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Gary C Brown

Publications and source records attributed to Gary C Brown.

41 records · Page 3Linked to original sources
PubMed2002

Quality of life and systemic comorbidities in patients with ophthalmic disease.

AIM: To ascertain the effect of serious systemic comorbidities upon the quality of life of patients with ophthalmic diseases. METHODS: Time tradeoff utility values were obtained in consecutive ophthalmic patients who presented with ocular disease. Multivariate analysis was undertaken to evaluate whether the systemic comorbidities of diabetes mellitus, heart disease, cancer, cerebrovascular accident, and/or renal failure requiring dialysis influenced ocular utility values. RESULTS: Among the 390 patients with ocular diseases studied, 250 had the systemic comorbidities of diabetes mellitus, heart disease, cancer, stroke, and/or renal failure requiring dialysis, while 140 lacked these comorbidities. There was no statistically significant difference (p = 0.091) between the comorbidity and no comorbidity groups in self assessed quality of life as measured by ocular utility values after taking into account potentially confounding variables. CONCLUSIONS: In patients with ocular disease, ocular utility values related to the visual loss do not appear to be affected by the presence of select, concomitant, serious systemic diseases. Thus, visual loss seems to cause a similar diminution in self assessed quality of life in those who do and do not have serious associated systemic comorbidities. This information has important implications for the calculation of cost effective analyses.

Adult↗
PubMed2002

Patient, community and clinician perceptions of the quality of life associated with diabetes mellitus.

BACKGROUND: A study was undertaken to assess the quality of life of patients with type 1 and type 2 diabetes mellitus and to ascertain whether clinicians and non-diabetic respondents from the general public have similar views of the impact of diabetes upon health-related quality of life. MATERIAL/METHODS: Time tradeoff utility values were generated from a standardized time-tradeoff questionnaire. Three hundred and fifty-two individuals with type 1 or type 2 diabetes mellitus, 157 non-diabetic participants from the general public (community), and 61 health care clinicians participated in the study. RESULTS: The mean utility score for diabetic patients was 0.889 and the median utility score was 1.000. The mean utility score for clinicians was 0.861, with a median value of 0.894, while the respective mean and median scores for the general public were 0.919 and 0.953. There was a significant difference between the distribution of the means of scores of clinicians and patients as well as between clinicians and the general public. There was no significant difference between the utility scores of patients and the general public. Within the group of diabetic patients, there was no significant difference in utility scores between type 1 and type 2 diabetics. CONCLUSIONS: Clinicians tended to overemphasize the impact that diabetes mellitus has on health related quality of life, while the non-diabetic publics' utility values are more closely correlated with those of diabetics themselves. We conclude that there is a significant difference in how clinicians, diabetics and the general public perceive the effect diabetes has upon quality of life.

Adult↗
PubMedDate not supplied

Health care economic analyses and value-based medicine.

Health care economic analyses are becoming increasingly important in the evaluation of health care interventions, including many within ophthalmology. Encompassed with the realm of health care economic studies are cost-benefit analysis, cost-effectiveness analysis, cost-minimization analysis, and cost-utility analysis. Cost-utility analysis is the most sophisticated form of economic analysis and typically incorporates utility values. Utility values measure the preference for a health state and range from 0.0 (death) to 1.0 (perfect health). When the change in utility measures conferred by a health care intervention is multiplied by the duration of the benefit, the number of quality-adjusted life-years (QALYs) gained from the intervention is ascertained. This methodology incorporates both the improvement in quality of life and/or length of life, or the value, occurring as a result of the intervention. This improvement in value can then be amalgamated with discounted costs to yield expenditures per quality-adjusted life-year ($/QALY) gained. $/QALY gained is a measure that allows a comparison of the patient-perceived value of virtually all health care interventions for the dollars expended. A review of the literature on health care economic analyses, with particular emphasis on cost-utility analysis, is included in the present review. It is anticipated that cost-utility analysis will play a major role in health care within the coming decade.

Cost of Illness↗