Measurement of disability-free survival after surgery

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Survival and freedom from disability are arguably the most important patient-centered outcomes after surgery, but it is unclear how postoperative disability should be measured. The authors thus evaluated the World Health Organization Disability Assessment Schedule 2.0 in a surgical population. Methods: The authors examined the psychometric properties of World Health Organization Disability Assessment Schedule 2.0 in a diverse cohort of 510 surgical patients. The authors assessed clinical acceptability, validity, reliability, and responsiveness up to 12 months after surgery. Results: Criterion and convergent validity of World Health Organization Disability Assessment Schedule 2.0 were supported by good correlation with the 40-item quality of recovery scale at 30 days after surgery (r = -0.70) and at 3, 6, and 12 months after surgery with physical functioning (The Katz index of independence in Activities of Daily Living; r = -0.70, r = -0.60, and rho = -0.47); quality of life (EQ-5D; r = -0.57, -0.60, and -0.52); and pain interference scores (modified Brief Pain Inventory Short Form; r = 0.72, 0.74, and 0.81) (all P <0.0005). Construct validity was supported by increased hospital stay (6.9 vs. 5.3 days, P = 0.008) and increased day 30 complications (20 vs. 11 , P = 0.042) in patients with new disability. There was excellent internal consistency with Cronbach s a and split-half coefficients greater than 0.90 at all time points (all P <0.0005). Responsiveness was excellent with effect sizes of 3.4, 3.0, and 1.0 at 3, 6, and 12 months after surgery, respectively. Conclusions: World Health Organization Disability Assessment Schedule 2.0 is a clinically acceptable, valid, reliable, and responsive instrument for measuring postoperative disability in a diverse surgical population. Its use as an endpoint in future perioperative studies can provide outcome data that are meaningful to clinicians and patients alike. Copyright ? 2015, the American Society of Anesth
Original languageEnglish
Pages (from-to)524 - 536
Number of pages13
JournalAnesthesiology
Volume122
Issue number3
DOIs
Publication statusPublished - 2015

Cite this

@article{a3143e752fbf422cbaa34bd31150a3af,
title = "Measurement of disability-free survival after surgery",
abstract = "Survival and freedom from disability are arguably the most important patient-centered outcomes after surgery, but it is unclear how postoperative disability should be measured. The authors thus evaluated the World Health Organization Disability Assessment Schedule 2.0 in a surgical population. Methods: The authors examined the psychometric properties of World Health Organization Disability Assessment Schedule 2.0 in a diverse cohort of 510 surgical patients. The authors assessed clinical acceptability, validity, reliability, and responsiveness up to 12 months after surgery. Results: Criterion and convergent validity of World Health Organization Disability Assessment Schedule 2.0 were supported by good correlation with the 40-item quality of recovery scale at 30 days after surgery (r = -0.70) and at 3, 6, and 12 months after surgery with physical functioning (The Katz index of independence in Activities of Daily Living; r = -0.70, r = -0.60, and rho = -0.47); quality of life (EQ-5D; r = -0.57, -0.60, and -0.52); and pain interference scores (modified Brief Pain Inventory Short Form; r = 0.72, 0.74, and 0.81) (all P <0.0005). Construct validity was supported by increased hospital stay (6.9 vs. 5.3 days, P = 0.008) and increased day 30 complications (20 vs. 11 , P = 0.042) in patients with new disability. There was excellent internal consistency with Cronbach s a and split-half coefficients greater than 0.90 at all time points (all P <0.0005). Responsiveness was excellent with effect sizes of 3.4, 3.0, and 1.0 at 3, 6, and 12 months after surgery, respectively. Conclusions: World Health Organization Disability Assessment Schedule 2.0 is a clinically acceptable, valid, reliable, and responsive instrument for measuring postoperative disability in a diverse surgical population. Its use as an endpoint in future perioperative studies can provide outcome data that are meaningful to clinicians and patients alike. Copyright ? 2015, the American Society of Anesth",
author = "Mark Shulman and Myles, {Paul S} and Chan, {Matthew T V} and McIlroy, {David Richard} and Sophia Wallace and Ponsford, {Jennie Louise}",
year = "2015",
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volume = "122",
pages = "524 -- 536",
journal = "Anesthesiology",
issn = "0003-3022",
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}

Measurement of disability-free survival after surgery. / Shulman, Mark; Myles, Paul S; Chan, Matthew T V; McIlroy, David Richard; Wallace, Sophia; Ponsford, Jennie Louise.

