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The feasibility and validity of a preference-weighted composite endpoint to establish value in geriatric care
BMC Health Services Research volume 14, Article number: P55 (2014)
As part of the Dutch National Care for the Elderly Programme, The Older Persons and Informal Caregivers Survey Minimum Data Set (TOPICS-MDS) was developed to gather uniform information on outcome measures. Furthermore, to combine the outcome measures into one single index and to promote comparability between studies, a preference-weighted Composite End Point (called: TOPICS-CEP) was developed . The aim of this study was to validate TOPICS-CEP in a large heterogeneous sample of older persons aged ≥65 years.
Materials and methods
Data from 17,603 older persons were derived from TOPICS-MDS (http://www.topics-mds.eu); a public data repository. Feasibility was evaluated by the prevalence of missing values among TOPICS-CEP scores. To assess convergent validity, TOPICS-CEP scores were cross validated against the Cantril’s ladder life satisfaction scale and the EuroQol-5D utility score. Known-group validity of TOPICS-CEP was investigated across socio-demographic and clinical characteristics. To assess whether TOPICS-CEP scores were generalizeble across different settings, we conducted pooled and subgroup analyses: older persons in the general population, general practitioner setting, and hospital.
In the complete sample, TOPICS-CEP scores could be calculated for the majority of the participants (88.7%). There were no floor and ceiling effects found and the distribution was slightly skewed to the left. The correlation between TOPICS-CEP and Cantril’s ladder was 0.43 (95%CI [0.39-0.48]) and the correlation between TOPICS-CEP and EuroQol-5D was 0.63 (95%CI [0.58-0.67]). Expectedly, mean TOPICS-CEP scores differed significantly (p<0.05) across marital status (married or cohabiting: 7.50 versus partner deceased: 7.13), living arrangements (independent living with others: 7.56 versus dependent living: 6.37), dementia (no: 7.43 versus yes: 6.30), depression (no: 7.42 versus yes: 6.26), and dizziness with falls (no: 749 versus yes: 6.42). When stratified by subgroups, similar results were found for feasibility, convergent and known-group validity.
The TOPICS-CEP was able to accurately reflect general wellbeing in a large pooled dataset as well as across subgroups. Our data support that the TOPICS-CEP score is an objective and robust measure for researchers interested in investigating the general well-being of older persons. The TOPICS-CEP guideline version 1.1 is now available online http://www.topics-mds.eu.
Hofman CS, Makai P, Buurman BM, de Craen AJM, Boter H, OldeRikkert MGM, Donders ART, Melis RJF: Establishing a composite endpoint for measuring the effectiveness of geriatric interventions based on older persons’ and informal caregivers’ preference weights: A vignette study. BMC Geriatrics. 2014, 14: 51-10.1186/1471-2318-14-51.
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Hofman, C., Lutomski, J., Boter, H. et al. The feasibility and validity of a preference-weighted composite endpoint to establish value in geriatric care. BMC Health Serv Res 14, P55 (2014) doi:10.1186/1472-6963-14-S2-P55
- Life Satisfaction
- Living Arrangement
- Utility Score
- Informal Caregiver
- Geriatric Care