CORRELATION OF THE DISEASE-SPECIFIC CSS/NYHA CLASSIFICATION WITH GENERIC HEALTH-RELATED QUALITY OF LIFE IN CORONARY ARTERY DISEASE PATIENTS
Author(s)
Lavikainen P1, Hartikainen J1, Miettinen H1, Viljakainen M1, Martikainen JA2, Tolppanen A2, Roine R2
1Kuopio University Hospital, Kuopio, Finland, 2University of Eastern Finland, Kuopio, Finland
OBJECTIVES: The importance of both disease-specific, as well as generic, patient-reported outcomes is increasingly emphasized when evaluating the effectiveness of treatments. In heart disease patients the CSS/NYHA – classification is widely used to describe the most common symptoms of disease. However, as a disease-specific measure it mostly provides information related to the function of the heart and thus does not cover the overall subjective health effect of treatment. We studied how well the observed change in the CSS/NYHA score correlates with generic health-related quality of life (HRQoL) in coronary artery disease (CAD) patients during a one-year follow-up. METHODS: Patients entering for treatment of suspected CAD in the Kuopio University Hospital have, since June 2015, been asked to fill in the CSS/NYHA questionnaire and the 15D HRQoL questionnaire at baseline and one year after entering treatment. The change in the CSS/NYHA score from baseline to one year (on a scale of 1 to 5, with 1 indicating deterioration and 5 improvement) was compared with the change in the 15D score classified into 5 categories based on the reported minimal important difference for the instrument. RESULTS: In 140 coronary artery bypass grafting (CABG) patients the correlation between the observed change in the instruments was 0.332 (p<0.001), in 226 percutaneous coronary intervention (PCI) patients 0.429 (p<0.001), and in 289 medically treated patients 0.310 (p<0.001). CONCLUSIONS: Although being statistically significant, the correlation between the change in the CSS/NYHA score, estimated by the patient, and the patient-reported HRQoL, was only moderate. This indicates that the symptom-based evaluation of the change in the health state of a patient does not always appear to catch the full benefit or harm of treatment. Both disease-specific and generic subjective measures of treatment outcome are warranted to more comprehensively capture the full effect of treatment.
Conference/Value in Health Info
2018-11, ISPOR Europe 2018, Barcelona, Spain
Value in Health, Vol. 21, S3 (October 2018)
Code
PCV156
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Cardiovascular Disorders