Sieber W J, David K M, Adams J E, Kaplan R M, Ganiats T G
University of California, San Diego Health Outcomes Assessment Program, San Diego, CA, USA.
Headache. 2000 Sep;40(8):662-71. doi: 10.1046/j.1526-4610.2000.040008662.x.
To compare the interviewer-administered Quality of Well-being Scale (QWB) with a self-administered form (QWB-SA) for patients with migraine, and to compare the health status of migraineurs to other medical populations.
With the increasing need to document the cost-effectiveness of treatment for migraine, limitations with both the Medical Outcomes Study Short Form-36 items and the QWB have been an impediment to research using cost-effectiveness as an outcome. Demonstrating the sensitivity of an alternative instrument which addresses these limitations would facilitate cost-effectiveness analyses on treatments for migraine.
Eighty-nine adults (87% women) known to suffer from migraine were asked to complete both the interviewer-administered QWB and the self-administered version (QWB-SA) on three occasions. The first occasion was on a day when no migraine was experienced in the previous 7 days. The second and third assessments were completed within 48 hours of the onset of a migraine.
While both the QWB and the QWB-SA successfully distinguished migraine from nonmigraine days, more migraines were reported on the QWB-SA. Overall, both instruments showed similar patterns of patient dysfunction during a migraine attack. Each component of the QWB-SA successfully distinguished migraine from nonmigraine days, and the QWB-SA showed a linear sensitivity to pain intensity and disability during a migraine episode. Both instruments are able to detect a migraine's effect on multiple domains of quality of life. Study participants scored significantly lower on the QWB-SA during a migraine episode than several comparison medical populations.
The QWB and the QWB-SA appear to have sensitivity to migraine severity, and the ability to quantitate an effect in multiple quality-of-life domains. Both measures can be used to calculate quality-adjusted life-years, thus facilitating cost-effectiveness and health policy work in this important clinical area.
比较由访谈者实施的幸福感质量量表（QWB）与自我管理形式（QWB-SA）在偏头痛患者中的应用情况，并将偏头痛患者的健康状况与其他医学人群进行比较。
随着记录偏头痛治疗成本效益的需求不断增加，医学结果研究简表36项和QWB的局限性一直阻碍着以成本效益为结果的研究。证明一种能解决这些局限性的替代工具的敏感性将有助于偏头痛治疗的成本效益分析。
89名已知患有偏头痛的成年人（87%为女性）被要求在三个时间点分别完成由访谈者实施的QWB和自我管理版本（QWB-SA）。第一次是在过去7天内未经历偏头痛的一天。第二次和第三次评估在偏头痛发作后48小时内完成。
虽然QWB和QWB-SA都成功区分了偏头痛日和非偏头痛日，但QWB-SA报告的偏头痛更多。总体而言，两种工具在偏头痛发作期间显示出相似的患者功能障碍模式。QWB-SA的每个组成部分都成功区分了偏头痛日和非偏头痛日，并且QWB-SA在偏头痛发作期间对疼痛强度和残疾表现出线性敏感性。两种工具都能够检测偏头痛对生活质量多个领域的影响。研究参与者在偏头痛发作期间在QWB-SA上的得分明显低于几个对照医学人群。
QWB和QWB-SA似乎对偏头痛严重程度具有敏感性，并且能够量化在多个生活质量领域的影响。两种测量方法都可用于计算质量调整生命年数，从而促进这一重要临床领域的成本效益和卫生政策工作。
