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      Riesgo cardiovascular, calidad de Vida y años de vida ajustados por calidad: un estudio de caso Translated title: Risco cardiovascular, qualidade de vida e anos de vida ajustados por qualidade: um estudo de caso Translated title: Cardiovascular risk, quality of life and quality-adjusted years of life: a case report

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          Abstract

          Objetivo: determinar la razón costo-utilidad de un programa de promoción y prevención de enfermedades cardiovasculares (ECV) en una institución que presta servicios de salud en la ciudad de Medellín (Colombia). Metodología: se comparó el programa preventivo con el esquema de control convencional bajo el diseño de un estudio cuasiexperimental de evaluación antes y después con grupo control no equivalente. Entre los grupos de estudio se evaluaron diferencias al final del primero y segundo año de los siguientes resultados: puntaje de Framingham, costo directo para el programa, calidad de vida, índice de salud y años de vida ajustados por calidad. Resultados: entre los grupos evaluados se encontró diferencia estadísticamente significante entre los momentos inicial y final para las variables: puntaje de Framingham, índice de salud y años de vida ajustados por calidad. Conclusión: la participación de los pacientes en programa de promoción y prevención de ECV está relacionado con reducción en el riesgo y mejoría en la calidad de vida.

          Translated abstract

          Objetivo: determinar a razão custo-utilidade de um programa de promoção e prevenção de doenças cardiovasculares (ECV) numa instituição que presta serviços de saúde na cidade de Medellín (Colômbia). Metodologia: comparou-se o programa preventivo com o esquema de controle convencional sob o desenho de um estudo quase-experimental de avaliação antes e depois com grupo controle não equivalente. Entre os grupos de estudo se avaliaram diferenças ao final do primeiro e segundo ano dos seguintes resultados: pontuação de Framingham, custo direto para o programa, qualidade de vida, índice de saúde e anos de vida ajustados por qualidade. Resultados: entre os grupos avaliados se encontrou diferença estatisticamente significante entre os momentos inicial e final para as variáveis: pontuação de Framingham, índice de saúde e anos de vida ajustados por qualidade. Conclusão: a participação dos pacientes em programa de promoção e prevenção de ECV está relacionada com redução no risco e melhoria na qualidade de vida.

          Translated abstract

          Objective: to determine the ratio cost-utility of cardiovascular diseases (CVD) promotion and prevention programs in a health care providing institution in the city of Medellin (Colombia). Methodology: the preventive program was compared before and after with the conventional control scheme under the design of a quasi experimental study evaluation with a non equivalent control group. Between the studied groups’ differences of the following results were evaluated at the end of the first and second year: Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Results: in the evaluated groups a statistically meaningful difference was found between the initial and final moments for the variables:Framingham score, direct cost of the program, quality of life, health indexes and quality-adjusted years of life. Conclusion: the participation of patients in CVD prevention and promotion programs is related with risk reduction and a better quality of life.

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          Most cited references21

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          Prediction of Coronary Heart Disease Using Risk Factor Categories

          The objective of this study was to examine the association of Joint National Committee (JNC-V) blood pressure and National Cholesterol Education Program (NCEP) cholesterol categories with coronary heart disease (CHD) risk, to incorporate them into coronary prediction algorithms, and to compare the discrimination properties of this approach with other noncategorical prediction functions. This work was designed as a prospective, single-center study in the setting of a community-based cohort. The patients were 2489 men and 2856 women 30 to 74 years old at baseline with 12 years of follow-up. During the 12 years of follow-up, a total of 383 men and 227 women developed CHD, which was significantly associated with categories of blood pressure, total cholesterol, LDL cholesterol, and HDL cholesterol (all P or =130/85). The corresponding multivariable-adjusted attributable risk percent associated with elevated total cholesterol (> or =200 mg/dL) was 27% in men and 34% in women. Recommended guidelines of blood pressure, total cholesterol, and LDL cholesterol effectively predict CHD risk in a middle-aged white population sample. A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.
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            Modeling valuations for EuroQol health states.

            Paul Dolan (1997)
            It has become increasingly common for preference-based measures of health-related quality of life to be used in the evaluation of different health-care interventions. For one such measure, The EuroQol, designed to be used for these purposes, it was necessary to derive a single index value for each of the 243 health states it generates. The problem was that it was virtually impossible to generate direct valuations for all of these states, and thus it was necessary to find a procedure that allows the valuations of all EuroQol states to be interpolated from direct valuations on a subset of these. In a recent study, direct valuations were elicited for 42 EuroQol health states (using the time trade-off method) from a representative sample of the UK population. This article reports on the methodology that was adopted to build up a "tariff" of EuroQol values from this data. A parsimonious model that fits the data well was defined as one in which valuations were explained in terms of the level of severity associated with each dimension, an intercept associated with any move away from full health, and a term that picked up whether any dimension in the state was at its most severe level. The model presented in this article appears to predict the values of the states for which there are direct observations and, thus, can be used to interpolate values for the states for which no direct observations exist.
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              Estimating an EQ-5D population value set: the case of Japan.

              Quality adjustment weights for quality-adjusted life years (QALYs) are available with the EQ-5D Instrument, which are based on a survey that quantified the preferences of the British public. However, the extent to which this British value set is applicable to other, especially non-European, countries is yet unclear. The objectives of this study are (a) to compare the valuations obtained in Japan and Britain, and (b) to explore a local Japanese value set. A diminished study design is employed, where 17 hypothetical EQ-5D health states are evaluated as opposed to 42 in the British study. The official Japanese version of the instrument and the Time Trade-Off method are used to interview 543 members of the public. The results are: firstly, the evaluations obtained in Japan and those from Britain differ by 0.24 on average on a [-1, +1] scale, and mean absolute error (MAE) in predicting the Japanese preferences with the British value set is 0.23. Secondly, comparable regressions suggest that the two peoples have systematically different preference structures (p<0.001 for 8 of 12 coefficients; F-test). Thirdly, using alternative models, the predictions are improved so that the local Japanese value set achieves MAE in the order of 0.01. Copyright 2002 John Wiley & Sons, Ltd.
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                Author and article information

                Journal
                iee
                Investigación y Educación en Enfermería
                Invest. educ. enferm
                Imprenta Universidad de Antioquia (Medellín, Antioquia, Colombia )
                0120-5307
                2216-0280
                March 2010
                : 28
                : 1
                : 32-42
                Affiliations
                [02] orgnameUniversidad Nacional de Colombia sede Medellín Colombia jovasquezve@ 123456unal.edu.co
                [01] orgnameUniversidad de Antioquia orgdiv1Facultad de Enfermería Colombia
                Article
                S0120-53072010000100005 S0120-5307(10)02800105
                c89b277d-dbf2-40ad-b965-07f195abf122

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 26 February 2010
                : 28 June 2009
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 11
                Product

                SciELO Colombia

                Categories
                Artículos Originales

                evaluación de programas y proyectos de salud,quality of life,program evaluation,risk groups,cardiovascular diseases,qualidade de vida,avaliação de programas e projetos de saúde,grupos de risco,doenças cardiovasculares,calidad de vida,grupos vulnerables,enfermedades cardiovasculares

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