Composite outcome measures in a pragmatic clinical trial of chronic heart failure management: A comparative assessment

Chang, S; Davidson, PM; Newton, PJ; Macdonald, P; Carrington, MJ; Marwick, TH; Horowitz, JD; Krum, H; Reid, CM; Chan, YK; Scuffham, PA; Sibbritt, D; Stewart, S

Composite outcome measures in a pragmatic clinical trial of chronic heart failure management: A comparative assessment

Chang, S

Davidson, PM

Newton, PJ

Macdonald, P

Carrington, MJ Marwick, TH Horowitz, JD Krum, H Reid, CM Chan, YK Scuffham, PA Sibbritt, D

Stewart, S

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Publication Type:: Journal Article
Citation:: International Journal of Cardiology, 2015, 185 pp. 62 - 68
Issue Date:: 2015-04-15

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Field	Value	Language
dc.contributor.author	Chang, S https://orcid.org/0000-0003-0723-3192	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Newton, PJ https://orcid.org/0000-0002-5006-2037	en_US
dc.contributor.author	Macdonald, P https://orcid.org/0000-0001-5378-2825	en_US
dc.contributor.author	Carrington, MJ	en_US
dc.contributor.author	Marwick, TH	en_US
dc.contributor.author	Horowitz, JD	en_US
dc.contributor.author	Krum, H	en_US
dc.contributor.author	Reid, CM	en_US
dc.contributor.author	Chan, YK	en_US
dc.contributor.author	Scuffham, PA	en_US
dc.contributor.author	Sibbritt, D https://orcid.org/0000-0003-3561-9447	en_US
dc.contributor.author	Stewart, S	en_US
dc.date.available	2015-03-03	en_US
dc.date.issued	2015-04-15	en_US
dc.identifier.citation	International Journal of Cardiology, 2015, 185 pp. 62 - 68	en_US
dc.identifier.issn	0167-5273	en_US
dc.identifier.uri	http://hdl.handle.net/10453/41869
dc.description.abstract	© 2015 Elsevier Ireland Ltd. All rights reserved. Background A number of composite outcomes have been developed to capture the perspective of the patient, clinician and objective measures of health in assessing heart failure outcomes. To date there has been a limited examination in the composition of these outcomes. Methods and results Three commonly used scoring systems in heart failure trials: Packer's composite, Patient Journey and the African American Heart Failure Trial (A-HeFT) scores were compared in assessing outcomes from the Which heart failure intervention is most cost-effective & consumer friendly in reducing hospital care (WHICH(?)) Trial. Comparability and interpretability of these outcomes and the influence of each component to the final outcome were examined. Despite all three composite outcomes incorporating mortality, hospitalisation and quality of life (QoL), the contribution of each individual component to the final outcomes differed. The component with the most influence in deteriorating condition for the Packer's composite was hospitalisation (67.7%), while in Patient Journey it was QoL (61.5%) and for A-HeFT composite score it was mortality (45.4%). Conclusions The contribution made by each component varied in subtle, but important ways. This study emphasises the importance of understanding the value system of the composite outcomes to enable meaningful interpretation of results.	en_US
dc.relation.ispartof	International Journal of Cardiology	en_US
dc.relation.isbasedon	10.1016/j.ijcard.2015.03.071	en_US
dc.subject.classification	Cardiovascular System & Hematology	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Chronic Disease	en_US
dc.subject.mesh	Hospitalization	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Outcome Assessment (Health Care)	en_US
dc.subject.mesh	Heart Failure	en_US
dc.subject.mesh	Outcome Assessment, Health Care	en_US
dc.title	Composite outcome measures in a pragmatic clinical trial of chronic heart failure management: A comparative assessment	en_US
dc.type	Journal Article
utslib.citation.volume	185	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access
pubs.publication-status	Published	en_US
pubs.volume	185	en_US

Abstract:

© 2015 Elsevier Ireland Ltd. All rights reserved. Background A number of composite outcomes have been developed to capture the perspective of the patient, clinician and objective measures of health in assessing heart failure outcomes. To date there has been a limited examination in the composition of these outcomes. Methods and results Three commonly used scoring systems in heart failure trials: Packer's composite, Patient Journey and the African American Heart Failure Trial (A-HeFT) scores were compared in assessing outcomes from the Which heart failure intervention is most cost-effective & consumer friendly in reducing hospital care (WHICH(?)) Trial. Comparability and interpretability of these outcomes and the influence of each component to the final outcome were examined. Despite all three composite outcomes incorporating mortality, hospitalisation and quality of life (QoL), the contribution of each individual component to the final outcomes differed. The component with the most influence in deteriorating condition for the Packer's composite was hospitalisation (67.7%), while in Patient Journey it was QoL (61.5%) and for A-HeFT composite score it was mortality (45.4%). Conclusions The contribution made by each component varied in subtle, but important ways. This study emphasises the importance of understanding the value system of the composite outcomes to enable meaningful interpretation of results.

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http://hdl.handle.net/10453/41869