Background: The EQ-5D is a widely used generic health-related quality of life instrument that has been used to describe population health and health outcomes in clinical trials and health economic evaluations. Aims: To generate Danish population norms for the EQ-5D index score, stratified by age and gender. Methods: The EQ-5D data from three population health surveys were pooled, thus providing EQ-5D profile data for 15,700 individuals aged 20-79 years. The Danish TTO scoring algorithm was used to weight each respondent's profile data to derive a single index score. Mean values were computed by gender and 10-year age groups, and educational groups. Results: In a random sample from the general Danish population, the mean EQ-5D index score ranged between 0.93 for 20—29 year-olds and 0.83 for 70—79 year-olds. Men had a significantly higher score than women in all age groups. Longer education was associated with higher EQ-5D index score in most age groups. Conclusions: The calculated mean values for the EQ-5D index score may be used as reference values for comparative purposes in future Danish population health and evaluative studies.

Health impact assessment (HIA) of exposure to air pollution is commonly based on city level (fine) particle concentration and may underestimate health consequences of changing local traffic. Exposure to traffic-related air pollution can be assessed at a high resolution by modelling levels of nitrogen dioxide (NO2), which together with ultrafine particles mainly originate from diesel-powered vehicles in urban areas. The purpose of this study was to estimate the health benefits of reduced exposure to vehicle emissions assessed as NO2 at the residence among the citizens of Copenhagen Municipality, Denmark. We utilized residential NO2 concentrations modelled by use of chemistry transport models to calculate contributions from emission sources to air pollution. The DYNAMO-HIA model was applied to the population of Copenhagen Municipality by using NO2 concentration estimates combined with demographic data and data from nationwide registers on incidence and prevalence of selected diseases, cause specific mortality, and total mortality of the population of Copenhagen. We used exposure-response functions linking NO2 concentration estimates at the residential address with the risk of diabetes, cardiovascular diseases, and respiratory diseases derived from a large Danish cohort study with the majority of subjects residing in Copenhagen between 1971 and 2010. Different scenarios were modelled to estimate the dynamic impact of NO2 exposure on related diseases and the potential health benefits of lowering the NO2 level in the Copenhagen Municipality. The annual mean NO2 concentration was 19.6 μg/m3 and for 70% of the population the range of exposure was between 15 and 21 μg/m3. If NO2 exposure was reduced to the annual mean rural level of 6 μg/m3, life expectancy in 2040 would increase by one year. The greatest gain in disease-free life expectancy would be lifetime without ischemic heart disease (1.4 years), chronic obstructive pulmonary disease (1.5 years for men and 1.6 years for women), and asthma (1.3 years for men and 1.5 years for women). Lowering NO2 exposure by 20% would increase disease-free life expectancy for the different diseases by 0.3-0.5 years. Using gender specific relative risks affected the results. Reducing the NO2 exposure by controlling traffic-related air pollution reduces the occurrence of some of the most prevalent chronic diseases and increases life expectancy. Such health benefits can be quantified by DYNAMO-HIA in a high resolution exposure modelling. This paper demonstrates how traffic planners can assess health benefits from reduced levels of traffic-related air pollution.

Background: The prevalence and consequences of obesity among children and adolescents remain a leading global public health concern, and evidence-based, multidisciplinary lifestyle interventions are the cornerstone of treatment. Mobile electronic devices are widely used across socioeconomic categories and may provide a means of extending the reach and efficiency of health care interventions. Objective: We aimed to synthesize the evidence regarding mobile health (mHealth) for the treatment of childhood overweight and obesity to map the breadth and nature of the literature in this field and describe the characteristics of published studies. Methods: We conducted a systematic scoping review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, by searching nine academic databases in addition to gray literature for studies describing acceptability, usability, feasibility, effectiveness, adherence, or cost-effectiveness of interventions assessing mHealth for childhood obesity treatment. We also hand searched the reference lists of relevant articles. Studies aimed at the prevention of overweight or obesity were excluded, as were studies in which mHealth was not the primary mode of treatment delivery for at least one study arm or was not independently assessed. A random portion of all abstracts and full texts was double screened by a second reviewer to ensure consistency. Data were charted according to study characteristics, including design, participants, intervention content, behavior change theory (BCT) underpinning the study, mode of delivery, and outcomes measured. Results: We identified 42 eligible studies assessing acceptability (n=7), usability (n=2), feasibility or pilot studies (n=15), treatment effect (n=17), and fidelity (n=1). Change in BMI z-scores or percentiles was most commonly measured, among a variety of dietary, physical activity, psychological, and usability or acceptability measures. SMS, mobile apps, and wearable devices made up the majority of mobile interventions, and 69% (29/42) of the studies specified a BCT used. Conclusions: Pediatric weight management using mHealth is an emerging field, with most work to date aimed at developing and piloting such interventions. Few large trials are published, and these are heterogeneous in nature and rarely reported according to the Consolidated Standards of Reporting Trials for eHealth guidelines. There is an evidence gap in the cost-effectiveness analyses of such studies.

