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Table 3 Health-related quality of life

From: A systematic review and meta-analysis of risks and benefits with breast reduction in the public healthcare system: priorities for further research

Author
Year
Country
Study design Number of patients Withdrawals—dropouts Intervention
Breast reduction
Mean (SD)
Control
No surgery
Mean (SD)
P values of intergroup difference if not state otherwise
Comments Directness* Study limitations* Precision*
Araujo
2014
Brazil [40]
RCT 60
I: 30
C: 30
2
1: 0
C: 2
SF-6D
Median (range)
Preop: 0.61 (0.45–0.83)
3 m: 0.75 (0.50–0.97)
6 m: 0.76 (0.44–0.97)
SF-6D
Median (range)
Preop: 0.61 (0.39–0.835)
3 m: 0.65 (0.43–0.83), p < 0.001
6 m: 0.63 (0.42–0.88)
p = 0.008
SF-6D: Short Form 6 Dimensions questionnaire. Scale 0.29–1.00 (1.00 denotes perfect health). Minimal important difference (MID) for SF-6D has been suggested to be in the range of 0.01 to 0.10 [35]
(SF-36 measured but not reported)
? ? ?
Iwuagwu
2006
UK [31]
RCT 73
I: 36
C: 37
0
I: 0
C: 0
FANLT
Physical well-being: 24.2 (3.7)
Social well-being: 24.6 (4.7)
Emotional well-being: 17.3 (3.7)
Functional well-being: 23.3 (5.2)
SF-36
Physical component score: 50.0 (7.5)
Mental component score: 53.2 (8.8)
EQ-5D
Self-care: 1.03 (0.18)
Activities: 1.32 (0.61)
Pain: 1.46 (0.57)
Anxiety and depression: 1.21 (0.50)
FANLT
Physical well-being: 19.2 (5.1)
p < 0.001
Social well-being: 20.7 (4.7)
p = 0.002
Emotional well-being: 13.0 (3.5)
p < 0.001
Functional well-being: 17.1 (6.2)
p < 0.001
SF-36
Physical component score: 42.0 (9.6)
p < 0.001
Mental component score: 42.0 (11.1)
p < 0.001
EQ-5D
Self-care: 1.05 (0.23)
p = 0.978
Activities: 1.48 (0.51)
p = 0.061
Pain: 2.05 (0.52)
p < 0.001
Anxiety and depression:
1.59 (0.55)
p = 0.006
FANLT: Functional Assessment of Non-Life-Threatening Conditions (higher score = better health, range not stated)
SF-36: Short Form-36 Health survey (36 items, range 0–100, higher score = better health)
EQ-5D (EuroQol): The European Quality of Life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Range 1–3, lower score = better. 4 dimensions reported in article
All are validated HRQoL tools
Control group underwent physiotherapy
? ? ?
Saariniemi
2008
Finland [34]
RCT 82
I: 40
C: 42
18
I: 11
C: 7
SF-36
Utility index score (SF-6D): 0.820 (SD NR)
Physical component score:
51.7 (SD NR)
Mental component score: 53.8 (SD NR)
15D index score
0.917 (SD NR)
SF-36
Utility index score (SF-6D): 0.663 (SD NR)
MD 0.157 (95% CI 0.107 to 0.220)
p < 0.0001
Physical component score:
43.3 (SD NR)
MD 8.4 (95% CI 5.8 to 11.8) p < 0.0001
Mental component score:
46.2 (SD NR)
MD 7.6 (95% CI 3.2 to 13.1) p < 0.002
15D index score
0.861 (SD NR)
MD 0.056 (95% CI 0.041 to 0.103), p < 0.0001
SF-36: Short Form-36 Health survey (range 0–100, higher score = better health)
SF-6D: Single health utility index score. Part of SF-36 (range 0.29–1.00, higher score = higher function)
15D: Finish QoL questionnaire (higher score = better health, range 0–1)
?/ +  ?  + 
Andrade
2018
Brazil [42]
Non-randomized controlled study 100
I: 50
C: 50
NR Breast-Q
Median (range)
Satisfaction with breasts:
70 (30–100)
Psychosocial well-being:
92 (0–100)
Sexual well-being:
88 (21–100)
Physical well-being:
79 (48–100)
Breast-Q
Median (range)
Satisfaction with breasts:
23 (0–50) p = 0.001
Psychosocial well-being:
33 (0–71) p = 0.001
Sexual well-being:
29 (0–78) p = 0.001
Physical well-being:
48 (0–83) p = 0.001
Breast-Q: Total scores ranging from 0–100. Higher score indicates greater satisfaction or better quality of life  +  ?/ + 
Hermans
2005
Netherlands [43]
Non-randomized controlled study 165
I: 94
C: 71
10
I: 10
C: 0
SF-36
Physical function:
84.76
Pain:
77.65
Vitality:
67.01
Social activities:
83.69
Emotional status:
80.95
Mental health:
75.22
Physical activities:
76.19
Health perceptions:
72.26
EQ-5D
Pain:
No problems: 51.2%
Some problems: 44.0%
Many problems: 4.8%
Daily activities:
No problems: 72.3%
Some problems: 25.3%
Many problems: 2.4%
SF-36
Physical function:
77.46, p < 0.05
Pain:
57.00, p < 0.001
Vitality:
56.83, p < 0.01
Social activities:
68.30, p < 0.001
Emotional status:
64.32, p < 0.01
Mental health:
66.42, p < 0.01
Physical activities:
65.85, p = NR
Health perceptions:
65.42, p < 0.05
EQ-5D
Pain:
No problems: 14.1%, p < 0.001
Some problems: 78.9%
Many problems: 7.0%
Daily activities:
No problems: 46.5%, p < 0.005
Some problems: 50.7%
Many problems: 2.8%
SF-36: Short Form-36 Health survey (higher score = better health, range 0–100)
EQ-5D: The European Quality of Life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). 3 answers possible within each dimension. Only 2 dimensions stated in article
? ?/− ?
  1. * + No or minor problems; ? Some problems; - Major problems
  2. SF-6D Short Form 6 Dimensions questionnaire Scale, FANLT Functional Assessment of Non-Life-Threatening Conditions, SF-36 Short Form-36 Health survey, MD Mean difference, 15D Finish QoL questionnaire, EQ-5D The European Quality of Life-5 Dimensions, NR not reported, SD standard deviation