title: Establishing a composite endpoint for measuring the effectiveness of geriatric interventions based on older persons' and informal caregivers' preference weights: a vignette study.
abstract: BACKGROUND
  The Older Persons and Informal Caregivers Survey Minimal Dataset's (TOPICS-MDS) questionnaire which measures relevant outcomes for elderly people was successfully incorporated into over 60 research projects of the Dutch National Care for the Elderly Programme. A composite endpoint (CEP) for this instrument would be helpful to compare effectiveness of the various intervention projects. Therefore, our aim is to establish a CEP for the TOPICS-MDS questionnaire, based on the preferences of elderly persons and informal caregivers.
  
  
  METHODS
  A vignette study was conducted with 200 persons (124 elderly and 76 informal caregivers) as raters. The vignettes described eight TOPICS-MDS outcomes of older persons (morbidity, functional limitations, emotional well-being, pain experience, cognitive functioning, social functioning, self-perceived health and self-perceived quality of life) and the raters assessed the general well-being (GWB) of these vignette cases on a numeric rating scale (0-10). Mixed linear regression analyses were used to derive the preference weights of the TOPICS-MDS outcomes (dependent variable: GWB scores; fixed factors: the eight outcomes; unstandardized coefficients: preference weights).
  
  
  RESULTS
  The mixed regression model that combined the eight outcomes showed that the weights varied from 0.01 for social functioning to 0.16 for self-perceived health. A model that included "informal caregiver" showed that the interactions between this variable and each of the eight outcomes were not significant (p > 0.05).
  
  
  CONCLUSIONS
  A preference-weighted CEP for TOPICS-MDS questionnaire was established based on the preferences of older persons and informal caregivers. With this CEP optimal comparing the effectiveness of interventions in older persons can be realized.
authors.affiliation: Department of Geriatric Medicine (HP 925), Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Netherlands. Cynthia.Hofman@Radboudumc.nl.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Hofman
authors.forename: Peter
authors.initials: P
authors.lastname: Makai
authors.forename: Han
authors.initials: H
authors.lastname: Boter
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Buurman
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde Rikkert
authors.forename: Rogier A R T
authors.initials: RA
authors.lastname: Donders
authors.forename: René J F
authors.initials: RJ
authors.lastname: Melis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000592:standards; D061345:Early Medical Intervention / Q000379:methods* / Q000592:standards; D023381:Endpoint Determination / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011795:Surveys and Questionnaires / Q000592:standards; D016896:Treatment Outcome
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