Biomedical subjects

Jennifer Roberts

Publications and source records attributed to Jennifer Roberts.

23 records · Page 2Linked to original sources

PubMed2002

The estimation of a preference-based measure of health from the SF-36.

This paper reports on the findings of a study to derive a preference-based measure of health from the SF-36 for use in economic evaluation. The SF-36 was revised into a six-dimensional health state classification called the SF-6D. A sample of 249 states defined by the SF-6D have been valued by a representative sample of 611 members of the UK general population, using standard gamble. Models are estimated for predicting health state valuations for all 18,000 states defined by the SF-6D. The econometric modelling had to cope with the hierarchical nature of the data and its skewed distribution. The recommended models have produced significant coefficients for levels of the SF-6D, which are robust across model specification. However, there are concerns with some inconsistent estimates and over prediction of the value of the poorest health states. These problems must be weighed against the rich descriptive ability of the SF-6D, and the potential application of these models to existing and future SF-36 data set.

Activities of Daily Living↗

PubMed2002

To what extent can we explain time trade-off values from other information about respondents?

The time trade-off (TTO) is one of the most widely used health state valuation methods and was recently used to develop a set of values for the EQ-5D descriptive system from 3000 members of the UK general population. However, there is currently very little understanding of precisely what determines responses to TTO questions. The data that were used to generate this set of values are ideal for addressing this question since they contain a plethora of information relating to the respondents and their cognition during the TTO exercise. A particularly useful characteristic of this dataset is the existence of visual analogue scale (VAS) valuations on the same states for the same respondents. The results suggest that age, sex and marital status are the most important respondent characteristics determining health state valuations. The VAS valuations were found to add very little to the explanatory power of the models.

Abstracting and Indexing↗

PubMed2002

Modelling valuations for Eq-5d health states: an alternative model using differences in valuations.

OBJECTIVES: The EQ-5D is a preference-based measure of health and is increasingly being used in the evaluation of health technologies. A 'tariff' of values for all 243 EQ-5D health states has been generated using direct valuations on a subset of these states. The tariff is used to express the value of differences between health states, and so this paper explores whether a tariff with better predictive ability can be calculated using differences between values rather than using the values themselves. METHODS: The original tariff (reported in this journal) was based on valuations for 42 EQ-5D states elicited from a representative sample of 2997 members of the UK general population using the time trade-off method. This same data are used to estimate a tariff based upon the differences in value between the worst possible state (33333) and all other states. RESULTS: A simple model that fits the data well is one in which the differences in value between 33333 and all other states are explained in terms of the change in each dimension plus a term to pick up whether some dimensions change by the maximum amount whereas others do not change at all. The mean absolute difference between the actual values and those predicted by this model is 0.03 (compared with 0.039 in the original model). CONCLUSION: The model presented in this paper predicts the difference between 33333 and all other states remarkably well and can be used to generate a tariff for all EQ-5D health states. In fact, this model more accurately predicts the values of states for which there are direct observations, and so we recommend its comparison with the original model in evaluative studies.

Activities of Daily Living↗

PubMed2002

Health professionals' views of contracting for infection control in the NHS internal market.

This paper reports a national study which investigated the involvement of infection control professionals in (and their views about) the formal processes of contracting for health care in the NHS internal market. Health care professionals needed to be involved contracting, if it was to be effective. The study found that many infection control professionals were not, in fact, involved in contracting, while the importance of both contracts and informal professional networks were recognised But respondents did not think that their professional networks entirely compensated for their lack of involvement in contracting. As formal agreements continue to be central to achieving quality of care in the post-internal market NHS, infection control professionals need to be involved in specification and implementation of these arrangements.

Attitude of Health Personnel↗

PubMedDate not supplied

Acute stress disorder after burn injury: a predictor of posttraumatic stress disorder?

OBJECTIVES: The principal goals of this study were to determine whether ASD predicted chronic PTSD and whether dissociation is more characteristic of the acute-trauma period than PTSD symptoms. METHODS: Eighty-three hospitalized adult burn patients were assessed with structured interviews and self-report measures within 2 weeks of injury and again at least 6 months postburn. RESULTS: Nineteen percent had ASD. Dissociative symptoms were not more common or more severe than PTSD symptoms. Thirty-six percent had chronic PTSD. While ASD predicted chronic PTSD, meeting the symptom criteria for PTSD within 2 weeks postburn also predicted chronic PTSD. CONCLUSIONS: Our data support the inclusion of an ASD diagnosis in the DSM, which would allow the diagnosis of symptoms in the first month posttrauma as a psychiatric disorder but questions whether dissociation is more characteristic of the acute trauma period than the PTSD symptom clusters.

Adult↗