Verteporfin photodynamic therapy for neovascular age-related ...

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58 Results (3) – objective E10.8SF-6D utility score0.60.40.20 10 20 30 40 50Best CS in either eyeFIGURE 14 Scatterplot showing SF-6D preference-based measure of health (equivalent to utility score) compared withbetter-seeing eye CS. The fitted regression line (see Table 13) is superimposed on a scatterplot of the raw data.100NEIVFQ composite total score806040200–200 20 40 60 80 100Best BCVA in either eyeFIGURE 15 Scatterplot showing the NEIVFQ composite total score compared with better-seeing eye BCVA. Thefitted regression line (see Table 16) is superimposed on a scatterplot of the raw data. Values of BCVA < 0 (–10 and –20)represent ‘counting fingers’ and ‘hand movements’ levels of vision respectively.similar relationships were observed for distance and near NEIVFQ scores. Relationships werepositive and quadratic and had steeper gradients (in relation to the range of BCVA) than thoseseen for SF-6D and SF-36 component scores. Gradients were steeper for the distance and nearactivities subscores than for the composite total score. Predicted changes in composite total,distance and near NEIVFQ scores for 5- and 100-letter reductions in BCVA are shown inTable 16. Because the functions were quadratic, the predicted NEIVFQ changes for 100-letterreductions are described as approximate.
DOI: 10.3310/hta16060Health Technology Assessment 2012; Vol. 16: No. 659TABLE 16 Relationships between visual function and NEIVFQ scoresHRQoL scoreBCVANEIVFQcompositeNEIVFQ distanceactivitiesNEIVFQ nearactivitiesCSNEIVFQcompositeNEIVFQ distanceactivitiesNEIVFQ nearactivitiesHRQoLscaleLinear regressioncoefficient (95% CI)Quadratic regressioncoefficient (95% CI)0–100 –0.129 (–0.342 to 0.083) 0.0067 (0.0049 to0.0085)0–100 0.00002 (–0.236 to 0.236) 0.0075 (0.0054 to0.0096)0–100 0.397 (–0.626 to –0.127) 0.0111 (0.0090 to0.0131)0–100 –1.285 (–1.646 to –0.924) 0.0540 (0.0454 to0.0625)0–100 –1.737 (–2.181 to –1.292) 0.0694 (0.0589 to0.0799)0–100 –1.967 (–2.406 to –1.527) 0.0757 (0.0653 to0.0860)HRQoL change per 100HRQoL change per fiveline) a,b range) aletters (≡ one chart letters (i.e. whole chart3.90 ~55.05.08 ~72.55.48 ~72.8HRQoL change per 48HRQoL change per threesensitivity triad) a,b range) aletters (≡ one contrast letters (i.e. whole chart6.99 ~44.48.74 ~57.69.32 ~64.7a Estimated HRQoL change assumes the change in BCVA occurs in the better-seeing eye.b Changes in HRQoL estimated for a 5-letter drop in BCVA from 70 to 65 letters, and a 3-letter drop in CS (one triad) from 35 to 32 letters.Similarly, CS in the better-seeing eye strongly predicted the composite total, distance and nearactivity NEIVFQ score (p < 0.0001 for all three HRQoL measures, but less strongly than BCVA).The relationship between CS and NEIVFQ core total is shown in the scatterplot in Figure 16; therelationships were similar for distance and near NEIVFQ scores. As for BCVA, the relationshipswere positive and quadratic and had steeper gradients than those observed for SF-6D, PCS andMCS scores. Predicted changes in composite total, distance and near NEIVFQ scores for 3-letter(one triad) and 48-letter reductions in CS are shown in Table 16. Because the functions wereagain quadratic, the predicted NEIVFQ changes for 48-letter reductions are again describedas approximate.Based on the best-fitting model for the NEIVFQ composite total score and an average presentingBCVA of 50 letters and CS of 23 letters, the differences in BCVA and CS observed in the TAPtrials for predominantly classic nAMD lesions (11 ETDRS and 5 CS letters, respectively) 4,30‘translate’ into differences in score of about 9 and 12 respectively (on a scale of 0 to 100). In theVPDT cohort study, the net BCVA benefit was slightly smaller, at about nine letters (see Figure 7);this BCVA benefit ‘translates’ into a difference in NEIVFQ composite total score of about 7.For minimally classic nAMD lesions, the visual benefit observed in the TAP trials of four ETDRSletters after 1 year 4,30 ‘translates’ into a difference in NEIVFQ composite total score of about 3. Thelarger net BCVA benefit observed in the study, of about five letters (see Figure 8), ‘translates’ intoa difference in NEIVFQ composite total score of about 4.© Queen’s Printer and Controller of HMSO 2012. This work was produced by Reeves et al. under the terms of a commissioning contract issued by theSecretary of State for Health.
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DOI: 10.3310/hta16060Health Technol
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xExecutive summaryretreat on criter
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xiiExecutive summaryof data, with i
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2 Introductionon-going or new clini
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4 Introductionof VPDT in routine cl
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Page 84 and 85: 70 Discussion of resultsOur analyse
Page 86 and 87: 72 Discussion of resultsA further c
Page 88 and 89: 74 Discussion of resultsVPDT. It is
Page 98 and 99: 84 References16. Stelmack J. Qualit
Page 100 and 101: 86 References49. Guymer RH, Chiu AW
Page 102 and 103: 88 References83. Margrain TH. Minim
Page 104 and 105: 90 Appendix 1THE VERTEPORFIN PHOTOD
Page 106 and 107: 92 Appendix 11. Overview of Manual
Page 108 and 109: 94 Appendix 1And, if also collectin
Page 110 and 111: 96 Appendix 1more patients in the v
Page 112 and 113: 98 Appendix 12.4 Limitations of the
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108 Appendix 1Table 1: Schedule of
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110 Appendix 1The Verteporfin Photo
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112 Appendix 1• Additional clinic
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114 Appendix 18. Recording adverse
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116 Appendix 1level of benefit from
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118 Appendix 1• comparison of num
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120 Appendix 110.6 Sub-group analys
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122 Appendix 112. Data issues12.1 D
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124 Appendix 113. Organisation13.1
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126 Appendix 114. References[1] Ref
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128 Appendix 1Barnes RM, Gee L, Tay
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130 Appendix 1Appendix 1: Classifyi
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132 Appendix 1Liverpool re-treatmen
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134 Appendix 1Service StructurePlea
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136 Appendix 1Has your photographer
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138 Appendix 1There are many differ
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140 Appendix 1testing on vision tes
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144 Appendix 1College of Ophthalmol
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146 Appendix 1Appendix 5:Protocol f
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148 Appendix 16.2 Subjective Refrac
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152 Appendix 1Appendix 6:Protocol f
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170 Appendix 1Dos and Don’tsDosDo
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172 Appendix 1Resource use question
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174 Appendix 1Appendix 11: Recommen
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176 Appendix 1ADVERSE REACTION AND
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178 Appendix 1acute Trust; note tha
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180 Appendix 1Ophthalmologistrespon
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192 Appendix 3manufacturer’s pers
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FeedbackThe HTA programme and the a
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