Kaplan Robert M, Ries Andrew L, Reilly John, Mohsenifar Zab
Mail Code 0628, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093-0628, USA.
Chest. 2004 Sep;126(3):781-9. doi: 10.1378/chest.126.3.781.
To evaluate two generic and two disease-specific measures of health-related quality of life (QOL) using prerandomization data from the National Emphysema Treatment Trial (NETT).
The analyses used data collected from the 1,218 subjects who were randomized in the NETT. Patients completed evaluations before and after completion of the prerandomization phase of the NETT pulmonary rehabilitation program. Using data obtained prior to participation in the rehabilitation program, QOL measures were evaluated against physiologic and functional criteria using correlational analysis. The physiologic criteria included estimates of emphysema severity based on FEV(1) and measures of Pao(2) obtained with the subject at rest and breathing room air. Functional measures included the 6-min walk distance (6MWD), maximum work, and hospitalizations in the prior 3 months.
Correlation coefficients between QOL measures ranged from -0.31 to 0.70. In comparison to normative samples, scores on general QOL measures were low, suggesting that the NETT participants were quite ill. All QOL measures were modestly but significantly correlated with FEV(1), maximum work, and 6MWD. Patients who had stayed overnight in a hospital in the prior 3 months reported lower QOL on average than those who had not been hospitalized. There were significant improvements for all QOL measures following the rehabilitation program, and improvements in QOL were correlated with improvements in 6MWD.
The disease-specific and general QOL measures used in the NETT were correlated. Analyses suggested that these measures improved significantly following the rehabilitation phase of the NETT.
利用国家肺气肿治疗试验（NETT）随机分组前的数据，评估两种通用的和两种特定疾病的健康相关生活质量（QOL）测量方法。
分析使用了从NETT中随机分组的1218名受试者收集的数据。患者在NETT肺康复计划随机分组前阶段完成前后均进行了评估。利用参与康复计划之前获得的数据，通过相关性分析，根据生理和功能标准对QOL测量方法进行评估。生理标准包括基于第一秒用力呼气容积（FEV₁）的肺气肿严重程度估计值以及受试者静息呼吸室内空气时的动脉血氧分压（Pao₂）测量值。功能测量包括6分钟步行距离（6MWD）、最大运动量以及前3个月的住院次数。
QOL测量方法之间的相关系数范围为-0.31至0.70。与标准样本相比，通用QOL测量方法的得分较低，表明NETT参与者病情相当严重。所有QOL测量方法均与FEV₁、最大运动量和6MWD呈适度但显著的相关性。前3个月在医院过夜的患者平均报告的QOL低于未住院的患者。康复计划后所有QOL测量方法均有显著改善，且QOL的改善与6MWD的改善相关。
NETT中使用的特定疾病和通用QOL测量方法具有相关性。分析表明，在NETT康复阶段后，这些测量方法有显著改善。
