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- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Timing of quality of life (QoL) assessments as a source of error in oncological trials
- 2001
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 35:5, s. 709-16
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Tidskriftsartikel (refereegranskat)abstract
- AIM OF THE STUDY: To produce an empirical estimate of the nature and magnitude of the error produced by incorrect timing quality of life (QoL) measurements in patients receiving chemotherapy. DESIGN: In a multicentre trial, 283 patients were randomized to receive either docetaxel (T) or sequential methotrexate and 5-fluorouracil (MF). The QoL was assessed at baseline and before each treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The study design was retrospective. Data were analysed using t-tests. RESULTS: Erroneous timing affected the QoL findings in both treatment arms. At baseline, there were statistically significant differences in the MF group on the nausea/vomiting scale, with ill-timed assessment showing more symptoms, and in the T group on the physical functioning scale with ill-timed assessments indicating better QoL. The mean scores of correct vs. incorrect timings over the first 14 cycles showed statistically significant differences on several scales. In the MF group, ill-timed assessments indicated significantly worse physical functioning and global QoL, and significantly more of the following symptoms: fatigue, nausea/vomiting, insomnia, appetite loss, and constipation. In the T group, ill-timed assessment showed better physical functioning, less dyspnoea and more insomnia than correctly timed assessments. The reasons for erroneous timing were not always detectable retrospectively. However, in some cases the MF group, being in standard treatment, seemed to have followed a clinical routine not involving the active participation of the study nurse responsible, whereas patients in the experimental T group were more consistently taken care of by the study nurses. CONCLUSIONS: Incorrect timing of QoL assessments in oncological trials jeopardises both the reliability of the QoL findings within treatment and the validity of QoL outcome comparisons between treatments. This issue should be emphasized in the planning of both the study design and clinical routines.
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| 2. |
- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Quality of life in patients with metastatic breast cancer receiving either docetaxel or sequential methotrexate and 5-fluorouracil : A multicentre randomised phase III trial by the Scandinavian breast group
- 2000
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Ingår i: European Journal of Cancer. - 0959-8049 .- 1879-0852. ; 36:11, s. 1411-7
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate the effects of two alternative chemotherapy regimes on the quality of life (QoL) of patients with advanced breast cancer. In a multicentre trial, 283 patients were randomised to receive either docetaxel (T) or sequential methotrexate and 5-fluorouracil (MF). QoL was assessed at baseline and before each treatment using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Initial compliance in the QoL study was 96% and the overall compliance 82%. QoL data were available for 245 patients (T 130 and 115 MF). Both treatment groups showed some improvement in emotional functioning during treatment, with a significant difference favouring the MF group at treatment cycles 5 and 6. In the T group, the scores on the other functional scales remained stable throughout the first six cycles. There were significant differences favouring the MF group on the social functioning scale at treatment cycle 6 and on the Global QoL scale at treatment cycles 5 and 6. On most symptom and single-item scales there were no statistically significant differences between the groups. However, at baseline, the T patients reported more appetite loss, at treatment cycles 2-4, the MF patients reported more nausea/vomiting, and at treatment cycle 6, the T patients reported more symptoms of fatigue, dyspnoea and insomnia. There were no statistically significant differences between the groups in the mean change scores of the functional and symptom scales. Interindividual variance was, however, larger in the T group. Differences in QoL between the two treatment groups were minor. Hence, given the expectancy of comparable QoL outcomes, the choice of treatment should be made on the basis of the expected clinical effect.
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| 4. |
- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Fyrtiotalisterna som framtida äldre trafikanter
- 2005
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- A questionnaire was sent by post to a sample of holders of driving licenseswho had been born in the year 1944. The questionnaire covered present travelhabits, expectations regarding the future as older road users, and givinglifts to elderly people. By targeting this group, it is anticipated that amore correct picture can be obtained of such things as future travel patternscompared with the usual method of basing forecasts on today's elderly people.As regards present travel patterns, the results showed such things as acontinuation of the unequal distribution of car driving between males andfemales, that the car dominated as a method of travel, and that the car wasconsidered to be necessary more often by men than it was by women.Expectations regarding the future were captured by asking the respondent toimagine that he or she was 80 years old at the time of filling in thequestionnaire, and indicating his or her view of the probability of variousphenomena at that age. Most of the respondents anticipated a rather activeand mobile old age ahead of them, and the degree of optimism increased withincreased mileage driven annually. However, over one-third of the womenconsidered that it was not at all probable that they would be driving a carat the age of 80. Almost half of the respondents gave lifts to olderrelatives and acquaintances regularly, typically up to four times a month.