In: Anesthesiology, Vol. 122, No. 3, 2015, p. 524 - 536.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Measurement of disability-free survival after surgery

AU - Shulman, Mark

AU - Myles, Paul S

AU - Chan, Matthew T V

AU - McIlroy, David Richard

AU - Wallace, Sophia

AU - Ponsford, Jennie Louise

PY - 2015

Y1 - 2015

N2 - Survival and freedom from disability are arguably the most important patient-centered outcomes after surgery, but it is unclear how postoperative disability should be measured. The authors thus evaluated the World Health Organization Disability Assessment Schedule 2.0 in a surgical population. Methods: The authors examined the psychometric properties of World Health Organization Disability Assessment Schedule 2.0 in a diverse cohort of 510 surgical patients. The authors assessed clinical acceptability, validity, reliability, and responsiveness up to 12 months after surgery. Results: Criterion and convergent validity of World Health Organization Disability Assessment Schedule 2.0 were supported by good correlation with the 40-item quality of recovery scale at 30 days after surgery (r = -0.70) and at 3, 6, and 12 months after surgery with physical functioning (The Katz index of independence in Activities of Daily Living; r = -0.70, r = -0.60, and rho = -0.47); quality of life (EQ-5D; r = -0.57, -0.60, and -0.52); and pain interference scores (modified Brief Pain Inventory Short Form; r = 0.72, 0.74, and 0.81) (all P <0.0005). Construct validity was supported by increased hospital stay (6.9 vs. 5.3 days, P = 0.008) and increased day 30 complications (20 vs. 11 , P = 0.042) in patients with new disability. There was excellent internal consistency with Cronbach s a and split-half coefficients greater than 0.90 at all time points (all P <0.0005). Responsiveness was excellent with effect sizes of 3.4, 3.0, and 1.0 at 3, 6, and 12 months after surgery, respectively. Conclusions: World Health Organization Disability Assessment Schedule 2.0 is a clinically acceptable, valid, reliable, and responsive instrument for measuring postoperative disability in a diverse surgical population. Its use as an endpoint in future perioperative studies can provide outcome data that are meaningful to clinicians and patients alike. Copyright ? 2015, the American Society of Anesth

AB - Survival and freedom from disability are arguably the most important patient-centered outcomes after surgery, but it is unclear how postoperative disability should be measured. The authors thus evaluated the World Health Organization Disability Assessment Schedule 2.0 in a surgical population. Methods: The authors examined the psychometric properties of World Health Organization Disability Assessment Schedule 2.0 in a diverse cohort of 510 surgical patients. The authors assessed clinical acceptability, validity, reliability, and responsiveness up to 12 months after surgery. Results: Criterion and convergent validity of World Health Organization Disability Assessment Schedule 2.0 were supported by good correlation with the 40-item quality of recovery scale at 30 days after surgery (r = -0.70) and at 3, 6, and 12 months after surgery with physical functioning (The Katz index of independence in Activities of Daily Living; r = -0.70, r = -0.60, and rho = -0.47); quality of life (EQ-5D; r = -0.57, -0.60, and -0.52); and pain interference scores (modified Brief Pain Inventory Short Form; r = 0.72, 0.74, and 0.81) (all P <0.0005). Construct validity was supported by increased hospital stay (6.9 vs. 5.3 days, P = 0.008) and increased day 30 complications (20 vs. 11 , P = 0.042) in patients with new disability. There was excellent internal consistency with Cronbach s a and split-half coefficients greater than 0.90 at all time points (all P <0.0005). Responsiveness was excellent with effect sizes of 3.4, 3.0, and 1.0 at 3, 6, and 12 months after surgery, respectively. Conclusions: World Health Organization Disability Assessment Schedule 2.0 is a clinically acceptable, valid, reliable, and responsive instrument for measuring postoperative disability in a diverse surgical population. Its use as an endpoint in future perioperative studies can provide outcome data that are meaningful to clinicians and patients alike. Copyright ? 2015, the American Society of Anesth

UR - http://anesthesiology.pubs.asahq.org/article.aspx?articleid=2119575

U2 - 10.1097/ALN.0000000000000586

DO - 10.1097/ALN.0000000000000586

M3 - Article

VL - 122

SP - 524

EP - 536

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 3

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