van Straten A, de Haan R J, Limburg M, van den Bos G A
Department of Social Medicine, Academic Medical Center, University of Amsterdam, Netherlands.
Stroke. 2000 Nov;31(11):2610-5. doi: 10.1161/01.str.31.11.2610.
Handicap or health-related quality of life (HRQL) measures are seldom used in stroke trials, although the importance of these measures has been stressed frequently. We studied the clinical meaning of the Stroke-Adapted Sickness Impact Profile-30 (SA-SIP30) and the original SIP136 for use in stroke research.
We included 418 patients who had had a stroke 6 months earlier. We studied the associations between the SA-SIP30 and SIP136 scores versus other frequently used outcome measures from the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) (Barthel Index, Rankin Scale) and the HRQL model (health perception items, Euroqol). To interpret the continuous SA-SIP30 and SIP136 scores, we used receiver operating characteristic curve analysis with the aforementioned measures as external criteria.
The psychosocial dimension scores of both SIP versions remained largely unexplained. The physical dimension and total scores of both SIP versions were mainly associated with the disability measures derived from the ICIDH model, as well as with the physical HRQL domains. Most patients with an SA-SIP30 total score >33 or an SIP136 total score >22 had poor health profiles. There were no major differences between the SA-SIP30 and the SIP136, although the SA-SIP30 scores were less skewed toward the healthier outcomes than the SIP136.
Our study showed that (1) both SIP total scores primarily represent aspects of physical functioning and not HRQL; (2) both SIP versions provide more clinical information than the frequently used disability measures; and (3) the SA-SIP30 should be preferred over the SIP136.
尽管残障或健康相关生活质量（HRQL）指标的重要性已被频繁强调，但在中风试验中却很少使用。我们研究了适用于中风研究的中风适应性疾病影响概况-30（SA-SIP30）和原始的SIP136的临床意义。
我们纳入了418例6个月前发生中风的患者。我们研究了SA-SIP30和SIP136评分与国际损伤、残疾和残障分类（ICIDH）（Barthel指数、Rankin量表）中其他常用结局指标以及HRQL模型（健康感知项目、欧洲五维健康量表）之间的关联。为了解释连续的SA-SIP30和SIP136评分，我们使用上述指标作为外部标准进行受试者工作特征曲线分析。
两个SIP版本的心理社会维度评分在很大程度上仍无法解释。两个SIP版本的身体维度和总分主要与源自ICIDH模型的残疾指标以及身体HRQL领域相关。大多数SA-SIP30总分>33或SIP136总分>22的患者健康状况不佳。SA-SIP30和SIP136之间没有重大差异，尽管SA-SIP30评分比SIP136更不倾向于健康结局。
我们的研究表明：（1）两个SIP总分主要代表身体功能方面而非HRQL；（2）两个SIP版本比常用的残疾指标提供了更多临床信息；（3）与SIP136相比，应优先选择SA-SIP30。
