Cleary P D, Greenfield S, McNeil B J
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115.
Control Clin Trials. 1991 Aug;12(4 Suppl):189S-203S. doi: 10.1016/s0197-2456(05)80023-6.
Researchers and clinicians increasingly are recognizing the importance of assessing a wide range of outcomes when evaluating the efficacy of medical therapies or procedures. We developed and evaluated a set of self-report scales that assessed both generic and condition-specific aspects of health-related quality of life before and after surgery. We report data from a study of patients having one of four types of surgery at six teaching hospitals in California and Massachusetts. The four surgical conditions studied were: total hip replacement, transurethral prostatectomy, cholecystectomy, and coronary artery bypass graft surgery. All the outcome scales, except for those assessing cognitive functioning and fatigue, had internal consistencies greater than 0.70. The pattern of correlations between the scales and other measures of health status are similar to those reported in other studies and provide evidence of their construct validity. The scales also appeared to be sensitive to differences between presurgical and postsurgical health-related quality of life. The results suggest that the scales used were easy to administer, reliable, valid, and offered important information about outcomes of surgery that is not provided by more traditional clinical indicators.
研究人员和临床医生越来越认识到，在评估医学疗法或手术的疗效时，评估广泛的结果具有重要意义。我们开发并评估了一套自我报告量表，用于评估手术前后健康相关生活质量的一般方面和特定疾病方面。我们报告了在加利福尼亚州和马萨诸塞州的六家教学医院对接受四种手术之一的患者进行研究的数据。所研究的四种手术情况分别是：全髋关节置换术、经尿道前列腺切除术、胆囊切除术和冠状动脉搭桥手术。除了评估认知功能和疲劳的量表外，所有结果量表的内部一致性均大于0.70。这些量表与其他健康状况测量指标之间的相关模式与其他研究报告的相似，并为其结构效度提供了证据。这些量表似乎也对术前和术后健康相关生活质量的差异敏感。结果表明，所使用的量表易于实施、可靠、有效，并提供了更多传统临床指标未提供的有关手术结果的重要信息。
