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癫痫患者社区样本中15D和EQ-5D效用测量指标的特性

Properties of the 15D and EQ-5D utility measures in a community sample of people with epilepsy.

作者信息

Stavem K, Bjørnaes H, Lossius M I

机构信息

Foundation for Health Services Research (HELTEF), Central Hospital of Akershus, N-1474, Nordbyhagen, Norway.

出版信息

Epilepsy Res. 2001 May;44(2-3):179-89. doi: 10.1016/s0920-1211(01)00201-7.

Abstract

To perform economic evaluation studies in epilepsy using utilities, such as cost-utility analyses, it is necessary to have reliable and valid instruments for eliciting people's preferences. The objective of this study was to assess the reliability and validity of two multiattribute utility measures in a community sample of 397 people with epilepsy. We assessed the test-retest reliability of individual questionnaire items and aggregate scores. Additionally, construct validity was assessed by correlating items of the EQ-5D with items of the 15D health status questionnaire, and discriminant validity was assessed by comparing scores for known groups. The test-retest reliabilities for the individual items of the 15D (weighted kappa 0.59-0.90, except mobility with only 0.28) and the EQ-5D (weighted kappa 0.49-0.86) were acceptable. For the composite utility scores the test-retest reliability was better (intraclass correlation coefficient 0.93 for both 15D and the EQ-5D). Spearman's rank correlations between EQ-5D single item scores and corresponding 15D single item scores were high (rho 0.34-0.79) and generally higher than the associations between non-corresponding items. Some EQ-5D and 15D items discriminated well between patients according to seizure status, psychiatric comorbidity and working status; less well after antiepileptic drug use and neurologic comorbidity. Both the EQ-5D and 15D were reliable instruments and showed properties supporting the construct validity of both measures.

摘要

要利用效用进行癫痫的经济学评估研究,如成本效用分析,就必须拥有可靠且有效的工具来引出人们的偏好。本研究的目的是评估在397名癫痫患者的社区样本中两种多属性效用测量方法的可靠性和有效性。我们评估了单个问卷项目和总分的重测信度。此外,通过将EQ-5D的项目与15D健康状况问卷的项目进行相关性分析来评估结构效度,并通过比较已知组的得分来评估区分效度。15D单个项目的重测信度(加权kappa值为0.59 - 0.90,除了活动能力仅为0.28)和EQ-5D单个项目的重测信度(加权kappa值为0.49 - 0.86)是可以接受的。对于综合效用得分,重测信度更好(15D和EQ-5D的组内相关系数均为0.93)。EQ-5D单个项目得分与相应的15D单个项目得分之间的Spearman等级相关性较高(rho值为0.34 - 0.79),且通常高于非对应项目之间的相关性。一些EQ-5D和15D项目根据癫痫发作状态、精神疾病合并症和工作状态在患者之间有较好的区分度;在使用抗癫痫药物和存在神经疾病合并症后区分度较差。EQ-5D和15D都是可靠的工具,并显示出支持这两种测量方法结构效度的特性。

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