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Health Related Quality of Life in Clinical Studies for Chronic Diseases—Design and Analytical Considerations

Chung, Sheng-Chia (2010) Health Related Quality of Life in Clinical Studies for Chronic Diseases—Design and Analytical Considerations. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

The dissertation uses health related quality of life (HRQoL) for evaluating treatment effectiveness. The research settings in the dissertation include observational cohort study and randomized clinical trial. The first research project examines the effect of Sahaja Yoga Meditation on quality of life. The study investigates whether the post intervention HRQoL, perceived anxiety assessment and hypertensive control is different in patients treated with meditation plus conventional therapy than patients treated with conventional therapy alone. The study shows that Sahaja Yoga Meditation treatment is associated with significant improvements in quality of life, anxiety reduction and blood pressure control. The second research project examines the association of age on clinical and quality of life outcomes in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D); specifically, among patients with both type 2 diabetes and coronary heart disease, whether a treatment strategy (prompt revascularization or medical therapy for heart disease and insulin sensitizing or insulin providing drugs for type 2 diabetes) is more preferable for older individuals in terms of clinical and HRQoL endpoints. The study shows that older patients are at greater risk for cardiovascular events but the effectiveness of cardiac treatment strategies and glycemic control strategies does not differ by age. Older patients experience an accelerated decline in health status than their younger peers. The third research project investigates the longitudinal relationship between body mass index (BMI) and heath status outcomes in BARI 2D. The study reports an inverse association between BMI and health status outcomes in patients with both stable ischemic heart disease and type 2 diabetes. Weight reduction is desirable for obese patients, but may not be necessary for overweight but non-obese patients to achieve improvements in functional capacity and perceived Energy outcomes. The public health significance of the dissertation lies in the research findings on treatments that result in better clinical or quality of life outcomes for patients with chronic diseases, but also contrasts the strength and weakness of HRQoL studies and demonstrates strategies to overcome the methodological challenges in conducting HRQoL research in clinical studies.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Chung, Sheng-Chiashengchiac@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBrooks, Maria Mmbrooks@pitt.eduMBROOKS
Committee MemberBromberger, Joyce Tbrombergerjt@upmc.eduJBROM
Committee MemberBalk, Judith Lbalkjl@mail.magee.edu
Committee MemberStone, Roslyn Aroslyn@pitt.eduROSLYN
Committee MemberKelsey, Sheryl Fkelsey@edc.pitt.eduKELSEYS
Date: 28 June 2010
Date Type: Completion
Defense Date: 19 April 2010
Approval Date: 28 June 2010
Submission Date: 12 April 2010
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: chronic disease; Health Related Quality of Life; randomized clinical trial; Sahaja Yoga Meditation
Other ID: http://etd.library.pitt.edu/ETD/available/etd-04122010-173142/, etd-04122010-173142
Date Deposited: 10 Nov 2011 19:36
Last Modified: 19 Dec 2016 14:35
URI: http://d-scholarship.pitt.edu/id/eprint/7074

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