Loading…
Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA
Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL...
Saved in:
Published in: | Health and quality of life outcomes 2013-10, Vol.11 (1), p.169-169 |
---|---|
Main Authors: | , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-b585t-d2966722d147804ae6558db033fa4a213f718442ecd140244b9be48afbe7040e3 |
---|---|
cites | |
container_end_page | 169 |
container_issue | 1 |
container_start_page | 169 |
container_title | Health and quality of life outcomes |
container_volume | 11 |
creator | Aballéa, Samuel Guelfucci, Florent Wagner, Julian Khemiri, Amine Dietz, Jean-Paul Sobel, Jack Toumi, Mondher |
description | Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.
A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing a single index value for health status. The SF-36 questionnaire was used for HRQoL assessment. Information on disease severity, treatment patterns and productivity was also collected.
12,834 members of online research panels were contacted. Among them, 620 women with RVVC (5%) were selected to complete the full questionnaire. The mean EQ-5D index score was 0.70 (95% confidence interval: [0.67, 0.72]) and the difference between women with a yeast infection at the time of questionnaire completion and other respondents was 0.05 (p = 0.47). The EQ-5D index score increased significantly with the time since last infection (p < 0.001). 68% of women reported depression/anxiety problems during acute episode, and 54% outside episodes, compared to less than 20% in general population (p < 0.001). All SF-36 domain scores were significantly below general population norms. Mental health domains were the most affected. The impact on productivity was estimated at 33 lost work hours per year on average, corresponding to estimated costs between €266/year and €1,130/year depending on the country.
Subjective health status and HRQoL during and in between acute inflammatory episodes in women with RVVC are significantly worse than in the general population, despite the use of antifungal therapy. The average index score in women with RVVC is comparable to other diseases such as asthma or COPD and worse than diseases such as headache/migraine according to US and UK catalogs of index scores. The survey also revealed a significant loss of productivity associated with RVVC. |
doi_str_mv | 10.1186/1477-7525-11-169 |
format | article |
fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3815627</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A534668426</galeid><sourcerecordid>A534668426</sourcerecordid><originalsourceid>FETCH-LOGICAL-b585t-d2966722d147804ae6558db033fa4a213f718442ecd140244b9be48afbe7040e3</originalsourceid><addsrcrecordid>eNp1kk1v1DAQhiMEoqVw54QscWkPKbFj5-OCtIoKVKqEtEv3ajnJZNcrJ976Y9v-Bv40DrssDSrywdb4ed8ZzziK3uPkEuMi-4Rpnsc5IyzGOMZZ-SI6PYZePjmfRG-s3SQJSQlhr6MTQjEuKclPo58LX2-gcXIHaA1CuTWyTjhvkRjaQyQ2oISDFt15oaR7RLpDSnaARK-HFbrXPQzoXgbpHBpvDAwOLb3a6Z1YyUEoVAUv2WorLTqfL5fVBZIDuvJGb-F3GrcGdLuYvY1edUJZeHfYz6LbL1c_qm_xzfev19XsJq5ZwVzckjLLckLa8LwioQIyxoq2TtK0E1QQnHY5Ligl0AQiIZTWZQ20EF0NeUITSM-iz3vfra97aJtQrxGKb43shXnkWkg-vRnkmq_0jqcFZhnJg0G1N6il_o_B9KbRPR-HwcdhcIx5mFVwOT-UYfSdB-t4L20DSokBtLdBwMqQj2Vjwo__oBvtTWjtSNEsK4oyp3-plVDA5dDpkLwZTfmMpSNGSRaoy2eosFroZaMH6GSITwQXE0FgHDy4lfDW8uvFfMome7Yx2loD3bEpOOHjl32uDR-eTuMo-PNH018DtOW-</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1446688974</pqid></control><display><type>article</type><title>Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA</title><source>Open Access: PubMed Central</source><source>Publicly Available Content Database</source><creator>Aballéa, Samuel ; Guelfucci, Florent ; Wagner, Julian ; Khemiri, Amine ; Dietz, Jean-Paul ; Sobel, Jack ; Toumi, Mondher</creator><creatorcontrib>Aballéa, Samuel ; Guelfucci, Florent ; Wagner, Julian ; Khemiri, Amine ; Dietz, Jean-Paul ; Sobel, Jack ; Toumi, Mondher</creatorcontrib><description>Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.
