Bayoumi A M, Redelmeier D A
Department of Medicine, University of Toronto, Canada.
Qual Life Res. 1999 Sep;8(6):471-80. doi: 10.1023/a:1008969512182.
Quality of life is measured as utilities for cost-effectiveness analyses.
To test the adequacy of three common utility elicitation methods for individuals with Human Immunodeficiency Virus (HIV) disease.
HIV-positive participants (n = 75) rated three standardized health states (symptomatic HIV infection, minor AIDS defining illness, and major AIDS defining illness) with two utility elicitation methods (Standard Gamble [SG], and Time Trade-off [TTO]) and one value method (Visual Analog [VA]). Participants also rated their own health with one utility method (Health Utilities Index [HUI]) and one conventional quality of life method (Medical Outcomes Study--HIV Health Survey [MOS-HIV]).
For all states, SG and TTO scores ranged from near 0.00 (equivalent to death) to 1.00 (best possible quality of life). Mean scores for symptomatic HIV were similar with the SG (0.80) and TTO (0.81) but higher than with the VA (0.70). Similar results were observed for minor AIDS defining illnesses (0.65, 0.65, 0.46 respectively) and major AIDS defining illnesses (0.42, 0.44, 0.25 respectively). Discrepant SG and TTO scores were observed in many individuals and were not explained by demographic characteristics. As expected, HUI scores of an individual's own health were related to the disease state. Four of ten MOS-HIV subscales (overall health, physical functioning, role functioning, and pain) were also related to disease state. HUI scores were correlated with the MOS-HIV score for overall health and for all MOS-HIV subscales except health transition.
Mean utility scores for HIV-related health states elicited by the Standard Gamble and Time Trade-off were similar but a large degree of individual variation persists. Economic methods provide imprecise estimates of the quality of life associated with HIV infection.
生活质量通过效用值来衡量，用于成本效益分析。
检验三种常用的效用值诱导方法对感染人类免疫缺陷病毒（HIV）疾病个体的适用性。
75名HIV阳性参与者使用两种效用值诱导方法（标准博弈法[SG]和时间权衡法[TTO]）以及一种赋值法（视觉模拟法[VA]）对三种标准化健康状态（有症状的HIV感染、轻度艾滋病界定疾病和重度艾滋病界定疾病）进行评分。参与者还使用一种效用值方法（健康效用指数[HUI]）和一种传统生活质量方法（医学结果研究——HIV健康调查[MOS-HIV]）对自身健康进行评分。
对于所有状态，SG和TTO评分范围从接近0.00（相当于死亡）到1.00（最佳生活质量）。有症状HIV感染的平均评分，SG法为0.80，TTO法为0.81，二者相似，但高于VA法（0.70）。轻度艾滋病界定疾病的结果类似（分别为0.65、0.65、0.46），重度艾滋病界定疾病的结果也类似（分别为0.42、0.44、0.25）。许多个体的SG和TTO评分存在差异，且无法用人口统计学特征解释。正如预期的那样，个体自身健康的HUI评分与疾病状态相关。MOS-HIV的十个分量表中有四个（总体健康、身体功能、角色功能和疼痛）也与疾病状态相关。HUI评分与MOS-HIV总体健康评分以及除健康转变外的所有MOS-HIV分量表评分相关。
标准博弈法和时间权衡法得出的HIV相关健康状态的平均效用值评分相似，但个体差异仍然很大。经济方法对与HIV感染相关的生活质量的估计并不精确。
