human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate the psychometric properties of the National Eye Institute Visual Function Question naire-25 ( NEI VFQ-25 ) and Visual Function Question naire Utility Index ( VFQ-UI ) in patients with non-infectious intermediate and posterior uveitis . Methods Secondary analysis of pooled data from a 26-week , multicenter , masked , r and omized , sham-controlled Phase 3 clinical trial . Health-related quality of life was assessed using the NEI VFQ-25 , the EQ-5D , and SF-36 . Internal consistency reliability , reproducibility , convergent validity , and known groups of BCVA and vitreous haze severity were assessed . Clinical ly significant difference was assessed using anchor-based and distribution-based methods . Results The study included 224 subjects with non-infectious intermediate ( 80.4 % ) or posterior uveitis ( 19.6 % ) . The NEI VFQ-25 and the VFQ-UI demonstrated good internal consistency ( Cronbach ’s alpha 0.87–0.94 ) and test – retest reliability ( ICCs 0.58–0.88 ) . Spearman ’s product – moment rank correlations between the NEI VFQ-25  and VFQ-UI scores and the SF-6D , EQ-5D , and BCVA ranged from small to moderate . There was a significant association between visual functioning and known groups of visual acuity ( p < 0.05 ) . Clinical significance , using the anchor-based method ( difference between visual acuity groups ≥10–<15 letter better and no change ) , was 10.2 for change from baseline to week 26 for the NEI VFQ-25 composite score and 0.05 for the VFQ-UI . Using the distribution-based method , the clinical significance was 3.86 for the composite score and 0.04 for the VFQ-UI . Conclusion The NEI VFQ-25 and the VFQ-UI are reliable and valid measures of vision-related functioning and preference-based status in patients with non-infectious intermediate and posterior uveitis BACKGROUND Cost-effectiveness/cost-utility analyses are increasingly needed to inform decisions about care . Algorithms have been developed using the Functional Assessment of Cancer Therapy ( FACT ) quality of life instrument to estimate utility weights for cost analyses . This study was design ed to compare these algorithms in the setting of ovarian cancer . METHODS GOG-0152 was a 550-patient r and omized phase III trial of interval cytoreduction , and GOG-0172 was a 415-patient r and omized phase III trial comparing intravenous versus intraperitoneal therapy among women with advanced ovarian cancer .  QOL data were collected via the FACT at four time points in each study . Two published mapping algorithms ( Cheung and Dobrez ) and a linear transformation method were applied to these data . The agreement between measures was assessed by the concordance correlation coefficient ( r(CCC ) ) , and paired t-tests were used to compare means . RESULTS While agreement between the estimation algorithms was good ( ranged from 0.72 to 0.81 ) , there were statistically significant ( p<0.001 ) and clinical ly meaningful differences between the scores : mean scores were higher with Dobrez than with Cheung or the linear transformation method . Scores were also statistically significantly different ( p<0.001 ) between studies . CONCLUSIONS In the absence of prospect ively collected utility data , the use of mapping algorithms is feasible , however , the optimal algorithm is not clear . There were significant differences between studies , which highlight the need for validation of these algorithms in specific setting s. If cost analyses incorporate mapping algorithms to obtain utility estimates , investigators should take the variability into account Background . Currently there are no reported cancer-specific health state valuations in low- and middle-income countries using a vali date d preference-based measure . The EORTC-8D , a cancer-specific preference-based measure , has 81,920 health states and is useful for economic evaluations in cancer care . The aim of this study was to develop a utility algorithm to value EORTC-8D health states using preferences derived from a representative population sample in Sri Lanka . Methods . The time-tradeoff method was used to elicit preferences from a general population sample of 780 in Sri Lanka . A block design of 85 health states , with a time horizon of 10 years , was used for the direct valuation . Data were analyzed using generalized least squares with r and om effects . All respondents with at least one logical inconsistency were excluded from the analysis . Results . After logical inconsistencies were excluded , 4520 observations were available from 717 respondents for the analysis . The preferred model specified main effects with an interaction term for any level 4 or worse descriptor within