Stevens K J, Brazier J E, McKenna S P, Doward L C, Cork M J
Division of Genomic Medicine; University of Sheffield, Western Bank, Sheffield, S10 2TN, UK.
Br J Dermatol. 2005 Aug;153(2):372-7. doi: 10.1111/j.1365-2133.2005.06736.x.
Outcomes of health care interventions can be measured in many different ways, but there has been growing interest in the role that quality-adjusted life-years (QALYs) can play in informing priorities in health care. While existing generic preference-based measures can be used to obtain QALYs, these measures may often be inappropriate for some conditions such as atopic dermatitis (AD). These measures are also usually developed for adults and may not capture the domains pertinent to children.
To develop a preference-based quality-of-life measure for use in children with AD.
Items generated from interviews conducted with parents of children with AD were used to form a health state classification system that gives 16 unique health states. One hundred and fifty members of the general population were interviewed to derive preference weights for these states, following the methods used in the valuation of the Health Utilities Index 2 (HUI 2). Each person valued 10 health states using the standard gamble technique. The primary analysis was the estimation of mean health state values for each of the 16 states.
Mean values across the 16 health states range from 0.36 (SD = 0.36) for the worst state to 0.84 (SD = 0.19) on a scale from zero to one, where zero is for health states thought to be as bad as being dead and one is for perfect health. There was some support for the validity of the values from the fact that the values were logically consistent with the ordering of the health state classification system.
These results show the perceived importance of the defined health states of childhood AD to the general population. The resultant health state classification and values can be used to calculate QALYs for use in assessing the cost-effectiveness of interventions for children with AD.
医疗保健干预措施的结果可以通过多种不同方式进行衡量，但人们越来越关注质量调整生命年（QALYs）在确定医疗保健优先事项中所起的作用。虽然现有的基于通用偏好的测量方法可用于获取QALYs，但这些方法对于某些病症（如特应性皮炎（AD））可能常常不合适。这些测量方法通常也是针对成年人开发的，可能无法涵盖与儿童相关的领域。
开发一种基于偏好的生活质量测量方法，用于AD患儿。
对AD患儿家长进行访谈所产生的项目用于形成一个健康状态分类系统，该系统给出16种独特的健康状态。按照健康效用指数2（HUI 2）估值中使用的方法，对150名普通人群进行访谈，以得出这些状态的偏好权重。每个人使用标准博弈技术对10种健康状态进行估值。主要分析是估计16种状态中每种状态的平均健康状态值。
在从0到1的量表上，16种健康状态的平均值范围从最差状态的0.36（标准差=0.36）到0.84（标准差=0.19），其中0表示被认为与死亡一样糟糕的健康状态，1表示完美健康状态。这些值在逻辑上与健康状态分类系统的排序一致，这一事实为这些值的有效性提供了一些支持。
这些结果表明了儿童AD定义的健康状态对普通人群的重要性。由此产生的健康状态分类和值可用于计算QALYs，以评估AD患儿干预措施的成本效益。
