Consiglio Ezequiel, Belloso Waldo H
Escuela de Salud Pública, Facultad de Medicina, Universidad de Buenos Aires, Marcelo T. de Alvear 2202, 1121 Buenos Aires, Argentina.
Medicina (B Aires). 2003;63(2):172-8.
In the last decades the need of better measurements of health outcomes has increased the interest for new clinical indicators. Health-related quality of life (HRQoL) has emerged in this context as a multidimensional model approach where the patient is the exclusive source of information. The main objective of HRQoL measurement is to provide a global evaluation of the impact of diseases and the consequences of treatments over the daily life of the patients. The instruments developed for that purpose are questionnaires; either generic--for the comparison between different diseases-, or specific--aimed to evaluate particular conditions. These questionnaires must demonstrate several psychometric properties, such as reliability, validity, responsiveness, and for some authors also feasibility. In many areas, HRQoL studies have demonstrated to increase the knowledge of the natural history of diseases and its global consequences, beyond the classic health outcomes information based on morbidity and mortality rates. This knowledge may assist in the design of epidemiological studies and improve the comparison of strategies in therapeutic interventions. Nevertheless, some controversial issues remain such as the clinical implications of absolute scores obtained, and the need for updating the content of the instruments in accordance with the changes in natural history of diseases under evaluation.
在过去几十年中，对更好地衡量健康结果的需求增加了人们对新临床指标的兴趣。在这种背景下，健康相关生活质量（HRQoL）作为一种多维模型方法出现，其中患者是唯一的信息来源。HRQoL测量的主要目的是对疾病的影响以及治疗对患者日常生活的后果进行全面评估。为此目的开发的工具是问卷；要么是通用的——用于不同疾病之间的比较，要么是特定的——旨在评估特定情况。这些问卷必须具备多种心理测量特性，如可靠性、有效性、反应性，而且对一些作者来说还包括可行性。在许多领域，HRQoL研究已证明，除了基于发病率和死亡率的经典健康结果信息之外，还能增加对疾病自然史及其总体后果的了解。这些知识有助于流行病学研究的设计，并改善治疗干预策略的比较。然而，一些有争议的问题仍然存在，例如所获得的绝对分数的临床意义，以及根据所评估疾病自然史的变化更新工具内容的必要性。
