Cella David, Nowinski Cindy J
Northwestern University, Evanston, IL, USA.
Arch Phys Med Rehabil. 2002 Dec;83(12 Suppl 2):S10-7. doi: 10.1053/apmr.2002.36959.
We focus on quality of life (QOL) measurement as applied to chronic illness. There are 2 major types of health-related quality of life (HRQOL) instruments-generic health status and targeted. Generic instruments offer the opportunity to compare results across patient and population cohorts, and some can provide normative or benchmark data from which to interpret results. Targeted instruments ask questions that focus more on the specific condition or treatment under study and, as a result, tend to be more responsive to clinically important changes than generic instruments. Each type of instrument has a place in the assessment of HRQOL in chronic illness, and consideration of the relative advantages and disadvantages of the 2 options best drives choice of instrument. The Functional Assessment of Chronic Illness Therapy (FACIT) system of HRQOL measurement is a hybrid of the 2 approaches. The FACIT system combines a core general measure with supplemental measures targeted toward specific diseases, conditions, or treatments. Thus, it capitalizes on the strengths of each type of measure. Recently, FACIT questionnaires were administered to a representative sample of the general population with results used to derive FACIT norms. These normative data can be used for benchmarking and to better understand changes in HRQOL that are often seen in clinical trials. Future directions in HRQOL assessment include test equating, item banking, and computerized adaptive testing.
我们专注于应用于慢性病的生活质量（QOL）测量。有两种主要类型的健康相关生活质量（HRQOL）工具——通用健康状况工具和针对性工具。通用工具提供了跨患者和人群队列比较结果的机会，有些还能提供用于解释结果的规范或基准数据。针对性工具提出的问题更多地聚焦于所研究的特定病症或治疗，因此，相比于通用工具，它们往往对临床重要变化更敏感。每种工具在慢性病的HRQOL评估中都有其作用，对这两种选择的相对优缺点进行考量最有助于工具的选择。慢性病治疗功能评估（FACIT）生活质量测量系统是这两种方法的结合。FACIT系统将一个核心通用测量方法与针对特定疾病、病症或治疗的补充测量方法相结合。因此，它利用了每种测量方法的优势。最近，FACIT问卷被发放给了具有代表性的普通人群样本，并利用结果得出了FACIT规范。这些规范数据可用于基准测试，并更好地理解在临床试验中经常出现的HRQOL变化。HRQOL评估的未来方向包括测试等值、题库建设和计算机自适应测试。
