Sturm Jonathan W, Osborne Richard H, Dewey Helen M, Donnan Geoffrey A, Macdonell Richard A L, Thrift Amanda G
National Stroke Research Institute, Department of Neurology, Austin, Australia.
Stroke. 2002 Dec;33(12):2888-94. doi: 10.1161/01.str.0000040407.44712.c7.
Generic utility health-related quality of life instruments are useful in assessing stroke outcome because they facilitate a broader description of the disease and outcomes, allow comparisons between diseases, and can be used in cost-benefit analysis. The aim of this study was to validate the Assessment of Quality of Life (AQoL) instrument in a stroke population.
Ninety-three patients recruited from the community-based North East Melbourne Stroke Incidence Study between July 13, 1996, and April 30, 1997, were interviewed 3 months after stroke. Validity of the AQoL was assessed by examining associations between the AQoL and comparator instruments: the Medical Outcomes Short-Form Health Survey (SF-36); London Handicap Scale; Barthel Index; National Institutes of Health Stroke Scale; and Irritability, Depression, Anxiety scale. Sensitivity of the AQoL was assessed by comparing AQoL scores from groups of patients categorized by severity of impairment and disability and with total anterior circulation syndrome (TACS) versus non-TACS. Predictive validity was assessed by examining the association between 3-month AQoL scores and outcomes of death or institutionalization 12 months after stroke.
Overall AQoL utility scores and individual dimension scores were most highly correlated with relevant scales on the comparator instruments. AQoL scores clearly differentiated between patients in categories of severity of impairment and disability and between patients with TACS and non-TACS. AQoL scores at 3 months after stroke predicted death and institutionalization at 12 months.
The AQoL demonstrated strong psychometric properties and appears to be a valid and sensitive measure of health-related QoL after stroke.
通用的与健康相关的生活质量效用工具在评估中风结局方面很有用，因为它们有助于更全面地描述疾病及其结局，便于进行疾病间的比较，还可用于成本效益分析。本研究的目的是在中风人群中验证生活质量评估（AQoL）工具。
从1996年7月13日至1997年4月30日基于社区的东北墨尔本中风发病率研究中招募的93名患者，在中风后3个月接受了访谈。通过检查AQoL与对照工具之间的关联来评估AQoL的有效性：医学结局简表健康调查（SF - 36）；伦敦残疾量表；巴氏指数；美国国立卫生研究院卒中量表；以及易怒、抑郁、焦虑量表。通过比较按损伤和残疾严重程度分类的患者组以及总前循环综合征（TACS）与非TACS患者组的AQoL得分来评估AQoL的敏感性。通过检查中风后3个月的AQoL得分与12个月后死亡或住院结局之间的关联来评估预测效度。
总体AQoL效用得分和各个维度得分与对照工具上的相关量表相关性最高。AQoL得分在损伤和残疾严重程度类别之间以及TACS和非TACS患者之间有明显差异。中风后3个月的AQoL得分可预测12个月后的死亡和住院情况。
AQoL表现出强大的心理测量特性，似乎是中风后与健康相关的生活质量的有效且敏感的测量工具。
