Yost Kathleen J, Haan Mary N, Levine Richard A, Gold Ellen B
Center on Outcomes, Research and Education (CORE), Evanston Northwestern Healthcare Research Institute, IL 60201, USA.
Qual Life Res. 2005 Jun;14(5):1251-61. doi: 10.1007/s11136-004-6673-8.
The widespread use of the Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36) facilitates the comparison of health-related quality of life (HRQL) across independent studies.
To compare the scores of eight scales and two summary scales of the SF-36 across participants in the Women's Healthy Eating and Living (WHEL) trial, the Women's Health Initiative-Dietary Modification trial (WHI-DM), and the MOS, and to illustrate the use of effect sizes for interpreting the importance of group differences.
WHEL and WHI-DM are both multi-center dietary interventions; only data from the UC Davis sites were used in our study. WHEL participants had a recent history of breast cancer, WHI-DM participants were healthy, postmenopausal women, and women in the MOS had a history of hypertension, diabetes, heart disease, or depression. General linear models were used to identify statistically significant differences in scale scores. Meaningful differences were determined by effect sizes computed using a common within-group standard deviation (SD) and SDs from normative data.
After adjusting for age and marital status, SF-36 scores for the WHI-DM and WHEL samples were similar and both had statistically significantly higher scores than the MOS sample. Relative to the WHEL or WHI-DM studies, MOS scores for scales related to the physical domain were clearly meaningfully lower whereas scale scores related to the mental health domain were potentially meaningfully lower.
The HRQL of breast cancer survivors is comparable to that of healthy women and better than that of women with chronic health conditions, particularly with respect to physical health. This study illustrated the use of ranges of effects sizes for aiding the interpretation of SF-36 scores differences across independent studies.
医学结局研究（MOS）36项简短健康调查（SF - 36）的广泛应用有助于独立研究间健康相关生活质量（HRQL）的比较。
比较女性健康饮食与生活方式（WHEL）试验、女性健康倡议饮食调整试验（WHI - DM）以及MOS研究中参与者的SF - 36八个分量表和两个总结量表的得分，并举例说明效应量在解释组间差异重要性方面的应用。
WHEL和WHI - DM均为多中心饮食干预研究；本研究仅使用了加州大学戴维斯分校站点的数据。WHEL参与者近期有乳腺癌病史，WHI - DM参与者为健康的绝经后女性，MOS研究中的女性有高血压、糖尿病、心脏病或抑郁症病史。采用一般线性模型确定量表得分的统计学显著差异。通过使用共同的组内标准差（SD）和来自标准数据的SD计算效应量来确定有意义的差异。
在调整年龄和婚姻状况后，WHI - DM和WHEL样本的SF - 36得分相似，且均显著高于MOS样本。相对于WHEL或WHI - DM研究，与身体领域相关的MOS量表得分明显更低，而与心理健康领域相关的量表得分可能更低。
乳腺癌幸存者的健康相关生活质量与健康女性相当，且优于患有慢性健康状况的女性，尤其是在身体健康方面。本研究举例说明了效应量范围在辅助解释独立研究间SF - 36得分差异方面的应用。