a health state . Worsening of physical functioning had a substantially greater utility decrement than any other dimension in this population . Limitations are that the data collection could not include the whole country and that females formed a large part of the sample . Conclusions . Preference weights for EORTC-8D health states for Sri Lanka have been derived : These will be very useful in economic evaluations of cancer-related interventions in a range of low- and middle-income countries Background The aim of the study was to develop a menopause-specific , preference-based health-related quality -of-life ( HRQoL ) index reflecting both menopausal symptoms and potential side-effects of Hormone Replacement Therapy ( HRT ) . Methods The study had three phases : the development of a health state classification , a prospect i ve valuation survey and the estimation of a model to interpolate HRQoL indices for all remaining health states as defined by the classification . A menopausal health state classification was developed with seven dimensions : hot flushes , aching joints/muscles , anxious/frightened feelings , breast tenderness , bleeding , vaginal dryness and undesirable and rogenic signs . Each dimension contains between three and five levels and defines a total of 6,075 health states . A sample of 96 health states was selected for the valuation survey . These states were valued by a sample of 229 women aged 45 to 60 , r and omly selected from 6 general practice lists in Sheffield , UK . Respondents were asked to complete a time trade-off ( TTO ) task for nine health states , result ing in an average of 16.5 values for each health state . Results Mean health states valued range from 0.48 to 0.98 ( where 1.0 is full health and zero is for states regarded as equivalent to death ) . Symptoms , as described by the classification system , can be rank-ordered in terms of their impact ( from high to low ) on menopausal HRQoL as follows : aching joints and muscles , bleeding , breast tenderness , anxious or frightened feelings , vaginal dryness , and rogenic signs . Hot flushes did not significantly contribute to model fit . The preferred model produced a mean absolute error of 0.053 , but suffered from bias at both ends of the scale . Conclusion This article presents an attempt to directly value a condition specific health state classification . The overall fit was disappointing , but the results demonstrate that menopausal symptoms are perceived by patients to have a significant impact on utility . The overall effect is modest compared to the more generic health state descriptions such as the EQ-5D . The result ant algorithm generates a preference-based index that can be used economic evaluation and that reflects the impact of this condition We developed a preference‐based measure , the Amyotrophic Lateral Sclerosis Utility Index ( ALSUI ) , allowing computation of US population ‐based utility weights for the wide range of health states observed among ALS patients . A multi‐attribute utility approach was used . An ALS Health State Classification System was developed comprising the following attributes with different severity levels : Speech and Swallowing ( A1 ) ; Eating , Dressing , and Bathing ( A2 ) ; Leg Function ( A3 ) ; and Respiratory Function ( A4 ) . An internet‐based survey was administered to a r and om sample of the US population to assess preferences for ALS health states based on this system using  visual analog scale ( VAS ) and st and ard gamble ( SG ) questions . Using the VAS and SG data from 1374 individuals in the general population , utility functions were computed that corresponded to each severity level within A1 , A2 , A3 , and A4 . ALSUI scores for a given patient are computed by inputting his corresponding utility functions into the following multiplicative formula : ALSUI score = 1.06 × (A1 × A2 × A3 × A4)−0.06 on a scale where 0.0 reflects death and 1.0 reflects healthy . This study provides a useful tool for classifying ALS patients and determining a general public‐based utility score for ALS health states STUDY OBJECTIVE To develop and evaluate a brief , easy-to-administer symptom assessment scale for use as a preference-based outcome measure in clinical trials and cost-effectiveness studies in asthma . DESIGN Cross-sectional survey with 2-week reproducibility assessment . SETTING Ambulatory care : university asthma and allergy center . PARTICIPANTS One hundred sixty-one adults with asthma , 59 % female , mean age 35+/-11 years . Mean FEV1 percent predicted was 86+/-17 % . INTERVENTIONS The  11-item Asthma Symptom Utility Index ( ASUI ) .  