Artikel geaccepteerd in AJGP

Ons artikel genaamd ‘Minor impact of multiple psychiatric symptoms on quality of life (EQ5D) in psycho-geriatric patients; a clinical-empirical structural modelling approach’ (Minimale invloed van multipele psychiatrische symptomen op de kwaliteit van leven (EQ5D) van psychogeriatrische patiënten; een statistisch modellerende aanpak) is geaccepteerd voor publicatie in The American Journal of Geriatric Psychiatry. Hieronder vindt u het abstract:

Background.  The relationship of clinical variables for cognitive functioning and other variables such as multiple neuropsychiatric symptoms and quality of life are usually analysed bivariately and multivariately. In randomised controlled trials analyses are mostly performed on individual outcome variables.  To unravel interdependencies of determinants and outcome variables Structural Equation Modeling (SEM) was applied.

Methods. Using SEM, we explored interdependencies of clinical determinants (MMSE, BI , and NPI-sum severity)  and quality of life (EQ5D) in psycho-geriatric patients (including dementia) suffering from cognitive problems and multiple neuropsychiatric symptoms.

Results. MMSE and BI showed direct and indirect impact on EQ5D, however the association with NPI-severity was minor. The identified model showed that R2 of EQ5D varied from 0.21 to 0.48.

Discussion. This clinical-empirical study showed that SEM could be employed to unravel and identify a model of complex direct and indirect effects of MMSE and BI on EQ5D. However, in relation to NPI-severity the validity of EQ5D seemed insufficient in psycho-geriatric patients  Consequently, the cost-utility analyses and cost-effectiveness analyses using QALYs of an intervention in psycho-geriatric patients with multiple neuropsychiatric symptoms, based on EQ5D, are considered questionable. Construction of a quality of life instrument that is more sensitive in regards to multiple neuropsychiatric symptoms in psycho-geriatric patients, is highly recommended.

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