Time trade-off study to establish utility decrements in individuals with a spinal cord injury who perform intermittent catheterization.

AIMS: To generate utility decrements for three attributes associated with catheterization for individuals with a spinal cord injury (SCI): the process of catheterization, the physical impact of urinary tract infections (UTIs) and worry associated with hospitalization. MATERIALS AND METHODS: Health state vignettes comprising various levels of the three attributes were developed. Two cohorts of respondents, corresponding to people with SCIs and a sample broadly representative of the UK population, were presented with nine vignettes (three vignettes for the mild, moderate and severe health states in addition to a random set of six vignettes). It was assumed no or a nominal decrement was associated with the mild health state. Utility decrements were derived from analysing the data obtained from the online time trade-off (TTO). A proportion of the SCI cohort (n = 57) also completed the EQ-5D-5L questionnaire. RESULTS: Utility decrements were generated using statistical models for the general population (n = 358), the SCI population (n = 48) and the two populations combined (merged model, n = 406). Results from the two cohorts showed minimal differences. For the merged model, SCI status was not statistically significant. All interaction terms, excluding SCI and the severe level of the physical attribute, were not statistically significant. Compared to the mild level, the greatest utility decrement calculated was the severe level of the emotional (worry) attribute (0.09, p < .001) for the SCI population. A significant decrement of 0.02 (p < .001) was calculated for the moderate level of the emotional attribute for all models. The mean utility score for those with SCI having completed the EQ-5D-5L was 0.371. LIMITATIONS: Modest sample size of respondents from the SCI population (n = 48). CONCLUSIONS: Worry associated with hospitalization had the greatest impact on patients' health-related quality of life (HRQoL). The catheterization process, such as the lubrication and repositioning of the catheter, also impacted on patients' HRQoL.

Further evidence of the reliability and validity of the premature ejaculation diagnostic tool.

This study details the further validation of the Premature Ejaculation Diagnostic Tool (PEDT), a five-item tool, developed to systematically apply the Diagnostic and Statistical Manual of Mental Disorders, revised version 4 (DSM-IV-TR), criteria in diagnosing presence or absence of premature ejaculation (PE). A total of 102 men completed the PEDT and were then interviewed by one of the seven clinical experts, who made a diagnosis of presence or absence of PE. The diagnoses from these two methods were compared to assess the convergent validity of PEDT. Retest reliability was also assessed, by men completing the PEDT a second time, approximately 2 weeks after the first administration. The level of agreement between clinical expert and PEDT diagnoses was very high (kappa-statistic=0.80 (95% CI=0.68-0.92)), and retest reliability was very good - Intraclass correlation coefficient=0.88. In summary, the PEDT is extensively validated, self-report measure that can systematically assess DSM-IV-TR criteria to provide accurate diagnoses of PE/no-PE.

PPVT-R as an estimate of premorbid intelligence in older adults.

The Peabody Picture Vocabulary Test-Revised (PPVT-R) was examined as an estimate of premorbid intelligence in a clinical sample of elderly patients (N = 150) undergoing clinical neuropsychological evaluation. PPVT-R standard scores were compared across grossly cognitively intact, mildly/moderately and severely impaired groups of patients, and compared to a short form of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Barona regression equation. Results indicate that, while the PPVT-R is vulnerable to increasing levels of cognitive impairment among patients with fewer years of education, the PPVT-R is stable across mild to moderate levels of impairment for patients with greater than 12 years of education. In a sub-sample of grossly cognitively intact patients (n = 91), the PPVT-R standard score correlated significantly with estimated WAIS-R FSIQ (r =.61). Compared to the Barona equation, the PPVT-R was less likely to over-estimate WAIS-R FSIQ in the grossly cognitively intact patients. These data suggest the PPVT-R to be a useful estimate of premorbid ability for patients with a greater than high-school education.