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Modelling and estimation of health-related quality of life after hip fracture

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Parsons, Nicholas R., Griffin, Xavier L., Achten, Juul, Chesser, T. J., Lamb, S. E. (Sallie E.) and Costa, Matthew L. (2018) Modelling and estimation of health-related quality of life after hip fracture. Bone & Joint Research, 7 (1). pp. 1-5. doi:10.1302/2046-3758.71.BJR-2017-0199

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Abstract

Objectives:
This study investigates the reporting of health-related quality of life (HRQoL) in patients following hip fracture. We compare the relative merits and make recommendations for the use for two methods of measuring HRQoL; (i) including patients who died during follow-up and (ii) including survivors only.

Methods:
The World Hip Trauma Evaluation has previously reported changes in HRQoL using EuroQol-5D for patients with hip fractures. We performed additional analysis to investigate the effect of including or excluding those patients who died during the first four months of the follow-up period.

Results:
The dataset included 503 patients, 25 of whom died between 30 days and four months of injury. There was a statistically significant difference in 30-day HRQoL between those alive (mean 0.331 and standard deviation (sd) 0.360) and those dead (mean 0.156 and sd 0.421) by four months (independent-samples t-test; p 0.022). The estimated difference of 0.175 in HRQoL (95% confidence interval 0.025 to 0.325) was also highly clinically significant.

Conclusion:
When reporting HRQoL for patients after a hip fracture, excluding patients who die during follow-up leads to an overestimate of the effects of the intervention or treatment pathway. We would recommend that death-adjusted estimates should be used routinely when reporting HRQoL in this population.

Item Type: Journal Article
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Pelvic bones -- Fractures -- Rehabilitation
Journal or Publication Title: Bone & Joint Research
Publisher: British Editorial Society of Bone and Joint Surgery
ISSN: 2046-3758
Official Date: 1 January 2018
Dates:
DateEvent
1 January 2018Published
10 November 2017Accepted
Volume: 7
Number: 1
Page Range: pp. 1-5
DOI: 10.1302/2046-3758.71.BJR-2017-0199
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access

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