Wahlqvist Peter, Guyatt Gordon H, Armstrong David, Degl'innocenti Alessio, Heels-Ansdell Diane, El-Dika Samer, Wiklund Ingela, Fallone Carlo A, Tanser Lisa, Veldhuyzen van Zanten Sander, Austin Peggy, Barkun Alan N, Chiba Naoki, Schünemann Holger J
AstraZeneca R&D, Mölndal, Sweden.
Pharmacoeconomics. 2007;25(5):385-96. doi: 10.2165/00019053-200725050-00003.
A validated productivity questionnaire, the Work Productivity and Activity Impairment questionnaire for Gastroesophageal Reflux Disease (WPAI-GERD), exists for Swedish patients with GERD.
To assess responsiveness to change of the WPAI-GERD and construct validity of the English language version.
We used the WPAI-GERD in a before-after treatment clinical study of Canadian GERD patients with moderate or severe symptoms treated with esomeprazole 40 mg once daily for 4 weeks. We measured productivity variables including GERD-specific absence from work, reduced productivity while at work and reduced productivity while carrying out regular daily activities other than work during the preceding week.
The analysis included 217 patients, of whom 71% (n = 153) were employed. Before treatment, employed patients reported an average 0.9 hours of absence from work due to GERD and 14.0% reduced work productivity (5.8 hours equivalent) in the previous week, as well as 21.0% reduced productivity in daily activities (all patients). After treatment, the corresponding figures decreased to 0.3 hours, 3.0% (1.1 hours equivalent) and 4.9%, respectively. Thus, the improvement (difference from start of treatment) in productivity was 0.6 hours (p = 0.011) for absence from work and 11.0% units (p < 0.001) for reduced work productivity (4.7 hours equivalent, p < 0.001). This translated into an avoided loss of work productivity of 5.3 hours in total on a weekly basis per employed patient. In addition, a 16.1% unit (p < 0.001) improvement for reduced productivity in activities was observed. Cross-sectional correlation coefficients of WPAI variables with symptoms (range 0.04-0.63) and health-related quality of life (HR-QOL; range 0.02-0.65) supported cross-sectional construct validity. Corresponding change score correlations between WPAI variables and HR-QOL (range 0.05-0.56) supported longitudinal construct validity of the WPAI-GERD while low change score correlations between productivity variables and relevant symptoms (range 0.06-0.34) did not.
The English version of the WPAI-GERD showed good cross-sectional construct validity, and results indicated that the WPAI-GERD is responsive to change. Although the results also indicated that longitudinal construct validity may be poor, the overall findings suggest that further study of the instrument remains warranted.
针对瑞典胃食管反流病（GERD）患者，存在一份经过验证的生产率调查问卷，即胃食管反流病工作生产率与活动受损问卷（WPAI - GERD）。
评估WPAI - GERD对变化的反应性以及英文版的结构效度。
我们在一项前后对照的临床研究中，对加拿大患有中度或重度症状的GERD患者使用WPAI - GERD，这些患者每日服用40毫克埃索美拉唑，持续治疗4周。我们测量了生产率变量，包括因GERD导致的特定缺勤、工作时生产率降低以及前一周除工作外进行日常活动时生产率降低。
分析纳入了217名患者，其中71%（n = 153）受雇。治疗前，受雇患者报告因GERD平均缺勤0.9小时，前一周工作生产率降低14.0%（相当于5.8小时），日常活动生产率降低21.0%（所有患者）。治疗后，相应数字分别降至0.3小时、3.0%（相当于1.1小时）和4.9%。因此，工作缺勤生产率的改善（与治疗开始时的差异）为0.6小时（p = 0.011），工作生产率降低的改善为11.0个百分点（p < 0.001）（相当于4.7小时，p < 0.001）。这意味着每位受雇患者每周总共避免了5.3小时的工作生产率损失。此外，活动生产率降低方面观察到改善了16.1个百分点（p < 0.001）。WPAI变量与症状（范围0.04 - 0.63）以及健康相关生活质量（HR - QOL；范围0.02 - 0.65）的横断面相关系数支持横断面结构效度。WPAI变量与HR - QOL之间相应的变化得分相关性（范围0.05 - 0.56）支持WPAI - GERD的纵向结构效度，而生产率变量与相关症状之间的变化得分相关性较低（范围0.06 - 0.34）则不支持。
WPAI - GERD英文版显示出良好的横断面结构效度，结果表明WPAI - GERD对变化有反应。尽管结果也表明纵向结构效度可能较差，但总体研究结果表明该工具仍值得进一步研究。
