Walker M, Brown J, Brown K, Gregor A, Whittle I R, Grant R
Edinburgh Centre for Neuro-Oncology, Western General Hospital, Edinburgh, Scotland, UK.
J Neurooncol. 2003 Jun;63(2):179-86. doi: 10.1023/a:1023900802254.
To assess the problems involved with the collection and interpretation of serial collected health related quality of life assessments in patients with malignant glioma.
One-hundred and fifty nine patients with malignant glioma from three Scottish neurosurgical centres in whom assessments of performance status, neurological impairment, mood, and quality of life had been recorded over a 6-month period were prospectively identified. The amount of missing data and the reasons for missing data were assessed. Characteristics of patients that were fully compliant with serial assessments were then compared with those that were not.
Compliance with serial assessments (both patient and observer reported) was poor, dropping to less than 50% at 6 months. Observer reported measures showed a similar pattern of decline as patient reported measures. The largest single cause of missing data (approximately 70%) was due to administrative failure. Compliant patients were found to have a significantly greater probability of survival compared to non-compliant patients and were also found to be younger and fitter relative to the rest of the study population.
Studies utilising quality of life outcomes should give early consideration to minimising avoidable sources of missing data and recording the reasons for non-compliance. Quality of life studies basing conclusions on a complete case analysis should be wary of possible bias.
评估恶性胶质瘤患者连续收集的健康相关生活质量评估的收集和解读中所涉及的问题。
前瞻性地确定了来自苏格兰三个神经外科中心的159例恶性胶质瘤患者，这些患者在6个月期间记录了其功能状态、神经功能损害、情绪和生活质量评估情况。评估了缺失数据的数量和缺失数据的原因。然后将完全依从连续评估的患者特征与未依从的患者特征进行比较。
连续评估的依从性（患者和观察者报告）较差，6个月时降至50%以下。观察者报告的测量结果与患者报告的测量结果显示出相似的下降模式。缺失数据的最大单一原因（约70%）是管理失误。发现依从的患者与不依从的患者相比有显著更高的生存概率，并且相对于研究人群的其他部分，他们也更年轻、身体状况更好。
利用生活质量结果的研究应尽早考虑尽量减少可避免的缺失数据来源并记录不依从的原因。基于完整病例分析得出结论的生活质量研究应警惕可能的偏倚。
