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008 141104s2012 mdua on f000 0 eng
060 00 WK 835
100 1 Milne, Andrea,|eauthor.
245 10 Measuring health-related quality of life for patients with
diabetic retinopathy /|cUniversity of Alberta Evidence-
based Practice Center ; Andrea Milne, Jeffery A. Johnson,
Matthew Tennant, Christopher Rudnisky, Donna M. Dryden.
264 1 Rockville, Maryland :|bAgency for Healthcare Research and
Quality,|cApril 23, 2012.
300 1 online resource (1 PDF file (various pagings)) :
338 online resource|bcr|2rdacarrier
490 1 Technology assessment report
500 Title from PDF title page.
520 3 OBJECTIVES: To identify and evaluate the psychometric
properties of tools used to measure health-related quality
of life (HRQL) in patients receiving treatment for
diabetic retinopathy (DR), and to assess the effectiveness
of interventions for DR to improve HRQL. DATA SOURCES: We
conducted a systematic and comprehensive search in six
electronic databases and hand searched reference lists of
reviews and included studies. REVIEW METHODS: Study
selection, quality assessment, and data extraction were
completed by reviewers independently and in duplicate. We
included articles that presented data on HRQL outcomes
following an intervention for DR (including diabetic
macular edmema (DME). Mean differences and 95 percent
confidence intervals were calculated for continuous
outcomes. We did not conduct any meta-analyses due to
heterogeneity. RESULTS: We identified four validated HRQL
measures: 36-Item Short Form Health Survey (SF-36),
National Eye Institute Visual Functioning Questionnaire
(VFQ-25 and -51), Visual Function Index (VF-14), and
Diabetes Treatment Satisfaction Questionnaire (DTSQ). We
also identified two tools that are currently undergoing
evaluation: the Retinopathy Treatment Satisfaction
Questionnaire (RetTSQ) and the Retinopathy Dependent
Quality of Life (RetDQoL). Two randomized controlled
trials (RCTs) reported on HRQL outcomes following anti-
vascular endothelial growth factor (anti-VEGF) treatment
for DME. Seven observational studies reported on HRQL
outcomes following: laser photocoagulation (two),
vitrectomy (two), panretinal photocoagulation versus
vitrectomy (one), and phacoemulsification cataract surgery
(two). The RCT comparing pegaptanib sodium versus sham
reported a statistically significant improvement from
baseline for the composite score of the VFQ-25 at 2 years
(but not at 1 year). The three-arm RCT comparing
ranibizumab monotherapy versus ranibizumab plus laser
versus laser showed a statisitically significant
difference for the composite score of the VFQ-25 for both
anti-VEGF arms versus laser at 1 year. The strength of
evidence for anti-VEGF was assessed as low. For the
remaining interventions, the studies were at high risk of
bias due to weak study designs (before-after and cohort
studies) and poor implementation. There is insufficient
evidence to determine whether one of these treatments for
DR is more effective than another in improving HRQL in
this patient population. CONCLUSIONS: We identified few
HRQL measurement instruments that have been used to assess
the impact of treatment in patients with DR or DME;
however, the tools that have been used have been
adequately evaluated. Two tools developed specifically for
patients with DR are currently undergoing evaluation. In
general, HRQL was improved following interventions for DR.
Further research on HRQL following anti-VEGF treatment for
DME is needed to confirm the results of two RCTs. The
current research on the impact of other interventions for
DR on HRQL is insufficient to draw conclusions about the
relative effect of one intervention versus another. RCTs
that assess the impact of treatments for DR should include
HRQL as an outcome.
655 2 Review.
700 1 Johnson, Jeffrey A.|q(Jeffrey Allen),|d1965-|eauthor.
700 1 Tennant, Matthew|q(Matthew T. S.),|eauthor.
700 1 Rudnisky, Christopher,|eauthor.
700 1 Dryden, Donna M.,|eauthor.
710 2 University of Alberta Evidence-based Practice Center,
710 1 United States.|bAgency for Healthcare Research and Quality,
710 2 National Library of Medicine|eissuing body.
830 0 Technology assessment (Agency for Healthcare Research and
830 0 NCBI BookShelf
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990 National Center for Biotechnology Information
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991 |zNEW New collection NLM.bookshelf 2018-08-03