An evaluation of the Assessment of Quality of Life utility instrument as a measure of the impact of injury on health-related quality of life

The Assessment of Quality of Life (AQoL) is a generic health-related quality of life (HRQL) measure. It is the only HRQL instrument, currently available, that incorporates health preference values derived from an Australian population and has been extensively trialled in over 40 studies. However, prior to this study, it had not been used to measure HRQL in injury patients. The aim of this study was to evaluate the AQoL, as a measure of the impact of injury on HRQL, by examining its correlation with other commonly used measures of health outcome and its ability to discriminate between groups with injuries of varying type and severity. A total of 221 admitted injury patients, aged 18 – 74 years, were recruited into the study from four major Victorian metropolitan hospitals and followed up over 12 months. The AQoL and the SF-36 were administered to obtain retrospective measures of pre-injury HRQL and health status with post-injury measurements obtained at five intervals post-injury (to 12 months). A preliminary analysis of data from this study showed the AQoL was positively related to other common outcome measures and, overall, showed a strong correlation with the SF-36 Physical Component Summary and a moderate correlation with the Mental Component Summary. It also demonstrated good discrimination between groups on the basis of type of injury, body region injured and severity of injury. While further testing of the AQoL, in this context, is still necessary, this study suggests that the AQoL may be a useful measure of the impact of injury on HRQL.

[1]  Graeme Hawthorne,et al.  Quality of life assessment in the community-dwelling elderly: validation of the Assessment of Quality of Life (AQoL) Instrument and comparison with the SF-36. , 2003, Journal of clinical epidemiology.

[2]  R. Osborne,et al.  Measurement of rapid changes in health outcomes in people with influenza symptoms. , 2000 .

[3]  Saakje Mulder,et al.  Distribution and determinants of health and work status in a comprehensive population of injury patients. , 2004, The Journal of trauma.

[4]  A. Kasuya.  EuroQol--a new facility for the measurement of health-related quality of life. , 1990, Health policy.

[5]  D. Hoyt,et al.  Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. , 1999, The Journal of trauma.

[6]  G. Hawthorne.  The effect of different methods of collecting data: Mail, telephone and filter data collection issues in utility measurement , 2003, Quality of Life Research.

[7]  Tracey Phelan,et al.  National Statement on Ethical Conduct in Research Involving Humans , 1999 .

[8]  G. Hawthorne,et al.  Health-related quality-of-life outcomes from adult cochlear implantation: a cross-sectional survey , 2001, Cochlear implants international.

[9]  E. Mackenzie,et al.  The development of the Functional Capacity Index. , 1996, The Journal of trauma.

[10]  E J MacKenzie,et al.  Predicting ambulatory function following lower extremity trauma using the functional capacity index. , 2001, Accident Analysis and Prevention.

[11]  John E. Ware,et al.  SF-36 physical and mental health summary scales : a user's manual , 1994 .

[12]  George W. Torrance,et al.  Application of Multi-Attribute Utility Theory to Measure Social Preferences for Health States , 1982, Oper. Res..

[13]  J E Ware,et al.  Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. , 1998, Journal of clinical epidemiology.

[14]  T. Ashman,et al.  The reliability and validity of the SF-36 health survey questionnaire for use with individuals with traumatic brain injury. , 2001, Brain injury.

[15]  Leonie Segal,et al.  Can we reduce disease burden from osteoarthritis? , 2004, The Medical journal of Australia.

[16]  Alan D. Lopez,et al.  The burden of disease and injury in Australia. , 2001, Bulletin of the World Health Organization.

[17]  A Villers Ruiz,et al.  Statistical package for the social sciences (spss) , 1981 .

[18]  Joan Ozanne-Smith,et al.  The cost of injury to Victoria , 1997 .

[19]  J. Richardson,et al.  Construction and Utility Scaling of the Assessment of Quality of Life ( AQoL ) Instrument , 2001 .

[20]  Anne W. Taylor,et al.  Subsyndromal depression: prevalence, use of health services and quality of life in an Australian population , 2004, Social Psychiatry and Psychiatric Epidemiology.

[21]  H. Brodaty,et al.  The relationship between quality of life, Mini-Mental State Examination, and the Instrumental Activities of Daily Living in patients with Alzheimer's disease. , 2004, Archives of gerontology and geriatrics.

[22]  R M Kaplan,et al.  A general health policy model: update and applications. , 1988, Health services research.

[23]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[24]  R. Sanson-Fisher,et al.  Adaptation and validation of the SF-36 Health Survey for use in Australia. , 1998, Journal of clinical epidemiology.

[25]  G. Hawthorne,et al.  A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments , 2001, Annals of medicine.

[26]  G. Hawthorne,et al.  Quality of life assessment in people living with psychosis , 2002, Social Psychiatry and Psychiatric Epidemiology.

[27]  B. Ford.  International Classification of Impairments, Disabilities and Handicaps , 1984, Releve epidemiologique hebdomadaire.

[28]  Richard H. Osborne,et al.  Can we reduce disease burden from osteoarthritis? An evidence-based priority-setting model , 2004 .

[29]  D. Miller,et al.  Health-related quality of life , 2002, Multiple sclerosis.

[30]  G. Hawthorne,et al.  Introducing co-ordinated care (1): a randomised trial assessing client and cost outcomes. , 2004, Health policy.

[31]  R. Osborne,et al.  The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of Health-Related Quality of Life , 1999, Quality of Life Research.

[32]  J P Anderson,et al.  Outcome after major trauma: discharge and 6-month follow-up results from the Trauma Recovery Project. , 1998, The Journal of trauma.

[33]  A. Edgar.  Bowling, A.: 1997, Measuring Health; a Review of Quality of Life Measurement Scales (2nd ed.) , 1998 .

[34]  L. Gray,et al.  Effectiveness of case management and post‐acute services in older people after hospital discharge , 2003, The Medical journal of Australia.

[35]  A. Williams.  EuroQol : a new facility for the measurement of health-related quality of life , 1990 .

[36]  B. Kopjar,et al.  The SF-36 health survey: a valid measure of changes in health status after injury. , 1996, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[37]  Richard H Osborne,et al.  Brief Comprehensive Quality of Life Assessment After Stroke: The Assessment of Quality of Life Instrument in the North East Melbourne Stroke Incidence Study (NEMESIS) , 2002, Stroke.

[38]  H. Hansluwka.  Measuring health. A review of quality of life measurement scales: by Ann Bowling , 1992 .

[39]  R. Osborne,et al.  Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure , 2005, Australian and New Zealand journal of public health.

[40]  S. Luchter,et al.  Validating the Functional Capacity Index as a measure of outcome following blunt multiple trauma , 2002, Quality of Life Research.

[41]  E. Mackenzie,et al.  Measuring Disability and Quality of Life Postinjury , 2000 .

[42]  B. Ford.  International classification of impairments, disabilities and handicaps. , 1984, The Medical journal of Australia.

[43]  G. Hawthorne,et al.  The Excess Cost of Depression in South Australia: A Population-Based Study , 2003, The Australian and New Zealand journal of psychiatry.

[44]  J. Brazier,et al.  The estimation of a preference-based measure of health from the SF-36. , 2002, Journal of health economics.