MEASUREMENTS AND RESULTS Mean ASUI score for this sample was 0.71+/-0.23 , with a range from 0.02 to 1.0 . The ASUI was reproducible ( intraclass correlation coefficient = 0.74 ) and able to distinguish patients known to differ on disease severity according to clinician ratings ( p < 0.001 ) and by an asthma disease severity scale score ( p < 0.001 ) . The instrument was also significantly correlated with FEV1 percent predicted ( r = 0.27 , p < 0.001 ) , the Asthma Quality of Life Question naire ( r = 0.77 , p < 0.001 ) , and the Health Utilities Index Mark 2 ( r = 0.36 , p < 0.001 ) . CONCLUSION The results of this study support the reliability and validity of the ASUI , suggesting it will be a useful , complementary patient outcome measure for clinical trials and cost-effectiveness studies comparing treatment alternatives for persons with asthma Purpose Condition-specific preference-based measures can offer utility data where they would not otherwise be available or where generic measures may lack sensitivity , although they lack comparability across conditions . This study aim ed to develop an algorithm for estimating utilities from the short bowel syndrome health-related quality of life scale ( SBS-QoL ™ ) . Methods SBS-QoL ™ items were selected based on factor and item performance analysis of a European SBS-QoL ™ data set and consultation with 3 SBS clinical experts . Six-dimension health states were developed using 8 SBS-QoL ™ items ( 2 dimensions combined 2 SBS-QoL ™ items ) . SBS health states were valued by a UK general population sample ( N = 250 ) using the lead-time time trade-off method . Preference weights or ‘ utility decrements ’ for each severity level of each dimension were estimated by regression models and used to develop the scoring algorithm . Results Mean utilities for the SBS health states ranged from −0.46 ( worst health state , very much affected on all dimensions ) to 0.92 ( best health state , not at all affected on all dimensions ) . The r and om effects model with maximum likelihood estimation regression had the best predictive ability and lowest root mean squared error and mean absolute error , and was used to develop the scoring algorithm . Conclusions The preference-weighted scoring algorithm for the SBS-QoL ™ developed is able to estimate a wide range of utility values from patient-level SBS-QoL ™ data . This allows estimation of SBS HRQL impact for the purpose of economic evaluation of SBS treatment benefits BACKGROUND Condition-specific measures are frequently used to assess the health-related quality of life of people with multiple sclerosis ( MS ) . Such measures are unsuitable for use in economic evaluations that require estimates of cost per quality -adjusted life-year because they are not based on preferences . OBJECTIVES To report the estimation of a preference-based single index for an eight-dimensional instrument for MS , the Multiple Sclerosis Impact Scale - Eight Dimensions ( MSIS-8D ) , derived from an MS-specific measure of health-related quality of life , the 29-item Multiple Sclerosis Impact Scale ( MSIS-29 ) . METHODS We elicited preferences for a sample of MSIS-8D states ( n = 169 ) from a sample ( n = 1702 ) of the UK general population . Preferences were elicited using the time trade-off technique via an Internet-based survey . We fitted regression models to these data to estimate values for all health states described by the MSIS-8D . Estimated values were assessed against MSIS-29 scores and values derived from generic preference-based measures in a large , representative sample of people with MS . RESULTS Participants reported that the time trade-off questions were easy to underst and . Observed health state values ranged from 0.08 to 0.89 . The best-performing model was a main effects , r and om effects model ( mean absolute error = 0.04 ) . Validation analyses support the performance of the MSIS-8D index : it correlated more strongly than did generic measures with MSIS-29 scores , and it discriminated effectively between subgroups of people with MS . CONCLUSIONS The MSIS-8D enables health state values to be estimated from the MSIS-29 , adding to the methods available to assess health outcomes and to estimate quality -adjusted life-years for MS for use in health technology assessment and decision-making context Background . The Clinical Outcomes in Routine Evaluation– Outcome Measure ( CORE-OM ) is used to evaluate the effectiveness of psychological therapies in people with common mental disorders . The objective of this study was to estimate a preference-based index for this population using CORE-6D , a health state classification system derived from the CORE-OM consisting of a 5-item emot 
    Output:
    
agent
Conclusion Various methods have been used at all stages of CSPBM development .
