An Analysis of Quality of Life (QOL) and Survival Impact in Amyotrophic Lateral Sclerosis (ALS) Patients
Bowen, Gloria M.
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In neurodegenerative diseases, such as Amyotrophic Lateral Sclerosis (ALS), quality of life (QOL) – a patient’s ability and desire to lead a fulfilling life – is an important measure to determine disease evolution and treatment plan options. A comprehensive QOL assessment, however is challenging to gather in a clinical setting and relies on survey results convoluted with bias. Current research of QOL metrics in ALS are inadequate and limited to small, cross-sectional studies relying often on depression as the sole measure of QOL. This study proposes a new metric for QOL analysis gathered from qualitative physician remarks on patient mood in the clinical setting, referred to as clinic impression of mood (CIM). A meta-analysis of fifty-one factors gathered from over a thousand ALS patients who have visited the Emory ALS Center was performed to analyze the validity of CIM as a QOL measure. These factors are compared against CIM and depression scorings based on the revised clinical Assessment of Depression Index (ADI-12). A chi-square test was used to compare binary factors and a linear regression model was used for continuous metric analysis. The results of this study demonstrate a strong relationship between CIM and survival duration. Further research into the relationship between CIM, depression, physical health, and survival will allow for more accurate disease progression predictions and thus more suitable treatment plans that center around a patient’s QOL.