Use of the 15D

Ways of using the 15D

The instrument can be used for

  • assessing effectiveness and efficiency (cost-effectiveness/utility) of health care programmes and technologies

  • measuring and monitoring health status and HRQoL of patients and population groups, and whole populations

  • improving medical decision making by

    • identifying health problems of individual patients (use as a diagnostic tool) and

    • following-up their health status and HRQoL in a standard way as a part of medical records

  • setting output objectives for hospitals/clinics/wards and measuring their output

  • standardising patient-mix when comparing and analysing the productivity of hospitals/clinics/wards

The 15D instrument is recommended by the Washington Panel (Gold M et al. (eds.) Cost-effectiveness in health and medicine. Oxford University Press, New York and Oxford 1996).

Use as a profile instrument

When a person fills in the 15D questionnaire, the result is a 15-dimensional description of her/his health status. It shows the position of the person on the levels of each of the 15 dimensions of health. This is referred to as the 15D profile.

Similarly, a 15D profile for a group of persons (patients, population) can be constructed from the average position of the group on the levels of each of the 15 dimensions. It is recommended that the profiles are constructed on a 0-1 scale by using the variables, where the original ordinal numbers of the levels (1-5) have been replaced by level values produced by the valuation system.

Diseases/conditions/health problems studied

Drug evaluations:

- Breast cancer (tamoxifen vs. toremifen)

- Depression (fluoxetine vs. moclobemide, fluoxetine vs. dothiepine)

- Seasonal affective disorder (fluoxetine vs. moclobemide)

- Restenosis prevention after PTCA

- Osteoporosis (alendronate)

- A gastro-intestinal disorder (three drugs)

- Parkinson’s disease

- Chronic obstructive lung disease (COPD)

- Early rheumatoid arthritis (single drug treatment vs. 4-drug combination)

- Healthy postmenopausal women (hormone replacement therapy)

- Schizophrenia

- Psoriasis

- MS disease (interferon vs. not)

Surgery:

- Coronary artery disease (CABG, re-CABG, PTCA, conservative treatment).

- Knee and hip replacements

- Hip fracture

- Epilepsy (surgery vs. no surgery).

- Lumbar spinal stenosis (surgery vs. conservative treatment)

- Hallux valgus (surgery vs. conservative treatment)

- Herniated lumbar disc (surgery vs. conservative treatment)

- Adolescent idiopathic scoliosis (Harrington instrumentation)

- Varicose veins

- Gastrointestinal surgery

- Hernia

- Neurosurgery (several diagnoses)

- Esophageal cancer (surgery vs. palliative)

- Brain tumor

- Blood vessel surgery

- Breast cancer and reconstruction

- Breast reduction

- Lung cancer

- Severe obesity

- Hysterectomy

- Prostata hyperplasia

- Prostate cancer

- Bladder cancer

- Renal cancer

- Venuous leg ulcers (surgery vs. compression)

- Silicon implants

- Cataract

- Cochlear implant

- Incontinence (surgery vs. physiotherapy)

- Pneumonectomy

Rehabilitation:

- Stroke (treatment, intensive vs. conventional rehabilitation).

- Hip fracture (three approaches to rehabilitation)

- Lumbar disc herniation (muscle exercise program after surgery)

- MS patients (inpatient rehabilitation)

- Sub-acute low back pain (early activation and rehabilitation)

- Employed people with reduced ability to work (vocationally oriented medical rehabilitation

- Inspiration activity of the elderly

- Coronary artery disease (CAD) patients (rehabilitation)

- Geriatric rehabilitation (n=741, aged 65+)

- Holistic geriatric assessment, treatment and rehabilitation (n=1500, aged 75+)

- Orthopaedic patients (rehabilitation)

- Muscular strength training of the elderly

- Rehabilitation councelling of the elderly

- Visual impairment (rehabilitation)

- Speech rehabilitation

- Physiotherapy

Other conditions/treatments:

- Aphasia

- Acute low back pain

- Non-specific back pain

- Severe chronic pain (spinal cord stimulator)

- Chronic non-malignant pain (medical management)

- Fibromyalgia

- Sciatica

- Glaucoma

- Back pain in pregnant women (back supporting vest vs. conventional approach to treating back pain)

- Asthma (intensive vs. conventional patient education and supervision for self-management)

- ESRD

- Myocardial infarction

- Multiple myeloma

- Prostate cancer (screening and treatment)

- Arteriosclerotic disease (a multi-component intervention to prevent complications)

- HIV/AIDS

- Diabetes (prevention of type 2 in Finland; type 1 and 2 patients with different complications)

- Acromegaly

- Atrial fibrillation

- Nephrolith

- Sleep apnea

- Basedow’s disease

- Sparm of celebral arteries

- Esophagus atresia

- Cancer of thyroid gland

- Acoustic neurinoma

- Trigeminus neuralgia

- Atopic eczema

- Spinal cord injury

- Osteoarthritis

- Aneurysma (celebral haemorrhage)

- Duchenne-Erb paresis

- Teleultrasound examination

- Hearing problems

- Diastrophic dysplasia

- Irritable bowel syndrome

- Pancreatic exocrine insufficiency

- Human papilloma virus (HPV)

- Forearm fracture

- Gonarthritis

- Oral health

- Dizziness with migraine as an etiological factor

- Treatment of psychosis

- Eating disorders

- Bipolar affective disorder

- “Intelligent bracelet” for dementing elderly

- Patients coming to angiography

- Severe obesity (combined VLCD and behaviour modification)

- Fabry’s disease

- Weaning from smoking

- FH

Other projects:

- The Finnish National Health Survey 1995/96

- Health2000 survey in Finland (a random sample of 6329 of adult population aged 30+)

- Health2011 survey in Finland (a random sample of 5011 of adult population aged 18+)

- The Danish National Health Survey 2000.

- Experiment on feasibility and usefulness of measuring HRQoL of patients before and after treatment routinely in the hospitals of Helsinki and Uusimaa Hospital District (n≈7800, in 10 specialties, over 30 diagnoses)

- Experiment on including the 15D as a standard part of anamnesis in electronic medical records (Turku University Hospital)

- DEBATE-study (Drugs and Evidence-Based Medicine in the Elderly) (n=400, aged 75+ with cardiovascular diseases)

- Elderly in Helsinki, Finland vs. in Tallinn, Estonia

- The process of frailty and disability in older women (The Finnish Twin Study on Ageing, FITSA).

- The HRQoL of young military conscripts (15D vs. Rand-36)