A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing a single index value for health status. The SF-36 questionnaire was used for HRQoL assessment. Information on disease severity, treatment patterns and productivity was also collected.
12,834 members of online research panels were contacted. Among them, 620 women with RVVC (5%) were selected to complete the full questionnaire. The mean EQ-5D index score was 0.70 (95% confidence interval: [0.67, 0.72]) and the difference between women with a yeast infection at the time of questionnaire completion and other respondents was 0.05 (p = 0.47). The EQ-5D index score increased significantly with the time since last infection (p < 0.001). 68% of women reported depression/anxiety problems during acute episode, and 54% outside episodes, compared to less than 20% in general population (p < 0.001). All SF-36 domain scores were significantly below general population norms. Mental health domains were the most affected. The impact on productivity was estimated at 33 lost work hours per year on average, corresponding to estimated costs between €266/year and €1,130/year depending on the country.
Subjective health status and HRQoL during and in between acute inflammatory episodes in women with RVVC are significantly worse than in the general population, despite the use of antifungal therapy. The average index score in women with RVVC is comparable to other diseases such as asthma or COPD and worse than diseases such as headache/migraine according to US and UK catalogs of index scores. The survey also revealed a significant loss of productivity associated with RVVC.</description><identifier>ISSN: 1477-7525</identifier><identifier>EISSN: 1477-7525</identifier><identifier>DOI: 10.1186/1477-7525-11-169</identifier><identifier>PMID: 24119427</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Candidiasis ; Candidiasis, Vulvovaginal - psychology ; Chronic Disease ; Cross-Sectional Studies ; Epidemiology ; Europe ; Female ; Fungal infections ; Health aspects ; Health care ; Health Status ; Health surveys ; Humans ; Labor productivity ; Older people ; Population ; Quality of Life ; Questionnaires ; Recurrence ; Studies ; Surveys ; Surveys and Questionnaires ; United States ; Women ; Womens health ; Yeast ; Young Adult</subject><ispartof>Health and quality of life outcomes, 2013-10, Vol.11 (1), p.169-169</ispartof><rights>COPYRIGHT 2013 BioMed Central Ltd.</rights><rights>2013 Aballéa et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2013 Aballéa et al.; licensee BioMed Central Ltd. 2013 Aballéa et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b585t-d2966722d147804ae6558db033fa4a213f718442ecd140244b9be48afbe7040e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3815627/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1446688974?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24119427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aballéa, Samuel</creatorcontrib><creatorcontrib>Guelfucci, Florent</creatorcontrib><creatorcontrib>Wagner, Julian</creatorcontrib><creatorcontrib>Khemiri, Amine</creatorcontrib><creatorcontrib>Dietz, Jean-Paul</creatorcontrib><creatorcontrib>Sobel, Jack</creatorcontrib><creatorcontrib>Toumi, Mondher</creatorcontrib><title>Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA</title><title>Health and quality of life outcomes</title><addtitle>Health Qual Life Outcomes</addtitle><description>Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.
A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing a single index value for health status. The SF-36 questionnaire was used for HRQoL assessment. Information on disease severity, treatment patterns and productivity was also collected.
12,834 members of online research panels were contacted. Among them, 620 women with RVVC (5%) were selected to complete the full questionnaire. The mean EQ-5D index score was 0.70 (95% confidence interval: [0.67, 0.72]) and the difference between women with a yeast infection at the time of questionnaire completion and other respondents was 0.05 (p = 0.47). The EQ-5D index score increased significantly with the time since last infection (p < 0.001). 68% of women reported depression/anxiety problems during acute episode, and 54% outside episodes, compared to less than 20% in general population (p < 0.001). All SF-36 domain scores were significantly below general population norms. Mental health domains were the most affected. The impact on productivity was estimated at 33 lost work hours per year on average, corresponding to estimated costs between €266/year and €1,130/year depending on the country.
