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Establishing a composite endpoint for measuring the effectiveness of geriatric interventions based on older persons’ and informal caregivers’ preference weights: a vignette study

Cynthia S Hofman12*, Peter Makai1, Han Boter3, Bianca M Buurman4, Anton JM de Craen5, Marcel GM Olde Rikkert1, Rogier ART Donders2 and René JF Melis1

Author Affiliations

1 Department of Geriatric Medicine (HP 925), Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Netherlands

2 Department for Health Evidence (HP133), Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, Netherlands

3 Department of Epidemiology (FA41), University of Groningen, University Medical Centre, Groningen, PO Box 30001, 9700 RB, Groningen, Netherlands

4 Department of Internal Medicine, Section of Geriatric Medicine (F4-108), Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, Netherlands

5 Department of Gerontology and Geriatrics (C2-R), Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands

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BMC Geriatrics 2014, 14:51  doi:10.1186/1471-2318-14-51

Published: 18 April 2014



The Older Persons and Informal Caregivers Survey Minimal Dataset’s (TOPICS-MDS) questionnaire which measures relevant outcomes for elderly people was successfully incorporated into over 60 research projects of the Dutch National Care for the Elderly Programme. A composite endpoint (CEP) for this instrument would be helpful to compare effectiveness of the various intervention projects. Therefore, our aim is to establish a CEP for the TOPICS-MDS questionnaire, based on the preferences of elderly persons and informal caregivers.


A vignette study was conducted with 200 persons (124 elderly and 76 informal caregivers) as raters. The vignettes described eight TOPICS-MDS outcomes of older persons (morbidity, functional limitations, emotional well-being, pain experience, cognitive functioning, social functioning, self-perceived health and self-perceived quality of life) and the raters assessed the general well-being (GWB) of these vignette cases on a numeric rating scale (0–10). Mixed linear regression analyses were used to derive the preference weights of the TOPICS-MDS outcomes (dependent variable: GWB scores; fixed factors: the eight outcomes; unstandardized coefficients: preference weights).


The mixed regression model that combined the eight outcomes showed that the weights varied from 0.01 for social functioning to 0.16 for self-perceived health. A model that included “informal caregiver” showed that the interactions between this variable and each of the eight outcomes were not significant (p > 0.05).


A preference-weighted CEP for TOPICS-MDS questionnaire was established based on the preferences of older persons and informal caregivers. With this CEP optimal comparing the effectiveness of interventions in older persons can be realized.

Composite endpoint; Preference-weighted; Elderly persons; Informal caregivers; Effectiveness; Geriatric interventions