Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part B Therapy
Chapter 10.5. Measuring Patients' Experience
Toshi A. Furukawa, Roman Jaeschke, Deborah J. Cook, Gordon Guyatt
For example, in a study of methotrexate for patients with inflammatory bowel disease,39...
Topics Discussed:
arthritis, rheumatoid, chronic obstructive airway disease, diabetes mellitus, health outcomes, health-related quality of life, heart failure, incorporating patient values and preferences, measuring patient experience, patient evaluation, positive and negative syndrome scale, schizophrenia, validity of evidence
Excerpt:
"We have described how investigators often substitute endpoints that
make intuitive sense to them for those that patients value. Clinicians
can recognize these situations by asking themselves the following
question: if the endpoints measured by the investigators
were the only thing that changed, would patients be willing to take
the treatment? In addition to changes in clinical or physiologic
variables, patients would require that they feel better or live
longer. For instance, if a treatment for osteoporosis increased
bone density without preventing back pain, loss of height, or fractures,
patients would not be interested in risking the adverse effects—or
incurring the costs and inconvenience—of treatment.If, when we are trying to discriminate among people at a single
point in time, everyone gets the same score, we will not be able
to tell who is better and who is worse than others—in this
case, who should receive therapy and who should not. The key differences
we are trying to detect—the signal—come from cross-sectional
differences in scores among patients. The bigger these differences
are, the better off we will be...."
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