Value in Health最新文献

英文中文

Clinical Outcomes and Measures for Vaginal Relaxation Syndrome: A Systematic Review 阴道松弛综合征的临床结果和措施：系统综述。

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01 DOI: 10.1016/j.jval.2025.08.012

Hongqin Chen MD , Jian Meng MM , Qiao Li MM , Yajing Wang MM , Yueyue Chen MD , Xiaoyu Niu MD , Dongmei Wei MD

Objectives

This study systematically investigates the application of clinical outcomes and measures reported in the management of vaginal relaxation syndrome (VRS). It further analyzes and compares variations in clinical outcomes and measures across different interventions in VRS, with a focus on assessing their generalizability and applicability. The findings aim to inform the design of high-quality clinical trials and provide a foundation for developing a Core Outcome Set (COS) and a Core Outcome Measurement Set (COMS).

Methods

A systematic search of PubMed, Embase, Web of Science, and Cochrane databases (up to January 2025) identified clinical studies on VRS treatment. Two researchers independently screened studies, extracted data, and analyzed clinical outcomes, measurement tools, and assessment time points.

Results

A total of 74 studies (15 randomized controlled trials, 59 observational studies, and 4866 patients) reported 113 outcomes using 85 measurement tools. The most frequently used were patient-reported outcome measures (Female Sexual Function Index, Vaginal Laxity Questionnaire, VAS, and PISQ-12), followed by clinician-reported outcome measures (VHI and biopsy). Most follow-ups lasted under 6 months. Surgical treatments uniquely assessed recurrence, aesthetic satisfaction, and partners’ sexual satisfaction, whereas nonsurgical approaches focused on overall efficacy, tolerability, and patients satisfaction with vaginal tightness.

Conclusions

Clinical outcomes and measures for VRS are overly complex, particularly PROs. Future research should focus on optimizing PROs by developing highly feasible, practical PROMs. Delphi surveys and expert consensus could establish a comprehensive VRS-specific Core Outcome Set and Core Outcome Measurement Set, alongside standardized assessment time points, improving research consistency and evidence-based management of VRS.

目的：本研究系统地探讨了阴道松弛综合征（VRS）治疗的临床结果和措施的应用。它进一步分析和比较了VRS中不同干预措施的临床结果和措施的差异，重点是评估其普遍性和适用性。研究结果旨在为高质量临床试验的设计提供信息，并为制定核心结果集（COS）和核心结果测量集（COMS）提供基础。方法：系统检索PubMed、Embase、Web of Science和Cochrane数据库（截至2025年1月），确定VRS治疗的临床研究。两名研究人员独立筛选研究，提取数据，分析临床结果、测量工具和评估时间点。结果：74项研究（15项随机对照试验，59项观察性研究，4866例患者）使用85种测量工具报告了113项结果。最常用的是患者报告的结果测量（FSFI， VLQ， VAS, PISQ-12），其次是临床报告的结果测量（VHI，活检）。大多数随访持续不到6个月。手术治疗独特地评估复发率、审美满意度和性伴侣的性满意度，而非手术方法侧重于总体疗效、耐受性和患者对阴道紧绷度的满意度。结论：VRS的临床结果和措施过于复杂，尤其是PROs。未来的研究应侧重于通过开发高度可行、实用的prom来优化pro。德尔菲调查和专家共识可以建立全面的VRS特异性COS和COMS，以及标准化的评估时间点，提高VRS研究的一致性和循证管理。

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IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

引用次数: 0

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

引用次数: 0

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

引用次数: 0

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

引用次数: 0

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

引用次数: 0

A Head-to-Head Comparison of the Psychometric Properties of the EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D in Children Aged 8 to 18 Years With Eczema EQ-5D-Y-3L、EQ-5D-Y-5L和CHU9D对8-18岁湿疹患儿心理测量特性的正面比较

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01 DOI: 10.1016/j.jval.2025.07.021

Rachel Lee-Yin Tan BA , Jian Yi Soh MMed , Elizabeth Huiwen Tham MMed , Anne Eng Neo Goh MMed , Mark Jean Aan Koh MMed , Nisha Suyien Chandran MMed , Madeline Sheun Ling Ho MMed , Lucinda Siyun Tan MMed , Michael Herdman MSc , Nan Luo PhD

Objectives

This study evaluated and compared the psychometric properties (ceiling effects, construct validity, and responsiveness) of EQ-5D-Y-3L (Y-3L), EQ-5D-Y-5L (Y-5L), and child health utility 9D (CHU9D) in pediatric patients with eczema.

Methods

Patients completed the Y-3L, Y-5L, CHU9D, and the Child Dermatology Life Quality Index and were followed up during their next visit. Clinicians assessed patients’ skin status using the Validated Investigator Global Assessment scale for Atopic Dermatitis. Ceiling effects of the 3 instruments were compared. Convergent validity was assessed using correlation with the Child Dermatology Life Quality Index; known-group validity was evaluated using F-statistics; and responsiveness was assessed using standardized effect sizes (SESs) among patients reporting improved health.

Results

A total of 164 patients (mean age: 12.2 years; female: 47.6%) participated in the study. Of those, 67 patients (mean age:11.9; female: 53.8%) completed the follow-up survey. The ceiling effects of Y-3L, Y-5L, and CHU9D were 34.8%, 28.7%, and 9.8%, respectively. All known-group hypotheses, defined by the Validated Investigator Global Assessment scale for Atopic Dermatitis and scratching frequency, were met, with Y-5L showing the strongest performance in discriminating between patients based on symptom severity. Convergent validity was met in 70.0%, 70.0%, and 83.3% of hypotheses tested for Y-3L, Y-5L, and CHU9D, respectively. CHU9D (SES = 0.53) was relatively more responsive to change than Y-3L (SES= 0.18) or Y-5L (SES = 0.43).

