Atlas Steven J, Metson Ralph B, Singer Daniel E, Wu Yen A, Gliklich Richard E
General Medicine Division and the Clinical Epidemiology Unit, Medical Services, Massachusetts General Hospital, and the Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
Laryngoscope. 2005 May;115(5):846-54. doi: 10.1097/01.MLG.0000157693.92975.02.
OBJECTIVE/HYPOTHESIS: To assess the validity and responsiveness of a new health-related quality of life (HRQL) instrument for patients with chronic sinusitis.
Prospective case series.
Patients with chronic sinusitis undergoing endoscopic sinus surgery were assessed in two otolaryngology practices affiliated with an academic hospital. Patient-reported HRQL was assessed using a new instrument (includes symptom frequency, bothersomeness, and impact scales), the Chronic Sinusitis Survey (CSS), and the generic SF-12 at baseline and 3 months postsurgery. The psychometric properties of the new instrument were assessed including reliability, validity, responsiveness, and interpretability.
Among 50 enrolled patients, 49 underwent surgery and 39 (80%) completed 3-month follow-up. Internal consistency was high for the symptom impact scale. The symptom frequency and, especially, bothersomeness scales had lower internal consistency and were comparable with the CSS. Correlation analyses support the construct validity of the new measure compared with the CSS and SF-12. The responsiveness of the new instrument was excellent and similar to or better than the CSS. The mean score change was linearly related to the patient's global self-assessment, although the CSS symptom and total score better discriminated patients with major or moderate degrees of improvement.
This study demonstrates the validity and responsiveness of a new rhinosinusitis-specific HRQL instrument, the Rhinosinusitis Quality of Life survey, in patients with chronic sinusitis. The instrument's symptom frequency, bothersomeness, and impact scales compare favorably with a previously validated disease-specific and a generic HRQL measure. If validated in other patient populations, this disease-specific instrument may be useful in assessing severity and outcomes of treatment for sinusitis.
目的/假设：评估一种用于慢性鼻窦炎患者的新型健康相关生活质量（HRQL）工具的有效性和反应性。
前瞻性病例系列研究。
在一家学术医院附属的两家耳鼻喉科诊所对接受内窥镜鼻窦手术的慢性鼻窦炎患者进行评估。使用一种新工具（包括症状频率、困扰程度和影响量表）、慢性鼻窦炎调查问卷（CSS）以及通用的SF-12在基线和术后3个月评估患者报告的HRQL。评估新工具的心理测量特性，包括信度、效度、反应性和可解释性。
在50名登记患者中，49名接受了手术，39名（80%）完成了3个月的随访。症状影响量表的内部一致性较高。症状频率量表，尤其是困扰程度量表的内部一致性较低，与CSS相当。相关性分析支持新测量方法与CSS和SF-12相比的结构效度。新工具的反应性极佳，与CSS相似或优于CSS。平均得分变化与患者的整体自我评估呈线性相关，尽管CSS症状和总分在区分有重大或中度改善的患者方面表现更好。
本研究证明了一种新的鼻窦炎特异性HRQL工具——鼻窦炎生活质量调查问卷，在慢性鼻窦炎患者中的有效性和反应性。该工具的症状频率、困扰程度和影响量表与先前验证的疾病特异性和通用HRQL测量方法相比具有优势。如果在其他患者群体中得到验证，这种疾病特异性工具可能有助于评估鼻窦炎的严重程度和治疗结果。
