3.3.3 Measuring Quality of Life (QoL)

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来自 University of Minnesota 的课程

Medical Technology and Evaluation

135 个评分

University of Minnesota

Medical Technology and Evaluation

135 个评分

课程 4（共 5 门，Specialization 医疗市场）

Innovations in medical technologies are one of the leading areas of economic growth in the world. Whether new technologies take the form of pharmaceutical, medical device, biotechnology, information technology of some combination of these innovations, the opportunities for both private enterprise and social welfare are substantial. However, these innovations are not without cost, and require reimbursement from either a privately or publicly financed health care delivery system to enter the marketplace. This course aims to provide knowledge of the concepts, data, and methodology required to critically evaluate new medical technologies in order to secure financial investment, reimbursement, and regulatory compliance objectives, such as FDA approval. The course is designed to provide understanding of the analytic tools needed to evaluate medical technologies. After completing this course, students will have the skills needed to: - Understand the reimbursement systems financing medical technology use. - Understand the role of government and regulatory agencies in the development and use of new medical technologies. - Identify a population to be served by a medical technology. - Use health care data to evaluate a medical technology. - Perform cost/benefit and cost/effectiveness analysis of a new technology.

从本节课中

The Elements of Medical Technology Assessments

In this module we will discuss a variety of types of medical technology evaluation approaches and the types of assessments. We will go into detail about the pros and cons of each type of assessment as a way to illustrate situations where one approach may be better than another. Finally, we will also cover the details of the two fundamental features of any evaluation: measuring costs and benefits.

3.3.1 Benefits6:35

3.3.2 Quality Adjusted Life Years (QALYs)5:53

3.3.3 Measuring Quality of Life (QoL)5:11

与讲师见面

Eric Barrette
Director of Research
Health Care Cost Institute

This is lesson 3.3.3, Measuring Quality of Life.

In the previous lesson, if you recall we discussed QALYs, or

quality-adjusted life years, which are calculated using quality of life measures.

In this lesson, we discuss how to calculate those quality of life measures.

In order to calculate QALYS we first need to identify a patient's utility

in each health state.

The health state can be thought of as the health of an individual

at a particular point in time.

And the health-related quality of life measures are used to help define each

health state.

Large surveys of the views, attitudes, and preferences of patients and

the general public are used to assign utilities to every health state.

The typical dimensions or aspects of health related quality of

life measures include, health perceptions, social function,

psychological function, physical function, and measures of impairment.

Health perceptions are simply self reported health statuses.

Social function relates to how patients or individuals relate in society.

It includes social relations, their usual social role,

intimacy, sexual function, as well as communications in speech.

Psychological functions are related to their cognitive ability,

their emotional levels, and their moods and feelings.

Physical functions are what many people typically think of

when talking about health-related quality of life measures and

these include measures of mobility, physical activity, and self care.

Impairment is another common topic of health related quality of life

measures and that involves sensory or function loss, the types of symptoms or

impairments related with the disease, and levels of pain.

Measures of all of these health related quality of life

aspects can be ascertained through survey instruments.

General surveys, such as the Short Form Health Surveys that are commonly referred

to as the SF-36 or SF-12 because they have 36 or 12 questions

are common surveys to collect general health related quality of life measures.

Additionally, computer programs exist to convert scores from these two types of

surveys into scores from the SF-6D questionnaire.

Which can then be directly translated into the utilities needed

to calculate qualities.

There are also many types of disease specific quality of life surveys.

Unlike the general surveys, these surveys are designed for

particular diseases or conditions.

And although they're given to patients with these diseases and conditions,

they're also given to the general public to help determine the quality of life and

utilities that are needed to estimate the qualities.

The disease specific surveys are very specific and

often intended to estimate particular treatment effects.

They can also be sensitive to small changes in the disease or

the status of a condition.

The benefits of these types of surveys, however,

are that clinicians can link outcomes to specific actions or treatments.

Another way to collect quality of life information,

is to collect it during a clinical trial.

If quality of life information is to be collected during the clinical trial,

it needs to be considered before the clinical trial begins and

built into the trial design.

If it is, you can include a measurement of the quality of life survey

to find out how many qualities each treatment in a clinical trial produces.

During the trial, you have patients fill out the survey prior to the treatment and

after they receive the treatment.

Alternatively, you could have them fill out multiple surveys at

various points throughout the treatment before and after.

Using the results of these surveys you can convert the Health Related Quality of Life

measurements from the survey to QALYs.

After that you can evaluate the clinical trial directly with QALYs.

So with a QALY for each individual in the trial, you can measure the QALYs

gained on average as a result of a particular treatment and

perform other types of statistical testing using QALYs to help evaluate

the success of the clinical trial that was performed.

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