One in three women and one in five men over the age of 50 will experience an osteoporotic fracture. Vertebral fractures can be very painful, affect patients’ daily function, and in severe cases require hospitalization. Traditionally, fracture pain is treated conservatively with analgesics, and bracing. Vertebral augmentation, also known as vertebroplasty, has been used during the last three decades as a minimally invasive treatment option for vertebral compression fractures, but the evidence base for its efficacy is weak. We describe a double-blind randomized sham-controlled clinical trial to assess the impact of vertebroplasty on self-reported clinical outcomes in patients with painful osteoporotic vertebral compression fractures and vertebral oedema. Two hundred and forty patients with painful osteoporotic vertebral fractures and MRI verified oedema will be randomized in a prospective, double-blind, single-center, clinical trial to either vertebroplasty or a sham procedure, with the possibility of crossover 12 weeks after randomization and operation. The primary outcome will be difference in self-reported pain 12 weeks after treatment between the vertebroplasty and sham group. Secondary outcomes will be patient-reported disability, health-related quality of life, societal costs of treatment and complications. Analysis will be based on intention-to-treat. Repeated measures ANCOVA with baseline ODI, Numerical Pain Rating Scale, EQ-5D-5 L, and number of levels involved as co-variates will be performed. With an aging population, the prevalence of osteoporosis and related complications such as vertebral compression fractures is expected to increase. Therefore, there is a growing need for evidence-based fracture treatments. This study fills a gap in the evidence base for treatment of painful osteoporotic vertebral fractures and will likely influence future treatment guidelines. The study has been evaluated and approved by the Regional Committees on Health Research for Southern Denmark October 9 2023 (Projekt-ID S-20230058) and the Danish Data Protection Agency 23/40,938. The protocol has been registered at ClinicalTrials.gov with trial registration number NCT06141187 November 21, 2023.

Background: Exercise prescribed by the general practitioner may be an important health-improving intervention for inactive individuals with lifestyle diseases. The objective was to analyse changes in physical activity and health-related quality of life among participants in five similar ‘Exercise on Prescription’ (EoP) programmes. Methods: The analysis was based on self-reported information in a follow-up design without a control group. The intervention comprised group training twice weekly in the first 2 months and once weekly in the following 2 months (24 sessions in all) combined with four to five sessions of motivational counselling. Self-report questionnaires were administered at the first contact and again after 4, 10 and 16 months. Outcome measures were changes in self-reported activity levels converted to metabolic equivalents and health-related quality of life measured by standard instruments (SF-12v2 and EQ-5D). Results: 449 individuals (59% women, mean age 57 years) agreed to participate in the study. Dropout was considerable [123 (27%); 231 (52%) 297 (66%) after 4, 10 and16 months]. Participants increased their physical activity level and health-related quality of life from baseline to 4 months and maintained improvement throughout the observation period. One in three to six participants increased their physical activity level and one in 4–10 achieved improvements in health-related quality of life. Conclusion: Exercise on prescription can contribute to improvements in physical activity level and health-related quality of life in physically inactive patients with or at increased risk of developing lifestyle diseases. An acceptable number of participants achieved and maintained improvements in physical activity level and health-related quality of life.

The aim of this study was to estimate the annual number of days absent from work associated with diabetes-related complications. Registry data were obtained for 34,882 individuals aged 18–70 years with hospital-diagnosed diabetes (ICD-10 codes: E10–E14) identified from a large national sample (40% of the Danish population) with 6 years of hospital utilisation data. The occurrence of a complication was defined as a hospital admission with a specified diagnosis or procedure code. Data on sickness episodes with municipal subsidy were retrieved for each individual. Days absent from work attributable to complications were defined as the estimated difference in absence days between individuals with and without the specified complication and were estimated for the first and subsequent years after the initial episode of the recorded complication. Angina pectoris, ischaemic stroke, and heart failure were the three most frequent complications in the population. Heart failure, amputation, renal disease, and peripheral vascular disease were on average associated with more than three-month additional absence from work during the first and subsequent years. Leg ulcers and neuropathy were associated with more days absent from work during the first year than in subsequent years. Diabetes complications are associated with a substantial number of additional days absent from work. The avoidance of these complications would benefit both patients and society.