Methodological similarities and variations among EQ-5D-5L value set studies: a systematic review.

OBJECTIVES: (1) To descriptively compare the selected elements of valuation methods for EQ-5D-5L value set studies, (2) to compare the characteristics of the value sets, and (3) to examine the associations between the selected elements of valuation methods and the EQ-5D-5L value sets. METHODS: A systematic literature search of EQ-5D-5L valuation studies from 1 January 2009 to 22 April 2021 was conducted in selected databases. Following the initial search, we also explored additional studies published during the completion of the final version of the manuscript. Similarities and variations for selected elements of valuation methods were descriptively compared. The relative importance of dimensions, utility decrements between the levels, and distribution of the utility scores were used to compare value sets. A meta-regression analysis examined the associations between the selected methodological elements and the utility scores and dimension levels of EQ-5D-5L. RESULTS: A total of 31 studies were included in this review. Methodological similarities centered around data collection and preference elicitation method. On the other hand, variations include sampling technique, sample size, and value set modeling. The variations in value sets based on the relative importance of dimension, decrement in utility score, and distribution of utility score across countries were observed. Although the distribution of the utility scores differed across countries, higher levels of each dimension tended to have a larger decrement in the utility scores. Mean utility scores for the experience-based value sets were higher than those estimated using stated choice methods. The selected methodological elements were not significantly associated with the mean predicted utility scores or most dimension-level coefficients. CONCLUSIONS: EQ-5D-5L health state valuation methods and characteristics of value sets differed across studies. The impact of the variation of methodological elements on the value sets should be further investigated.

Persistent lip enlargement: An unusual presentation of lupus erythematosus.

Macrocheilia is a challenging problem with a variety of underlying causes that are both local and systemic, and granulomatous causes underlie the majority of cases. In this study, we report on a 31-year old man who presented with a chronic lower lip enlargement and a nodular submental erythematous lesion. He was otherwise clinically healthy. Laboratory test results were within the normal limit except for a positive anti-double stranded DNA test result. A diagnosis of cutaneous lupus erythematosus was made on the basis of histopathology and direct immunofluorescence. The lesions resolved dramatically after treatment with hydroxychloroquine. Lupus erythematosus should be considered when examining patients who present with chronic lip swelling.

The survey of diastolic function changes in end-stage renal disease patients before and 3 and 6 months after kidney transplantation.

INTRODUCTION: Left ventricular diastolic dysfunction, which is prevalent in end-stage renal disease, predicts morbidity and mortality among affected patients. The aim of this study was to evaluate diastolic function changes in end-stage renal disease patients before as well as 3 and 6 months after kidney transplantation. METHODS AND MATERIALS: This longitudinal study from November 2008 to November 2009, enrolled 27 consecutive kidney transplant patients. Systolic and diastolic blood pressures and echocardiograghic parameters such as ejection fraction, left ventricular mass, and diastolic functions were measured before, as well as 3 and 6 months after transplantation. Data were analyzed by repeated-measure analysis of variance and Friedman tests using SPSS version 18. RESULTS: The mean patients age was 39.47 ± 12.27 years with 55.6% males. The mean systolic and diastolic blood pressure and left ventricular mass decreased significantly in the first 3 (125.44 ± 11.35, 78.51 ± 6.32, 141.94 ± 3.32) and 6 months (121.48 ± 10.63, 72.96 ± 4.21, 138.25 ± 3.12) after renal transplantation compared to the values before the procedure (136.77 ± 14.09, 81.92 ± 9.01, 158.30 ± 3.58 respectively; P < .05). The left ventricular ejection fraction increased significantly at 3 (63.00 ± 6.49) and 6 months (66.11 ± 5.87) compared with preoperative (62.48 ± 5.74; P < .05). Step mean diastolic function also decreased significantly at 3 (1.94) and 6 months (1.81) compared with before transplantation (2.24; P < .05). CONCLUSION: According to our findings, transplantation can correct ejection fraction and systolic and diastolic blood pressure and lead to regression of left ventricular hypertrophy. Diastolic function was improved after transplantation.

A study of familial aggregation of depression, dementia and Parkinson's disease.

Depression is often accompanied by other disorders including Alzheimer's disease and Parkinson's disease. We studied the familial aggregation of these disorders in order to examine the possibility of a shared genetic origin. In a population-based study of 6596 subjects, we studied the association of self-reported depression, which required treatment by a psychiatrist, to family history of psychiatric disease, dementia, and Parkinson's disease. A family history of psychiatric disease was significantly associated with overall depression as well as with unipolar (n = 303 patients) and bipolar (n = 27 patients) depression. The risk of unipolar depression was associated with the presence of two or more demented individuals among their first degree relatives (e.g. parents, siblings and children). Since there was no evidence for familial aggregation in subjects with only one demented relative, our study suggests that unipolar depression may be associated specifically to a strongly familial, form of dementia. The risk of bipolar depression was increased for those with one or more relatives with dementia and, perhaps, for those with relatives with Parkinson's disease. The familial aggregation of depression with dementia and perhaps Parkinson's disease suggests that there may be shared susceptibility gene(s) underlying these diseases. Our study indicates further that there may be differences in the genetic etiology between unipolar and bipolar depression.

Lipophilin (PLP) gene in X-linked myelin disorders.

There are several X-linked diseases in animals and at least one in man in which there is a failure of CNS myelination. We have recently cloned cDNAs for lipophilin (PLP) with which PLP sequences were localized to a region of the long arm of the X chromosome (Xq13-q22 in man) close to the jimpy (jp) locus in that mouse mutant. The present communication pursues the postulate that some of this class of diseases may involve mutations at the PLP locus. Blot hybridization analysis of PLP mRNA levels revealed a five-to tenfold reduction in the brains of hemizygous jp/Y mice. The major PLP mRNA species of those mice was also reduced in size. However, Southern blots of jp DNA digested with many different restriction enzymes failed to detect major deletions or other rearrangements in the PLP gene. A human PLP cDNA was isolated and employed to similarly analyze DNA from four patients diagnosed as having Pelizaeus-Merzbacher disease. In one of these four a significant rearrangement of the PLP gene was found. These findings suggest that there may be alterations in the PLP gene in both jp mouse and Pelizaeus-Merzbacher disease.