Reply to Letter to the Editor
-
Tarja Heiskanen
,
Risto P. Roine
Dear Sir,
We thank Drs Johan Hambraeus and Fredrik Campbell for their comment on our study “Multidisciplinary pain treatment – Which patients do benefit?”.
The authors express their concern regarding the acceptance of patients for multidisciplinary pain management at the Pain Clinic of the Helsinki University Central Hospital. It seems that the concern of Hambraeus and Campbell is due to comparing apples with oranges, i.e. comparing two different quality of life measures.
The average quality of life in the general populationin Finland as assessed using the 15 Dis 0.903 [1]. In patients awaiting hip surgery for painful arthrosis and patients with osteoarthritis or chronic arthritis, the average 15D scores were 0.810 and 0.801, respectively [1,2]. The 15D quality of life of the patients of our study was at the baseline 0.714 which is significantly lower than that of the other patient groups with chronic pain and obviously even much lower than that of the general population.
Hambraeus and Campbell refer to another quality of life measure (EQ-5D).Incontrast to 15D, even negative scores may begiven in EQ-5D. In the two studies cited by the authors [3,4], negative EQ-5D values were given a score of 0. In 15D, a score of 0 is equal to being dead and obviously it is not used by (living) patients. In general, EQ-5D seems to give smaller index values and be less sensitive when compared with 15D [5]. In the two Swedish studies, the mean index value for EQ-5D in the Swedish general population ranged from 0.74 to 0.89. The scoring method usedinthe NRPR registry and by the authors in their study is obviously different, given that they report an average baseline EQ-5D value of 0.295–0.308 in patients accepted for rehabilitation.
We agree with the authors that it is important to assess health-related quality of life in chronic pain treatment.
DOI of refers to article: http://dx.doi.org/10.1016/j.sjpain.2012.11.009..
References
[1] Laas K, Roine RP, Räsänen P, Sintonen H, Leirisalo-Repo M. Health-related quality of life inpatients with common rheumatic diseases referredto a university clinic. Rheumatol Int 2009;29:267–73.Search in Google Scholar
[2] Räsänen P, Paavolainen P, Sintonen H, Koivisto AM, Blom M, Ryynänen OP, Roine RP. Effectivenessofhiporknee replacement surgeryintermsofquality-adjusted life years and costs. Acta Orthop 2007;78:108–15.Search in Google Scholar
[3] Burström K, Johannesson M, Diderichsen F. Swedish population health-related quality of life results using the EQ-5D. Qual Life Res 2001;10:621–35.Search in Google Scholar
[4] Burström K, Johannesson M, Rehnberg C. Deteriorating health status in Stockholm 1998–2002: results from repeated population surveys using the EQ-5D. Qual Life Res 2007;16:1547–53.Search in Google Scholar
[5] Vainiola T, Pettilä V, Roine RP, Räsänen P, Rissanen AM, Sintonen H. Comparison of two utility instruments, the EQ-5D and the 15D, in the critical care setting. Intensive Care Med 2010;36:2090–3.Search in Google Scholar
© 2012 Scandinavian Association for the Study of Pain
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