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The development and preliminary validation of a Preference-Based Stroke Index (PBSI).

Poissant L, Mayo NE, Wood-Dauphinee S, Clarke AE - Health Qual Life Outcomes (2003)

Bottom Line: Moderately high correlations were found between the physical function (r = 0.78), vitality (r = 0.67), social functioning (r = 0.64) scales of the SF-36 and the PBSI.Content validity and preliminary evidence of construct validity has been demonstrated.Further work is needed to develop a multiattribute utility function to gather information on psychometric properties of the PBSI.

View Article: PubMed Central - HTML - PubMed

Affiliation: McGill University, Health Informatics Research Group, 1140 Pine Ave West, Montreal, Quebec, H3A 1A3, Canada. lise.poissant@mcgill.ca

ABSTRACT

Background: Health-related quality of life (HRQL) is a key issue in disabling conditions like stroke. Unfortunately, HRQL is often difficult to quantify in a comprehensive measure that can be used in cost analyses. Preference-based HRQL measures meet this challenge. To date, there are no existing preference-based HRQL measure for stroke that could be used as an outcome in clinical and economic studies of stroke. The aim of this study was to develop the first stroke-specific health index, the Preference-based Stroke Index (PBSI).

Methods: The PBSI includes 10 items; walking, climbing stairs, physical activities/sports, recreational activities, work, driving, speech, memory, coping and self-esteem. Each item has a 3-point response scale. Items known to be impacted by a stroke were selected. Scaling properties and preference-weights obtained from individuals with stroke and their caregivers were used to develop a cumulative score.

Results: Compared to the EQ-5D, the PBSI showed no ceiling effect in a high-functioning stroke population. Moderately high correlations were found between the physical function (r = 0.78), vitality (r = 0.67), social functioning (r = 0.64) scales of the SF-36 and the PBSI. The lowest correlation was with the role emotional scale of the SF-36 (r = 0.32). Our results indicated that the PBSI can differentiate patients by severity of stroke (p < 0.05) and level of functional independence (p < 0.0001).

Conclusions: Content validity and preliminary evidence of construct validity has been demonstrated. Further work is needed to develop a multiattribute utility function to gather information on psychometric properties of the PBSI.

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Related in: MedlinePlus

Distribution of responses (%) on items in the PBSI among a group of community-dwelling stroke survivors (n = 68)
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Figure 2: Distribution of responses (%) on items in the PBSI among a group of community-dwelling stroke survivors (n = 68)

Mentions: The PBSI demonstrated a good capacity to capture different health states. Figures 2 and 3 illustrate the distribution of responses across levels on each item of the PBSI and the EQ-5D respectively. Three items showed poor distribution of responses across levels – speech, memory and self-esteem: rarely did subjects report severe difficulties in these areas. This finding was not surprising considering that these subjects were long-time community-dwelling stroke survivors. However, contrary to the mobility item of the EQ-5D response option '3' (being bedridden), the three mobility items of the PBSI were likely to be scored on each possible level, assuming a more diverse population of stroke survivors in which various severity levels would be captured.


The development and preliminary validation of a Preference-Based Stroke Index (PBSI).

Poissant L, Mayo NE, Wood-Dauphinee S, Clarke AE - Health Qual Life Outcomes (2003)

Distribution of responses (%) on items in the PBSI among a group of community-dwelling stroke survivors (n = 68)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC222917&req=5

Figure 2: Distribution of responses (%) on items in the PBSI among a group of community-dwelling stroke survivors (n = 68)
Mentions: The PBSI demonstrated a good capacity to capture different health states. Figures 2 and 3 illustrate the distribution of responses across levels on each item of the PBSI and the EQ-5D respectively. Three items showed poor distribution of responses across levels – speech, memory and self-esteem: rarely did subjects report severe difficulties in these areas. This finding was not surprising considering that these subjects were long-time community-dwelling stroke survivors. However, contrary to the mobility item of the EQ-5D response option '3' (being bedridden), the three mobility items of the PBSI were likely to be scored on each possible level, assuming a more diverse population of stroke survivors in which various severity levels would be captured.

Bottom Line: Moderately high correlations were found between the physical function (r = 0.78), vitality (r = 0.67), social functioning (r = 0.64) scales of the SF-36 and the PBSI.Content validity and preliminary evidence of construct validity has been demonstrated.Further work is needed to develop a multiattribute utility function to gather information on psychometric properties of the PBSI.

View Article: PubMed Central - HTML - PubMed

Affiliation: McGill University, Health Informatics Research Group, 1140 Pine Ave West, Montreal, Quebec, H3A 1A3, Canada. lise.poissant@mcgill.ca

ABSTRACT

Background: Health-related quality of life (HRQL) is a key issue in disabling conditions like stroke. Unfortunately, HRQL is often difficult to quantify in a comprehensive measure that can be used in cost analyses. Preference-based HRQL measures meet this challenge. To date, there are no existing preference-based HRQL measure for stroke that could be used as an outcome in clinical and economic studies of stroke. The aim of this study was to develop the first stroke-specific health index, the Preference-based Stroke Index (PBSI).

Methods: The PBSI includes 10 items; walking, climbing stairs, physical activities/sports, recreational activities, work, driving, speech, memory, coping and self-esteem. Each item has a 3-point response scale. Items known to be impacted by a stroke were selected. Scaling properties and preference-weights obtained from individuals with stroke and their caregivers were used to develop a cumulative score.

Results: Compared to the EQ-5D, the PBSI showed no ceiling effect in a high-functioning stroke population. Moderately high correlations were found between the physical function (r = 0.78), vitality (r = 0.67), social functioning (r = 0.64) scales of the SF-36 and the PBSI. The lowest correlation was with the role emotional scale of the SF-36 (r = 0.32). Our results indicated that the PBSI can differentiate patients by severity of stroke (p < 0.05) and level of functional independence (p < 0.0001).

Conclusions: Content validity and preliminary evidence of construct validity has been demonstrated. Further work is needed to develop a multiattribute utility function to gather information on psychometric properties of the PBSI.

Show MeSH
Related in: MedlinePlus