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Determinants of health related quality of life and health state utility in patients with age related macular degeneration: the association of contrast sensitivity and visual acuity

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Abstract

Background

There has been increasing interest in the use of measures of health related quality of life (HRQoL) and health state utility values in Age Related Macular Degeneration (ARMD). Visual acuity has been found to be an important determinant of such measures in previous studies. More recently, another measure of visual impairment, contrast sensitivity has received considerable attention. We designed a study to examine whether the contribution of contrast sensitivity in explaining HRQoL and health utilities over and above that of visual acuity.

Methods

209 patients with unilateral or bilateral ARMD were recruited into a cross-sectional study of patients from a large teaching hospital. Patients underwent visual tests (near and distant visual acuity, contrast sensitivity) and completed a vision function questionnaire, the VF-14, HUI3, and time trade-off.

Results

Using multivariate regression analysis, the study revealed that contrast sensitivity remained a statistically significant predictor of all outcome measures even when visual acuity was included. This result was supported by the correlation coefficients between measures.

Conclusions

The measurement of contrast sensitivity appears to be better related to a person’s HRQoL and health utility. Future studies should consider incorporating contrast sensitivity in addition to visual acuity. Studies, in particular economic evaluations, may underestimate the effect of treatment unless contrast sensitivity is considered.

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Abbreviations

ARMD:

age related macular degeneration

CS:

contrast sensitivity

VA:

visual acuity

VF:

visual function

HUI:

health utilities index

HRQol:

health related quality of life

TTO:

time trade off

SG:

standard gamble

LogMAR:

logarithm of the minimum angle of resolution

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Acknowledgements

Novartis provided financial support for this project and Mireia Espallargues received a grant from the DURSI, Government of Catalonia to do this work. John Brazier is funded by the MRC Health Services Research Collaboration. Our appreciation to Professor Gary Rubin for his comments on an earlier draft of this manuscript.

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Authors and Affiliations

  1. Health Economics and Decision Science, ScHARR (School of Health and Related Research), The University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK

    N. Bansback, C. Czoski-Murray, M. Espallargues & J. Brazier

  2. Catalan Agency for Health Technology Assessment and Research, Catalan Health Service, Catalan, Spain

    M. Espallargues

  3. Department of Orthoptics, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK

    J. Carlton, G. Lewis & L. Hughes

  4. Department of Ophthalomology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK

    C. Brand

Authors
  1. N. Bansback
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  2. C. Czoski-Murray
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  3. J. Carlton
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  4. G. Lewis
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  5. L. Hughes
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  6. M. Espallargues
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  7. C. Brand
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  8. J. Brazier
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Corresponding author

Correspondence to N. Bansback.

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Bansback, N., Czoski-Murray, C., Carlton, J. et al. Determinants of health related quality of life and health state utility in patients with age related macular degeneration: the association of contrast sensitivity and visual acuity. Qual Life Res 16, 533–543 (2007). https://doi.org/10.1007/s11136-006-9126-8

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  • DOI: https://doi.org/10.1007/s11136-006-9126-8

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