Haywood K L, Garratt A M, Dziedzic K, Dawes P T
Department of Health Sciences and Clinical Evaluation, University of York, York YO1 5DD, UK.
Rheumatology (Oxford). 2002 Dec;41(12):1380-7. doi: 10.1093/rheumatology/41.12.1380.
To assess the acceptability and measurement properties of two generic measures of health-related quality of life (HRQL): the EuroQol and the Short Form 12-item Health Survey Questionnaire (SF-12) in ankylosing spondylitis (AS).
Instruments were administered by means of a self-completed questionnaire to AS patients recruited from across the United Kingdom. Instruments were assessed for data quality and scaling assumptions. Test-retest reliability was assessed in those patients reporting no change in general health at 2 weeks. The convergent validity of both instruments was assessed and scores were correlated with responses to health transition questions. Responsiveness was assessed for patients reporting change in health at 6 months.
The instruments had high completion rates. Although slightly skewed towards better levels of health, scores covered the available range for both sections of the EuroQol [EQ-5D and EQ-visual analogue scale (EQ-VAS)]. Score distributions approximated normality for the SF-12. Test-retest reliability estimates support the use of both instruments in group evaluation and the SF-12 Physical Component Summary score (PCS) in individual evaluation (>0.90). Correlations between instruments were in the hypothesized direction and were of a moderate level. The EQ-VAS had the strongest linear relationship, with responses to both specific and general health transition questions (P<0.01). The EQ-VAS and SF-12 PCS were the most responsive instruments. The EQ-5D was the least responsive instrument.
The instruments have undergone a comprehensive comparative evaluation to assess the measurement properties required for patient-assessed measures of health outcome in AS. Adequate levels of acceptability, reliability and validity were found for both instruments. Although evidence supporting instrument responsiveness was strong for the EQ-VAS and SF-12 PCS, it was very weak for the EQ-5D and SF-12 Mental Component Summary Scale (MCS). The EQ-VAS and SF-12 PCS can both be recommended for use in group evaluation, and the SF-12 PCS is recommended in routine practice or research. However, the lower reliability of the SF-12 MCS and the limited ability of both the EQ-5D and SF-12 MCS to detect change in health may restrict these roles.
评估两种通用的健康相关生活质量（HRQL）测量工具——欧洲五维度健康量表（EuroQol）和12项简短健康调查问卷（SF - 12）在强直性脊柱炎（AS）患者中的可接受性和测量特性。
通过自填问卷的方式，将测量工具施用于从英国各地招募的AS患者。对测量工具进行数据质量和量表假设评估。在那些报告2周内总体健康状况无变化的患者中评估重测信度。评估两种工具的收敛效度，并将得分与健康转变问题的回答进行关联。对报告6个月内健康状况有变化的患者评估反应度。
测量工具的完成率很高。尽管得分略微倾向于更好的健康水平，但欧洲五维度健康量表[EQ - 5D和欧洲五维度健康量表视觉模拟量表（EQ - VAS）]两个部分的得分都涵盖了可用范围。SF - 12的得分分布近似正态分布。重测信度估计支持在群体评估中使用这两种工具，在个体评估中支持使用SF - 12身体成分汇总得分（PCS）（>0.90）。工具之间的相关性呈假设方向且为中等水平。EQ - VAS与特定和总体健康转变问题的回答具有最强的线性关系（P<0.01）。EQ - VAS和SF - 12 PCS是反应度最高的工具。EQ - 5D是反应度最低的工具。
这些工具已经过全面的比较评估，以评估AS患者自我评估健康结局测量所需的测量特性。两种工具都具有足够的可接受性、信度和效度。尽管支持EQ - VAS和SF - 12 PCS反应度的证据很强，但对于EQ - 5D和SF - 12心理成分汇总量表（MCS）来说，证据非常薄弱。EQ - VAS和SF - 12 PCS都可推荐用于群体评估，SF - 12 PCS推荐用于常规实践或研究。然而，SF - 12 MCS较低的信度以及EQ - 5D和SF - 12 MCS检测健康变化的能力有限，可能会限制它们的这些作用。