The choice between developing a classification system de novo or from an existing instrument may depend on the availability of a suitable existing measure , while the choice between a decomposed or composite approach appears to be determined primarily by the purpose for which the instrument is design ed .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective To evaluate the psychometric properties of the National Eye Institute Visual Function Question naire-25 ( NEI VFQ-25 ) and Visual Function Question naire Utility Index ( VFQ-UI ) in patients with non-infectious intermediate and posterior uveitis . Methods Secondary analysis of pooled data from a 26-week , multicenter , masked , r and omized , sham-controlled Phase 3 clinical trial . Health-related quality of life was assessed using the NEI VFQ-25 , the EQ-5D , and SF-36 . Internal consistency reliability , reproducibility , convergent validity , and known groups of BCVA and vitreous haze severity were assessed . Clinical ly significant difference was assessed using anchor-based and distribution-based methods . Results The study included 224 subjects with non-infectious intermediate ( 80.4 % ) or posterior uveitis ( 19.6 % ) . The NEI VFQ-25 and the VFQ-UI demonstrated good internal consistency ( Cronbach ’s alpha 0.87–0.94 ) and test – retest reliability ( ICCs 0.58–0.88 ) . Spearman ’s product – moment rank correlations between the NEI VFQ-25  and VFQ-UI scores and the SF-6D , EQ-5D , and BCVA ranged from small to moderate . There was a significant association between visual functioning and known groups of visual acuity ( p < 0.05 ) . Clinical significance , using the anchor-based method ( difference between visual acuity groups ≥10–<15 letter better and no change ) , was 10.2 for change from baseline to week 26 for the NEI VFQ-25 composite score and 0.05 for the VFQ-UI . Using the distribution-based method , the clinical significance was 3.86 for the composite score and 0.04 for the VFQ-UI . Conclusion The NEI VFQ-25 and the VFQ-UI are reliable and valid measures of vision-related functioning and preference-based status in patients with non-infectious intermediate and posterior uveitis BACKGROUND Cost-effectiveness/cost-utility analyses are increasingly needed to inform decisions about care . Algorithms have been developed using the Functional Assessment of Cancer Therapy ( FACT ) quality of life instrument to estimate utility weights for cost analyses . This study was design ed to compare these algorithms in the setting of ovarian cancer . METHODS GOG-0152 was a 550-patient r and omized phase III trial of interval cytoreduction , and GOG-0172 was a 415-patient r and omized phase III trial comparing intravenous versus intraperitoneal therapy among women with advanced ovarian cancer .  QOL data were collected via the FACT at four time points in each study . Two published mapping algorithms ( Cheung and Dobrez ) and a linear transformation method were applied to these data . The agreement between measures was assessed by the concordance correlation coefficient ( r(CCC ) ) , and paired t-tests were used to compare means . RESULTS While agreement between the estimation algorithms was good ( ranged from 0.72 to 0.81 ) , there were statistically significant ( p<0.001 ) and clinical ly meaningful differences between the scores : mean scores were higher with Dobrez than with Cheung or the linear transformation method . Scores were also statistically significantly different ( p<0.001 ) between studies . CONCLUSIONS In the absence of prospect ively collected utility data , the use of mapping algorithms is feasible , however , the optimal algorithm is not clear . There were significant differences between studies , which highlight the need for validation of these algorithms in specific setting s. If cost analyses incorporate mapping algorithms to obtain utility estimates , investigators should take the variability into account Background . Currently there are no reported cancer-specific health state valuations in low- and middle-income countries using a vali date d preference-based measure . The EORTC-8D , a cancer-specific preference-based measure , has 81,920 health states and is useful for economic evaluations in cancer care . The aim of this study was to develop a utility algorithm to value EORTC-8D health states using preferences derived from a representative population sample in Sri Lanka . Methods . The time-tradeoff method was used to elicit preferences from a general population sample of 780 in Sri Lanka . A block design of 85 health states , with a time horizon of 10 years , was used for the direct valuation . Data were analyzed using generalized least squares with r and om effects . All respondents with at least one logical inconsistency were excluded from the analysis . Results . After logical inconsistencies were excluded , 4520 observations were available from 717 respondents for the analysis . The preferred model specified main effects with an interaction term for any level 4 or worse descriptor within a health state . Worsening of physical functioning had a substantially greater utility decrement than any other dimension in this population . Limitations are that the data collection could not include the whole country and that females formed a large part of the sample . Conclusions . Preference weights for EORTC-8D health states for Sri Lanka have been derived : These will be very useful in economic evaluations of cancer-related interventions in a range of low- and middle-income countries Background The aim of the study was to develop a menopause-specific , preference-based health-related quality -of-life ( HRQoL ) index reflecting both menopausal symptoms and potential side-effects of Hormone Replacement Therapy ( HRT ) . Methods The study had three phases : the development of a health state classification , a prospect i ve valuation survey and the estimation of a model to interpolate HRQoL indices for all remaining health states as defined by the classification . A menopausal health state classification was developed with seven dimensions : hot flushes , aching joints/muscles , anxious/frightened feelings , breast tenderness , bleeding , vaginal dryness and undesirable and rogenic signs . Each dimension contains between three and five levels and defines a total of 6,075 health states . A sample of 96 health states was selected for the valuation survey . These states were valued by a sample of 229 women aged 45 to 60 , r and omly selected from 6 general practice lists in Sheffield , UK . Respondents were asked to complete a time trade-off ( TTO ) task for nine health states , result ing in an average of 16.5 values for each health state . Results Mean health states valued range from 0.48 to 0.98 ( where 1.0 is full health and zero is for states regarded as equivalent to death ) . Symptoms , as described by the classification system , can be rank-ordered in terms of their impact ( from high to low ) on menopausal HRQoL as follows : aching joints and muscles , bleeding , breast tenderness , anxious or frightened feelings , vaginal dryness , and rogenic signs . Hot flushes did not significantly contribute to model fit . The preferred model produced a mean absolute error of 0.053 , but suffered from bias at both ends of the scale . Conclusion This article presents an attempt to directly value a condition specific health state classification . The overall fit was disappointing , but the results demonstrate that menopausal symptoms are perceived by patients to have a significant impact on utility . The overall effect is modest compared to the more generic health state descriptions such as the EQ-5D . The result ant algorithm generates a preference-based index that can be used economic evaluation and that reflects the impact of this condition We developed a preference‐based measure , the Amyotrophic Lateral Sclerosis Utility Index ( ALSUI ) , allowing computation of US population ‐based utility weights for the wide range of health states observed among ALS patients . A multi‐attribute utility approach was used . An ALS Health State Classification System was developed comprising the following attributes with different severity levels : Speech and Swallowing ( A1 ) ; Eating , Dressing , and Bathing ( A2 ) ; Leg Function ( A3 ) ; and Respiratory Function ( A4 ) . An internet‐based survey was administered to a r and om sample of the US population to assess preferences for ALS health states based on this system using  visual analog scale ( VAS ) and st and ard gamble ( SG ) questions . Using the VAS and SG data from 1374 individuals in the general population , utility functions were computed that corresponded to each severity level within A1 , A2 , A3 , and A4 . ALSUI scores for a given patient are computed by inputting his corresponding utility functions into the following multiplicative formula : ALSUI score = 1.06 × (A1 × A2 × A3 × A4)−0.06 on a scale where 0.0 reflects death and 1.0 reflects healthy . This study provides a useful tool for classifying ALS patients and determining a general public‐based utility score for ALS health states STUDY OBJECTIVE To develop and evaluate a brief , easy-to-administer symptom assessment scale for use as a preference-based outcome measure in clinical trials and cost-effectiveness studies in asthma . DESIGN Cross-sectional survey with 2-week reproducibility assessment . SETTING Ambulatory care : university asthma and allergy center . PARTICIPANTS One hundred sixty-one adults with asthma , 59 % female , mean age 35+/-11 years . Mean FEV1 percent predicted was 86+/-17 % . INTERVENTIONS The  11-item Asthma Symptom Utility Index ( ASUI ) .  