-making,an emerging and novel role would be to inform clinical decision-making for patients,families and healthcare providers about what expected HRQoL may be during and after ICU care.Critical care randomized control trials(RCTs)have not routinely measured or reported HRQoL(until more recently),likely due to incapacity of some patients to participate in patient-reported outcome measures.Further differences in HRQoL measurement tools can lead to non-comparable values.To this end,we propose the validation of a gold-standard HRQoL tool in critical care,specifically the EQ-5D-5L.Both combined health-utility and mortality(disaggregated)and QALYs(aggregated)can be reported,with disaggregation allowing for determination of which components are the main drivers of the QALY outcome.Increased use of HRQoL,health-utility,and QALYs in critical care RCTs has the potential to:(1)Increase the likelihood of finding important effects if they exist;(2)improve research efficiency;and(3)help inform optimal management of critically ill patients allowing for decision-making about their HRQoL,in additional to traditional health-technology assessments. 关 键 词：Critical care health-related quality of life Quality-adjusted life-years Health-utility Mortality MORBIDITY Kaplan-Meier curves