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PROs and cost-effectiveness analysis
health outcomes classifications - ANSWER ✔✔-clinical outcomes
-clinical reported outcomes
-economic outcomes
-patient reported/humanistic outcomes
clinical outcomes examples - ANSWER ✔✔-lab results
-x ray results
,clinical reported outcomes examples - ANSWER ✔✔-MD palpation
during physical examination
-RN reporting a vomiting episode
economic outcomes examples - ANSWER ✔✔-total costs spent on
cancer treatment
-work days lost due to illness
patient reported outcome examples - ANSWER ✔✔-patient reported
symptoms/functions
-health related quality of life
why are PROs important? - ANSWER ✔✔-some treatment effects are
only known to the patient (pain, smoking cessation, anxiety)
-traditional assessments made by clinicians or lab values are not
sufficient to evaluate patient preferences
-patient's perspective may not coincide with objective assessments
how are PROs used? - ANSWER ✔✔they are used to measure
-drug effectiveness
-drug safety
-quality
,-and help with decision making
2 HRQOL instruments - ANSWER ✔✔-general/generic instruments
-disease or condition specific instruments
general or generic HRQOL instruments - ANSWER ✔✔-broadly
applicable to general population
-summarize range of basic domains
-Ex) SF-36, SF-12, SF-8
disease or condition specific HRQOL instruments - ANSWER ✔✔-
relevant to patients with specific disease or condition
-more sensitive to specific disease effects
-Example: asthma quality of life questionnaire (AQLQ)
health state utility - ANSWER ✔✔measures the patient preference of
a specific health state or health outcomes, higher utility scores are
associated with more desirable health states
how are health state utility and HRQOL different? - ANSWER ✔✔-for
HRQOL, the scoring mechanisms differ by the instrument
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, -health safety utility is always scored on a scale of 0 (death) to 1 (perfect
health)
QALY - ANSWER ✔✔-quality adjusted life years
-capture both quality and quantity of life simultaneously
-QALY = additional life years gained x utility of those life years
four different categories of costs - ANSWER ✔✔-direct medical costs
-direct nonmedical costs
-indirect costs
-intangible costs
direct medical mosts - ANSWER ✔✔-medically related inputs used
directly to provide the treatment
-Ex: drug costs, diagnostic tests, physician costs
direct nonmedical costs - ANSWER ✔✔-costs directly associated with
treatment but not medical in nature
-Ex: cost of traveling to the doctor's office
indirect costs - ANSWER ✔✔-costs tha tresult from the loss of
productivity during the illness
-Ex: cost of missing workdays (wage x missed time)