Mancuso C A, Peterson M G, Charlson M E
Weill Medical College of Cornell University, New York Presbyterian Hospital, Hospital for Special Surgery, 525 East 68th St. (Box 46), New York, NY 10021, USA.
J Clin Epidemiol. 2001 Mar;54(3):263-74. doi: 10.1016/s0895-4356(00)00307-3.
Health-related quality of life scales such as the Asthma Quality of Life Questionnaire and the Medical Outcomes Study Short-form General Health Survey SF-36 have become important measures of health status in clinical asthma trials. The discriminative properties of these scales, however, have not been extensively evaluated and compared. The purposes of this study were to assess and compare scale and discriminative properties of the Asthma Quality of Life Questionnaire (AQLQ) and the SF-36 in a group of patients with moderate asthma using a patient-rated global measure of disease activity as the criterion variable. Patients were interviewed in-person with a series of questionnaires including the AQLQ and the SF-36, and were also asked the global question "How active is your asthma now?" with possible responses of "extremely," "very," "moderately," "mildly" or "not active." Discriminative properties were determined using receiver operating characteristic (ROC) curves with responses to the global question as the criterion variable and mean domain scale scores as the independent variables. Relative validities for the AQLQ and SF-36 domains were also compared. A total of 230 patients, mean age of 41 years, were enrolled. Scores were lower and ranges were narrower for the AQLQ compared to the SF-36. In general, the AQLQ and the SF-36 were highly correlated, with r = 0.69 for the AQLQ overall score and the SF-36 Physical Component Summary (PCS) score. According to ROC analyses, both scales had excellent discriminative properties; however the area under the ROC curve was higher for the AQLQ overall score (0.81) than for the PCS (0.75). When ranked according to ROC area, the symptoms domain (0.83) had the greatest area under the ROC curve, followed by the emotional (0.76) and activities (0.76) domains of the AQLQ. However, in some cases, the area under the curve was less for an AQLQ domain (for example, 0.71 for the environmental domain) than for SF-36 domains (for example, 0.75 for the role physical, and 0.75 for the social domain). Similarly, the AQLQ overall had a higher relative validity (5.2) compared to the PCS (2.2), and the symptoms domain of the AQLQ had the highest relative validity (6.0). Thus, both the Asthma Quality of Life Questionnaire and the SF-36 were able to characterize patients with moderate asthma in our cross-sectional study. In addition, both scales had strong discriminative properties when assessed with a global patient rating of current disease activity.
与健康相关的生活质量量表，如哮喘生活质量问卷和医学结果研究简表36项健康调查（SF - 36），已成为临床哮喘试验中健康状况的重要衡量指标。然而，这些量表的区分特性尚未得到广泛评估和比较。本研究的目的是，以患者自评的疾病活动总体指标作为标准变量，评估和比较哮喘生活质量问卷（AQLQ）和SF - 36在一组中度哮喘患者中的量表特性和区分特性。通过一系列问卷对患者进行当面访谈，问卷包括AQLQ和SF - 36，并询问他们“您现在的哮喘有多活跃？”这一总体问题，可能的回答为“极其活跃”“非常活跃”“中度活跃”“轻度活跃”或“不活跃”。使用以总体问题的回答作为标准变量、各领域量表平均得分作为自变量的受试者工作特征（ROC）曲线来确定区分特性。还比较了AQLQ和SF - 36各领域的相对效度。共纳入230例患者，平均年龄41岁。与SF - 36相比，AQLQ的得分更低且范围更窄。总体而言，AQLQ和SF - 36高度相关，AQLQ总分与SF - 36身体成分总结（PCS）得分的相关系数r = 0.69。根据ROC分析，两个量表都具有出色的区分特性；然而，AQLQ总分的ROC曲线下面积（0.81）高于PCS（0.75）。按ROC面积排序时，症状领域（0.83）的ROC曲线下面积最大，其次是AQLQ的情感领域（0.76）和活动领域（0.76）。然而，在某些情况下，AQLQ某个领域的曲线下面积（例如，环境领域为0.71）小于SF - 36某些领域（例如，角色 - 身体领域为0.75，社会领域为0.75）。同样，AQLQ总体的相对效度（5.2）高于PCS（2.2），AQLQ的症状领域相对效度最高（6.0）。因此，在我们的横断面研究中，哮喘生活质量问卷和SF - 36都能够对中度哮喘患者进行特征描述。此外，当以患者对当前疾病活动的总体评分进行评估时，两个量表都具有很强的区分特性。