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| 5. |
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| 6. |
- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Körkortsdiagnostik i allmänläkares dagliga patientarbete med äldre : en jämförelse av svenska och finska allmänläkares aktiviteter, kunskaper och attityder
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I Sverige och Finland används olika metoder för att identifiera de äldre förare som av medicinska skäl inte borde fortsätta att köra bil. Svenska läkare är skyldiga att rapportera olämpliga förare, men inga medicinska undersökningar krävs för att förlänga ett körkorts giltighet. I Finland upphör körkortet att gälla vid 70 års ålder. De som önskar fortsätta köra bil måste, i samband med ansökan om ett nytt körkort, genomgå en medicinsk kontroll som omfattar det allmänna hälsotillståndet och synförmågan. Syftet med föreliggande undersökning var att jämföra finska och svenska allmänläkares aktiviteter, kunskaper och attityder beträffande åldrande och bilkörning, med avsikten att utvärdera effekterna av de bägge ländernas olika körkortspolicy. Hypotesen var att de finska allmänläkarna, p g a erfarenheten från de obligatoriska hälsokontrollerna, skulle vara bättre informerade och mera aktiva när det gäller att hantera frågan om körlämpligheten med sina äldre patienter än de svenska, som saknar denna typ av erfarenhet. Ett slumpmässigt urval av 3 000 svenska och finska allmänläkare tillfrågades i en postenkät om sina aktiviteter, kunskaper och attityder angående patienter som var aktiva förare och 65 år och däröver. Resultaten visade att den strikta finska policyn för förnyandet av körkortet för äldre förare inte medförde att allmänläkarna var bättre informerade eller mer aktiva när gällde att ta tag i körrelaterade frågor med de äldre patienterna. Skillnaderna var små mellan svenska och finska allmänläkares aktivitetsgrad och kunskapsnivå. De svenska läkarna var emellertid något mer aktiva och visste mer om demens som en riskfaktor. Icke desto mindre hade de finska läkarna en större tilltro till sin förmåga att bedöma körförmågan hos äldre patienter. Deras attityder var också mer restriktiva. Sålunda framkom inget i undersökningen som stödde hypotesen. Det finska systemet ger inte allmänläkarna bättre förutsättningar att hantera frågor om åldrande och bilkörning än de svenska allmänläkarna. Systemet kan till och med motverka sitt eget syfte genom att det hos de finska allmänläkarna skapar en illusorisk tilltro till sin förmåga att bedöma körlämpligheten.
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| 7. |
- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Older drivers - a review
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The proportion of senior citizens (aged 65+) will grow from about 15% in theyear 2000 to about 30% in the year 2050. The share of older drivers in thedriver population will grow even faster because of increasing licensing ratesamong the ageing population. Older drivers do not have higher accident riskthan others. They do however have higher risk of being injured and killed inaccidents because of their with age increasing physical frailty. Generallyspeaking, safety measures targeted towards older driver are beneficial forall. In the present report measures are described that focus on the drivers,on the traffic environment, on vehicles and on ITS applications.
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| 8. |
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| 9. |
- Hakamies-Blomqvist, Liisa, et al.
(författare)
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Recent European research on older drivers
- 2000
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Ingår i: Accident Analysis and Prevention. - 0001-4575 .- 1879-2057. ; 32:4, s. 601-607
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Tidskriftsartikel (refereegranskat)abstract
- This paper discusses European research on older drivers published since 1985. It is not intended to be an exhaustive review, rather, the focus is on those issues that have been most topical during the past fifteen years. First, the paper deals with general efforts to integrate ageing into transport policy design. The emphasis is placed on differences in the European and American perspectives and discourse. Second, some research issues that have been topical in the European research agenda are reviewed, with a few examples of each. Third, a brief outline is given of newly emerging research issues of importance. (C) 2000 Elsevier Science Ltd. All rights reserved.
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