Selai C E, Elstner K, Trimble M R
Raymond Way Neuropsychiatry Unit, Institute of Neurology, Queen Square, London, UK.
Epilepsy Res. 2000 Jan;38(1):67-74. doi: 10.1016/s0920-1211(99)00075-3.
The aim of this work was to assess the health-related quality of life (HRQL) of patients pre and post surgical treatment for epilepsy. A total of 145 patients were interviewed during their pre-surgical assessment on the telemetry unit, Queen Square. The HRQL assessment comprised the quality of life assessment schedule (QOLAS), the EuroQol EQ-5D and the epilepsy surgery inventory (ESI-55). A total of 40 patients were followed up, of which 22 had undergone surgery and achieved 75% or greater reduction in seizures. The QOLAS scores for the patients who achieved 75% or greater seizure reduction post-op were significantly lower (i.e. improved HRQL) compared to baseline. The descriptive data suggest that the EQ-5D may not be capturing all of the QOL issues of relevance to patients with chronic, intractable epilepsy and the EQ-5D may not be valid for this group. Most patients queried the visual analogue scale (VAS) which asks for an overall rating of the respondent's self-perceived health. The most frequent comments, from 42% of patients, was that 'health' did not include their epilepsy. Despite this, the group whose seizures were reduced had significantly higher VAS scores at follow-up. We can conclude that the VAS is sensitive to clinical change. The baseline EQ-5D utility and follow-up scores were compared. There were no significant changes in QOL scores for either group. The patients who achieved 75% or greater reduction in seizures post-op scored significantly higher (i.e. better QOL) on 2/3 composite scores of the ESI-55 at follow-up. The QOLAS, the EQ-5D VAS and the ESI-55 were sensitive to clinically defined outcome. The results for the EQ-5D profile and the EQ-5D utility suggest that the EQ-5D is not a valid and responsive instrument for use in patients with intractable epilepsy.
这项工作的目的是评估癫痫患者手术治疗前后与健康相关的生活质量（HRQL）。在女王广场遥测病房对145名患者进行了术前评估访谈。HRQL评估包括生活质量评估量表（QOLAS）、欧洲五维度健康量表（EuroQol EQ - 5D）和癫痫手术量表（ESI - 55）。共有40名患者接受随访，其中22名接受了手术且癫痫发作减少了75%或更多。术后癫痫发作减少75%或更多的患者，其QOLAS评分相比基线显著降低（即HRQL改善）。描述性数据表明，EQ - 5D可能未涵盖与慢性难治性癫痫患者相关的所有生活质量问题，且EQ - 5D可能不适用于该群体。大多数患者对要求对自身健康进行总体评分的视觉模拟量表（VAS）提出质疑。42%的患者最常见的评论是“健康”不包括他们的癫痫。尽管如此，癫痫发作减少的组在随访时VAS评分显著更高。我们可以得出结论，VAS对临床变化敏感。比较了基线EQ - 5D效用和随访评分。两组的生活质量评分均无显著变化。术后癫痫发作减少75%或更多的患者在随访时ESI - 55的2/3综合评分上显著更高（即生活质量更好）。QOLAS、EQ - 5D VAS和ESI - 55对临床定义的结果敏感。EQ - 5D概况和EQ - 5D效用的结果表明，EQ - 5D不是用于难治性癫痫患者的有效且敏感的工具。
