Kudel Ian, Farber Stacey L, Mrus Joseph M, Leonard Anthony C, Sherman Susan N, Tsevat Joel
Veterans Healthcare System of Ohio (VISN 10), Cincinnati, OH, USA.
J Gen Intern Med. 2006 Dec;21 Suppl 5(Suppl 5):S48-55. doi: 10.1111/j.1525-1497.2006.00645.x.
Health-related quality of life (HRQoL) has become an important facet of HIV/AIDS research. Typically, the unit of analysis is either the total instrument score or subscale score. Developing a typology of responses across various HRQoL measures, however, may advance understating of patients' perspectives.
In a multicenter study, we categorized 443 patients' responses on utility measures (time-tradeoff, standard gamble, and rating scale) and the HIV/AIDS-Targeted Quality of Life (HAT-QoL) scale by using latent profile analysis to empirically derive classes of respondents. We then used linear regressions to identify whether class membership is associated with clinical measures (viral load, CD4, time since diagnosis, highly active antiretroviral therapy [HAART]) and psychosocial function (depressed mood, alcohol use, religious coping).
Six classes were identified. Responses across the HAT-QoL subscales tended to fall into 3 groupings--high functioning (Class 1), moderate functioning (Classes 2 and 3), and low functioning (Classes 4 to 6); utility measures further distinguished individuals among classes. Regression analyses comparing those in Class 1 with those in the other 5 found significantly more symptoms of depression, negative religious coping strategies, and lower CD4 counts among subjects in Class 1. Those in Class 5 had been diagnosed with HIV longer, and members of Class 6 reported significantly less alcohol consumption, had higher viral loads, and were more likely to receive HAART.
Patients with HIV respond differentially to various types of HRQoL measures. Health status and utility measures are thus complementary approaches to measuring HRQoL in patients with HIV.
健康相关生活质量（HRQoL）已成为艾滋病病毒/艾滋病（HIV/AIDS）研究的一个重要方面。通常，分析单位是整个量表得分或子量表得分。然而，构建各类HRQoL测量方法的反应类型学，可能会加深对患者观点的理解。
在一项多中心研究中，我们通过使用潜在剖面分析，对443名患者在效用测量方法（时间权衡法、标准博弈法和评定量表）以及HIV/AIDS针对性生活质量（HAT-QoL）量表上的反应进行分类，以实证得出不同类型的受访者。然后，我们使用线性回归来确定类别归属是否与临床指标（病毒载量、CD4细胞计数、诊断后的时间、高效抗逆转录病毒疗法[HAART]）以及心理社会功能（抑郁情绪、饮酒、宗教应对方式）相关。
确定了六个类别。HAT-QoL子量表的反应往往分为三组——高功能组（第1类）、中等功能组（第2类和第3类）和低功能组（第4类至第6类）；效用测量方法进一步区分了不同类别中的个体。将第1类与其他5类进行比较的回归分析发现，第1类受试者中抑郁症状、消极宗教应对策略显著更多，CD4细胞计数更低。第5类患者被诊断出感染HIV的时间更长，第6类成员报告饮酒量显著更少、病毒载量更高，且更有可能接受HAART治疗。
HIV患者对各类HRQoL测量方法的反应存在差异。因此，健康状况和效用测量方法是测量HIV患者HRQoL的互补方法。