MEASUREMENTS AND RESULTS Mean ASUI score for this sample was 0.71+/-0.23 , with a range from 0.02 to 1.0 . The ASUI was reproducible ( intraclass correlation coefficient = 0.74 ) and able to distinguish patients known to differ on disease severity according to clinician ratings ( p < 0.001 ) and by an asthma disease severity scale score ( p < 0.001 ) . The instrument was also significantly correlated with FEV1 percent predicted ( r = 0.27 , p < 0.001 ) , the Asthma Quality of Life Question naire ( r = 0.77 , p < 0.001 ) , and the Health Utilities Index Mark 2 ( r = 0.36 , p < 0.001 ) . CONCLUSION The results of this study support the reliability and validity of the ASUI , suggesting it will be a useful , complementary patient outcome measure for clinical trials and cost-effectiveness studies comparing treatment alternatives for persons with asthma Purpose Condition-specific preference-based measures can offer utility data where they would not otherwise be available or where generic measures may lack sensitivity , although they lack comparability across conditions . This study aim ed to develop an algorithm for estimating utilities from the short bowel syndrome health-related quality of life scale ( SBS-QoL ™ ) . Methods SBS-QoL ™ items were selected based on factor and item performance analysis of a European SBS-QoL ™ data set and consultation with 3 SBS clinical experts . Six-dimension health states were developed using 8 SBS-QoL ™ items ( 2 dimensions combined 2 SBS-QoL ™ items ) . SBS health states were valued by a UK general population sample ( N = 250 ) using the lead-time time trade-off method . Preference weights or ‘ utility decrements ’ for each severity level of each dimension were estimated by regression models and used to develop the scoring algorithm . Results Mean utilities for the SBS health states ranged from −0.46 ( worst health state , very much affected on all dimensions ) to 0.92 ( best health state , not at all affected on all dimensions ) . The r and om effects model with maximum likelihood estimation regression had the best predictive ability and lowest root mean squared error and mean absolute error , and was used to develop the scoring algorithm . Conclusions The preference-weighted scoring algorithm for the SBS-QoL ™ developed is able to estimate a wide range of utility values from patient-level SBS-QoL ™ data . This allows estimation of SBS HRQL impact for the purpose of economic evaluation of SBS treatment benefits BACKGROUND Condition-specific measures are frequently used to assess the health-related quality of life of people with multiple sclerosis ( MS ) . Such measures are unsuitable for use in economic evaluations that require estimates of cost per quality -adjusted life-year because they are not based on preferences . OBJECTIVES To report the estimation of a preference-based single index for an eight-dimensional instrument for MS , the Multiple Sclerosis Impact Scale - Eight Dimensions ( MSIS-8D ) , derived from an MS-specific measure of health-related quality of life , the 29-item Multiple Sclerosis Impact Scale ( MSIS-29 ) . METHODS We elicited preferences for a sample of MSIS-8D states ( n = 169 ) from a sample ( n = 1702 ) of the UK general population . Preferences were elicited using the time trade-off technique via an Internet-based survey . We fitted regression models to these data to estimate values for all health states described by the MSIS-8D . Estimated values were assessed against MSIS-29 scores and values derived from generic preference-based measures in a large , representative sample of people with MS . RESULTS Participants reported that the time trade-off questions were easy to underst and . Observed health state values ranged from 0.08 to 0.89 . The best-performing model was a main effects , r and om effects model ( mean absolute error = 0.04 ) . Validation analyses support the performance of the MSIS-8D index : it correlated more strongly than did generic measures with MSIS-29 scores , and it discriminated effectively between subgroups of people with MS . CONCLUSIONS The MSIS-8D enables health state values to be estimated from the MSIS-29 , adding to the methods available to assess health outcomes and to estimate quality -adjusted life-years for MS for use in health technology assessment and decision-making context Background . The Clinical Outcomes in Routine Evaluation– Outcome Measure ( CORE-OM ) is used to evaluate the effectiveness of psychological therapies in people with common mental disorders . The objective of this study was to estimate a preference-based index for this population using CORE-6D , a health state classification system derived from the CORE-OM consisting of a 5-item emot 
    Output:
    