Schroter Sara, Lamping Donna L
Health Services Research Unit, London School of Hygiene & Tropical Medicine, London, UK.
Qual Life Res. 2006 Aug;15(6):1069-78. doi: 10.1007/s11136-005-5993-7.
We describe a comparison of the responsiveness of three validated instruments when used with patients undergoing coronary bypass surgery (CABG) and angioplasty (PTCA). Patients were randomly selected to receive the Coronary Revascularisation Outcome Questionnaire (CROQ), and either the Seattle Angina Questionnaire (SAQ), or the SF-36 before and 3 months after coronary revascularisation. At total of 199 patients (127 CABG, 72 PTCA) completed the CROQ; 55/72 CABG and 34/38 PTCA patients also completed the SAQ or SF-36, respectively. Effect sizes and standardised response means were calculated as change over the 3-month period for scales measuring similar constructs on each instrument. We used bootstrap estimation to derive 95% confidence intervals for differences in the responsiveness indices. For CABG, the CROQ demonstrated significantly greater change in psychosocial functioning than the SF-36, but less than the SAQ. For PTCA, the CROQ showed greater change for symptoms than the SAQ, but the SAQ was more responsive in terms of physical functioning; and the CROQ showed significantly greater change than the SF-36 for psychosocial functioning. There were no other significant differences between similar scales on the three instruments. In conclusion, the CROQ was as responsive as the disease-specific SAQ and more responsive than the generic SF-36.
我们描述了三种经过验证的工具应用于接受冠状动脉搭桥手术（CABG）和血管成形术（PTCA）的患者时的反应性比较。患者被随机选择在冠状动脉血运重建术前和术后3个月接受冠状动脉血运重建结果问卷（CROQ），以及西雅图心绞痛问卷（SAQ）或SF-36。共有199名患者（127例行CABG，72例行PTCA）完成了CROQ；分别有55/72例行CABG的患者和34/38例行PTCA的患者也完成了SAQ或SF-36。效应量和标准化反应均值被计算为每种工具上测量相似结构的量表在3个月期间的变化。我们使用自抽样估计得出反应性指标差异的95%置信区间。对于CABG，CROQ在心理社会功能方面的变化显著大于SF-36，但小于SAQ。对于PTCA，CROQ在症状方面的变化大于SAQ，但SAQ在身体功能方面反应性更强；并且CROQ在心理社会功能方面的变化显著大于SF-36。三种工具上相似量表之间没有其他显著差异。总之，CROQ与疾病特异性的SAQ反应性相当，且比通用的SF-36反应性更强。
