Raj Mehta

Prognostic value of the Framingham cardiovascular risk equation and the UKPDS risk engine for coronary heart disease in newly diagnosed Type 2 diabetes: results from a United Kingdom study

Aims  To determine the prognostic value of the Framingham equation and the United Kingdom Prospective Diabetes Study (UKPDS) risk engine in patients with newly diagnosed Type 2 diabetes.

Schizophrenia and Borderline Personality Disorder: Similarities and Differences in the Experience of Auditory Hallucinations, Paranoia, and Childhood Trauma

This study investigated similarities and differences in the experience of auditory hallucinations, paranoia, and childhood trauma in schizophrenia and borderline personality disorder (BPD). Patients with clinical diagnoses of schizophrenia or BPD were interviewed using the Structured Clinical Interviews for DSM-IV. Axes 1 and 2 and auditory hallucinations, paranoia, and childhood trauma were assessed. A total of 111 patients participated; 59 met criteria for schizophrenia, 33 for BPD, and 19 for both. The groups were similar in their experiences of voices, including the perceived location of them, but they differed in frequency of paranoid delusions. Those with a diagnosis of BPD, including those with schizophrenia comorbidity, reported more childhood trauma, especially emotional abuse. BPD and schizophrenia frequently coexist, and this comorbidity has implications for diagnostic classification and treatment. Levels of reported childhood trauma are especially high in those with a BPD diagnosis, whether they have schizophrenia or not, and this requires assessment and appropriate management.

EQ-5D versus SF-6D in an older, chronically Ill patient group.

Choosing between preference-based instruments of health-related quality of life (HR-QOL) in particular situations is an important area for research. Even where instruments can be assumed to be measuring the same thing, they may not be interchangeable. The study presented investigates the extent to which EQ-5D and SF-6D instruments are interchangeable in an older, chronically ill patient group undergoing haemodialysis. Head-to-head comparisons were made using ‘practicality’, ‘descriptive validity’, ‘empirical validity’, mean utilities and associated distributions. Overall it was difficult to choose between instruments on the basis of descriptive or empirical validity, since both performed similarly. Important differences were, however, found relating to practicality: a significantly higher response rate in favour of EQ-5D; and lower levels of missing data to derive health states. Non-response was significantly associated with age and co-morbidity of respondents. We suggest that in patients undergoing haemodialysis, and potentially other older chronically ill patient groups, EQ-5D is the primary preference-based generic HR-QOL instrument.