Subjective health status and HRQoL during and in between acute inflammatory episodes in women with RVVC are significantly worse than in the general population, despite the use of antifungal therapy. The average index score in women with RVVC is comparable to other diseases such as asthma or COPD and worse than diseases such as headache/migraine according to US and UK catalogs of index scores. The survey also revealed a significant loss of productivity associated with RVVC.</description><subject>Adult</subject><subject>Candidiasis</subject><subject>Candidiasis, Vulvovaginal - psychology</subject><subject>Chronic Disease</subject><subject>Cross-Sectional Studies</subject><subject>Epidemiology</subject><subject>Europe</subject><subject>Female</subject><subject>Fungal infections</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health Status</subject><subject>Health surveys</subject><subject>Humans</subject><subject>Labor productivity</subject><subject>Older people</subject><subject>Population</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Recurrence</subject><subject>Studies</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>United States</subject><subject>Women</subject><subject>Womens health</subject><subject>Yeast</subject><subject>Young Adult</subject><issn>1477-7525</issn><issn>1477-7525</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNp1kk1v1DAQhiMEoqVw54QscWkPKbFj5-OCtIoKVKqEtEv3ajnJZNcrJ976Y9v-Bv40DrssDSrywdb4ed8ZzziK3uPkEuMi-4Rpnsc5IyzGOMZZ-SI6PYZePjmfRG-s3SQJSQlhr6MTQjEuKclPo58LX2-gcXIHaA1CuTWyTjhvkRjaQyQ2oISDFt15oaR7RLpDSnaARK-HFbrXPQzoXgbpHBpvDAwOLb3a6Z1YyUEoVAUv2WorLTqfL5fVBZIDuvJGb-F3GrcGdLuYvY1edUJZeHfYz6LbL1c_qm_xzfev19XsJq5ZwVzckjLLckLa8LwioQIyxoq2TtK0E1QQnHY5Ligl0AQiIZTWZQ20EF0NeUITSM-iz3vfra97aJtQrxGKb43shXnkWkg-vRnkmq_0jqcFZhnJg0G1N6il_o_B9KbRPR-HwcdhcIx5mFVwOT-UYfSdB-t4L20DSokBtLdBwMqQj2Vjwo__oBvtTWjtSNEsK4oyp3-plVDA5dDpkLwZTfmMpSNGSRaoy2eosFroZaMH6GSITwQXE0FgHDy4lfDW8uvFfMome7Yx2loD3bEpOOHjl32uDR-eTuMo-PNH018DtOW-</recordid><startdate>20131011</startdate><enddate>20131011</enddate><creator>Aballéa, Samuel</creator><creator>Guelfucci, Florent</creator><creator>Wagner, Julian</creator><creator>Khemiri, Amine</creator><creator>Dietz, Jean-Paul</creator><creator>Sobel, Jack</creator><creator>Toumi, Mondher</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>3V.</scope><scope>7T2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PATMY</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PYCSY</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20131011</creationdate><title>Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA</title><author>Aballéa, Samuel ; Guelfucci, Florent ; Wagner, Julian ; Khemiri, Amine ; Dietz, Jean-Paul ; Sobel, Jack ; Toumi, Mondher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b585t-d2966722d147804ae6558db033fa4a213f718442ecd140244b9be48afbe7040e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Candidiasis</topic><topic>Candidiasis, Vulvovaginal - psychology</topic><topic>Chronic Disease</topic><topic>Cross-Sectional Studies</topic><topic>Epidemiology</topic><topic>Europe</topic><topic>Female</topic><topic>Fungal infections</topic><topic>Health aspects</topic><topic>Health care</topic><topic>Health Status</topic><topic>Health surveys</topic><topic>Humans</topic><topic>Labor productivity</topic><topic>Older people</topic><topic>Population</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Recurrence</topic><topic>Studies</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>United States</topic><topic>Women</topic><topic>Womens health</topic><topic>Yeast</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aballéa, Samuel</creatorcontrib><creatorcontrib>Guelfucci, Florent</creatorcontrib><creatorcontrib>Wagner, Julian</creatorcontrib><creatorcontrib>Khemiri, Amine</creatorcontrib><creatorcontrib>Dietz, Jean-Paul</creatorcontrib><creatorcontrib>Sobel, Jack</creatorcontrib><creatorcontrib>Toumi, Mondher</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Environmental Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Environmental Science Collection</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health and quality of life outcomes</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aballéa, Samuel</au><au>Guelfucci, Florent</au><au>Wagner, Julian</au><au>Khemiri, Amine</au><au>Dietz, Jean-Paul</au><au>Sobel, Jack</au><au>Toumi, Mondher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA</atitle><jtitle>Health and quality of life outcomes</jtitle><addtitle>Health Qual Life Outcomes</addtitle><date>2013-10-11</date><risdate>2013</risdate><volume>11</volume><issue>1</issue><spage>169</spage><epage>169</epage><pages>169-169</pages><issn>1477-7525</issn><eissn>1477-7525</eissn><abstract>Recurrent vulvovaginal candidosis (RVVC) is a chronic condition causing discomfort and pain. Health status and health-related quality of life (HRQoL) in RVVC were never previously described using validated questionnaires. The objective of this study is to describe subjective health status and HRQoL and estimate health state utilities among women with RVVC.
