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- Does Aortic Valve replacement surgery improve patients' Quality of Life?Publication . Coelho, Pedro; Ferreira, Lara; Vital, Clara; Fragata, JoséIntroduction: Aortic valve replacement surgery is done to increase patients' life expectancy and improve their health-related quality of life. Several published studies have found improvement in health-related quality of life after this procedure, but none have involved patients in Portugal. This study sought to evaluate patients' health-related quality of life after the implantation of aortic prostheses and compare these values with preoperative health-related quality of life and the general Portuguese population's health-related quality of life. Material and Methods: A retrospective study was done with elective patients who underwent implantation of an aortic prosthesis between August 2011 and April 2016. Health-related quality of life was evaluated using the Short Form 36 Health Survey and Short Form 6 Health Survey questionnaires in the preoperative period and 3, 6 and 12 months post-surgery. Descriptive and inferential analyses were conducted to process the data and compare preoperative health-related quality of life with postoperative values and the Portuguese population's norms. Results: The sample included 506 patients with an average age of 70.6 years. The majority are male (53.6%). The postoperative results show a statistically significant improvement compared to preoperative health-related quality of life in all eight dimensions of the Short Form 36 Health Survey. When contrasted with the general Portuguese population, patients' health-related quality of life is lower in the preoperative period, improving postoperatively and reaching higher than average health-related quality of life levels in some subgroups of patients and in various dimensions. An analysis of the Short Form 6 Health Survey results revealed that the patients undergoing this surgery have a higher level of preoperative problems compared with the general population, but these patients' values approach those of the general population by the end of one year post-surgery. Discussion: This is the first study in Portugal that compares health-related quality of life using a validated scale, before and after the aortic prosthesis implantation surgery. The results demonstrate a significant improvement in all dimensions, which is not consistently observed in other published studies. Conclusion: The results confirm that the implantation of aortic prostheses improves patients' health-related quality of life, over time bringing it close to the general population's levels.
- Health-related quality of life in patients with Rheumatoid ArthritisPublication . Ferreira, Lara; Ferreira, Pedro Lopes; Baleiro, RitaObjectives: Rheumatoid arthritis (RA) is a chronic rheumatic disease of unknown aetiology and greater incidence among the elderly. It can lead to serious consequences regarding functional limitations and patient's ability to work. The purpose of this study was to assess the health-related quality of life in patients with RA. Methods: Portuguese version of SF-6D and Portuguese translations of EQ-5D and AIMS2-SF were self-administered in a postal survey to a representative sample of the Portuguese population with RA. Data concerning the patients' characteristics and the stage of the disease were also collected. Results: The majority of the patients presented minor problems in some of the instruments' dimensions. In a scale from 0.30 to 1.00, the average utility score was 0.77. The lowest utility scores were reported by women, those who were divorced or separated, individuals with lower educational levels, who had lower incomes, were recently diagnosed and those who were not taking new biological therapies. Apart from these, patients who had a more severe RA and co-morbidity also report lower utility scores. Conclusions: The preference-based utility measures used in this study adequately discriminate across different RA severity and socio-demographic background. Assuming that these values represent the patients' preferences and the utility associated with their health state, the results presented in this paper may be used as an approximation to normative values for the SF-6D in economic evaluation studies as well as in clinical studies.
- Comparing the performance of the SF-6D and the EQ-5D in different patient groupsPublication . Ferreira, Lara N.; Ferreira, Pedro L.; Pereira, Luis N.Introduction: This research aims to explore the performance of the SF-6D and the EQ-5D in patients suffering from asthma, chronic obstructive pulmonary disease, cataracts, and rheumatoid arthritis. In particular, the aim of this research is twofold: 1) to study the level of agreement between the indexes and the descriptive systems of the dimensions of the SF-6D and the EQ-5D, and 2) to analyze the discriminative ability of the instruments. Material and Methods: A sample of 643 patients completed both the SF-36v2 and the EQ-5D. The discriminative ability of the instruments was analyzed. Furthermore, the level of agreement between the indexes and the descriptive systems of the dimensions of the SF-6D and the EQ-5D were studied. The level of agreement between instruments was investigated using correlation coefficients and the Bland-Altman plots, while the influence of medical condition and other socio-demographic variables was analyzed using non-parametric tests. Paired-samples tests were used to identify differences between the scores. Results and Discussion: The results show a strong correlation and agreement between both indexes. Overall, questionnaire indexes differ by medical condition and socio-demographic groups and both instruments are able to discriminate between socio-demographic groups. Conclusion: This study confirmed the hypothesis that the SF-6D generates higher utility values in less healthy individuals. The SF-6D and the EQ-5D seem to perform differently in each of the diseases studied since the descriptive statistics differ between instruments and the level of correlation is not uniform. Results show that the instruments generate different utility values, but there is a strong agreement between both indexes. Thus, the two instruments are not interchangeable and their results cannot be directly comparable.