Conclusions

Y-3L and Y-5L were more sensitive to clinical outcome differences, whereas CHU9D appeared to be more responsive to self-rated health improvement. Further research using clinical measures and more diverse eczema patient samples is needed to confirm these findings and support evidence-based instrument selection.

目的：本研究评估并比较了EQ-5D-Y-3L （Y-3L）、EQ-5D-Y-5L （Y-5L）和CHU9D在儿科湿疹患者中的心理测量特性（天花板效应、结构效度和反应性）。方法：患者完成Y-3L、Y-5L、CHU9D和儿童皮肤病生活质量指数（CDLQI），并在下次就诊时进行随访。临床医生使用经过验证的特应性皮炎研究者全球评估量表（vIGA-AD）评估患者的皮肤状况。比较了三种仪器的天花板效应。采用与CDLQI的相关性评估收敛效度；使用f统计量评估已知组效度；在报告健康状况改善的患者中，使用标准化效应量（SES）评估反应性。结果：共164例患者，平均年龄12.2岁；女性：47.6%)参与了研究。其中67例患者(平均年龄11.9岁；女性：53.8%)完成了随访调查。Y-3L、Y-5L和CHU9D的天花板效应分别为34.8%、28.7%和9.8%。所有已知组假设（由vIGA-AD和抓挠频率定义）均得到满足，Y-5L在根据症状严重程度区分患者方面表现出最强的表现。Y-3L、Y-5L和CHU9D的趋同效度分别为70%、70%和83.3%。CHU9D （SES= 0.52）对变化的反应比Y-3L （SES= 0.18）或Y-5L （SES= 0.43）稍强。结论：Y-3L和Y-5L对临床结果差异更敏感，而CHU9D对自评健康改善更敏感。需要使用临床测量和更多样化的湿疹患者样本进行进一步的研究来证实这些发现并支持基于证据的工具选择。

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Comparing Adolescent and Adult Preferences for EQ-5D-Y-3L Health States in Hong Kong 比较香港青少年和成人对EQ-5D-Y-3L健康状况的偏好。

IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01 DOI: 10.1016/j.jval.2025.08.005

Kailu Wang BMed, PhD , Oliver Rivero-Arias MSc, DPhil , Annie Wai-Ling Cheung MPhil , Amy Yuen-Kwan Wong MSc , Eng-Kiong Yeoh MBBS , Eliza Lai-Yi Wong BSN, MPH, PhD

Objectives

The EuroQol EQ-5D-Y-3L valuation protocol suggests eliciting adult preferences from the perspective of a 10-year-old child. However, further research on whether it is feasible to elicit adolescent preferences for EQ-5D-Y-3L health states and how adolescent preferences compare with adult preferences is needed. This study aimed to compare preferences for EQ-5D-Y-3L health states and survey response behaviors between adolescents and adults in the general population of Hong Kong.

Methods

Cross-sectional face-to-face surveys were conducted between December 2018 and July 2023 with adolescents and adults in Hong Kong. Discrete choice experiments (DCEs) were used to elicit adolescent preferences from their own perspective and adult preferences from a 10-year-old child’s perspective for EQ-5D-Y-3L health states. Mixed logit models estimated the relative importance attribute levels for comparison between adolescents and adults using separate models for each group or a pooled model combining responses. Survey response behaviors were also analyzed by comparing the dominant task responses and feedback to DCE tasks between adolescents and adults.

Results

DCE responses from 776 adolescents aged 12 to 17 years and 1001 adults were used in the analysis after exclusions. For both groups, the most important dimension was pain/discomfort, followed by worried/sad/unhappy, usual activities, mobility, and self-care. Adolescents placed greater importance on mobility and self-care, while valuing pain/discomfort and usual activities less. Significant differences in relative importance of levels across all dimensions between the 2 groups were observed.

Conclusions

Adolescents showed different preference weightings compared with adults but reported greater challenges in completing the DCE tasks. These findings suggest that including adolescents in the valuation of EQ-5D-Y-3L health state is feasible; however, data provided by this group can be of lower data quality than adults.

目的：EuroQol EQ-5D-Y-3L评价方案建议从10岁儿童的角度引出成人的偏好。然而，是否可以诱导青少年对EQ-5D-Y-3L健康状态的偏好，以及青少年偏好与成人偏好的比较，还需要进一步的研究。本研究旨在比较香港青少年和成人对EQ-5D-Y-3L健康状态的偏好和调查反应行为。方法：2018年12月至2023年7月，对香港青少年和成年人进行横断面面对面调查。采用离散选择实验（DCEs），分别从青少年和成人的角度对EQ-5D-Y-3L健康状态进行选择。混合logit模型估计了青少年和成年人之间比较的相对重要属性水平，使用每组单独的模型或组合响应的混合模型。通过比较青少年和成人的主导任务反应和对DCE任务的反馈，分析调查反应行为。结果：排除后，776名12-17岁青少年和1001名成年人的DCE应答被用于分析。对于这两组人来说，最重要的维度是疼痛/不适，其次是担心/悲伤/不快乐、日常活动、流动性和自我保健。青少年更重视活动能力和自我保健，而不太重视疼痛/不适和日常活动。观察到两组之间所有维度水平的相对重要性存在显著差异。结论：与成年人相比，青少年表现出不同的偏好权重，但在完成DCE任务时报告了更大的挑战。这些发现表明，将青少年纳入EQ-5D-Y-3L健康状态评估是可行的，但该群体提供的数据质量可能低于成人。

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IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

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IF 6 2区医学 Q1 ECONOMICS

Value in Health

Pub Date : 2026-01-01

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