A cross-sectional online survey was conducted among women who reported having suffered four or more yeast infections over the past 12 months, in five European countries (France, Germany, Italy, Spain and the UK) and the USA. Index scores were derived from the EQ-5D, a questionnaire providing a single index value for health status. The SF-36 questionnaire was used for HRQoL assessment. Information on disease severity, treatment patterns and productivity was also collected.
12,834 members of online research panels were contacted. Among them, 620 women with RVVC (5%) were selected to complete the full questionnaire. The mean EQ-5D index score was 0.70 (95% confidence interval: [0.67, 0.72]) and the difference between women with a yeast infection at the time of questionnaire completion and other respondents was 0.05 (p = 0.47). The EQ-5D index score increased significantly with the time since last infection (p < 0.001). 68% of women reported depression/anxiety problems during acute episode, and 54% outside episodes, compared to less than 20% in general population (p < 0.001). All SF-36 domain scores were significantly below general population norms. Mental health domains were the most affected. The impact on productivity was estimated at 33 lost work hours per year on average, corresponding to estimated costs between €266/year and €1,130/year depending on the country.
Subjective health status and HRQoL during and in between acute inflammatory episodes in women with RVVC are significantly worse than in the general population, despite the use of antifungal therapy. The average index score in women with RVVC is comparable to other diseases such as asthma or COPD and worse than diseases such as headache/migraine according to US and UK catalogs of index scores. The survey also revealed a significant loss of productivity associated with RVVC.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24119427</pmid><doi>10.1186/1477-7525-11-169</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1477-7525 |
ispartof | Health and quality of life outcomes, 2013-10, Vol.11 (1), p.169-169 |
issn | 1477-7525 1477-7525 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3815627 |
source | Open Access: PubMed Central; Publicly Available Content Database |
subjects | Adult Candidiasis Candidiasis, Vulvovaginal - psychology Chronic Disease Cross-Sectional Studies Epidemiology Europe Female Fungal infections Health aspects Health care Health Status Health surveys Humans Labor productivity Older people Population Quality of Life Questionnaires Recurrence Studies Surveys Surveys and Questionnaires United States Women Womens health Yeast Young Adult |
title | Subjective health status and health-related quality of life among women with Recurrent Vulvovaginal Candidosis (RVVC) in Europe and the USA |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-27T16%3A41%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Subjective%20health%20status%20and%20health-related%20quality%20of%20life%20among%20women%20with%20Recurrent%20Vulvovaginal%20Candidosis%20(RVVC)%20in%20Europe%20and%20the%20USA&rft.jtitle=Health%20and%20quality%20of%20life%20outcomes&rft.au=Aball%C3%A9a,%20Samuel&rft.date=2013-10-11&rft.volume=11&rft.issue=1&rft.spage=169&rft.epage=169&rft.pages=169-169&rft.issn=1477-7525&rft.eissn=1477-7525&rft_id=info:doi/10.1186/1477-7525-11-169&rft_dat=%3Cgale_pubme%3EA534668426%3C/gale_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-b585t-d2966722d147804ae6558db033fa4a213f718442ecd140244b9be48afbe7040e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1446688974&rft_id=info:pmid/24119427&rft_galeid=A534668426&rfr_iscdi=true |