Chang Ting-Jung, Tarn Yen-Huei, Hsieh Ching-Lin, Liou Wen-Shyong, Shaw James W, Chiou Xue Grace
Medical Equipment Review Committee, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
J Formos Med Assoc. 2007 Dec;106(12):1023-31. doi: 10.1016/S0929-6646(08)60078-9.
BACKGROUND/PURPOSE: We know of no validated Taiwanese-language instrument to measure a utility of the patient's health. Our aim was to evaluate the reliability and validity of a Taiwanese version of the EuroQol instrument (EQ-5D) in a Taiwanese population. METHODS: Questionnaires containing the Taiwanese versions of the EQ-5D and the Short-Form 12 Health Survey (SF-12) were sent to 12,923 people in Taiwan in December 2002. Concurrent validity of the EQ-5D was analyzed by assuming that subjects with problems in any EQ-5D dimensions had decreased SF-12 scores. Discriminant validity of the EQ-5D was analyzed by assuming that subjects with the following characteristics had lowered EQ-5D indexes and scores on the EQ-5D visual analog scale (VAS): more chronic diseases than others, serious illness, more hospitalizations in the past year than others, poor general health, and more outpatient visits than others. Test-retest reliability was analyzed in a subgroup of respondents who were evaluated twice within a month by using the intraclass correlation coefficient and the kappa method. RESULTS: The general survey response rate was 12.7% (1644 of 12,923). SF-12 scores were lower in subjects reporting problems on EQ-5D dimensions than in others without such problems (p < 0.01). Subjects with more health problems than others had lower EQ-5D indexes and VAS scores (p < 0.01). The physical dimension of the EQ-5D was more strongly correlated with the SF-12 Physical Component Summary than with the Mental Component Summary; this finding satisfied the a priori hypothesis. For test-retest reliability of items on the EQ-5D, kappa values ranged from 0.49 to 1 (p < 0.001). CONCLUSION: The Taiwanese EQ-5D instrument appears to be a moderately valid and reliable tool for measuring the health status of the general population in Taiwan.
背景/目的:我们尚未知晓有经过验证的用于测量患者健康效用的台湾地区语言工具。我们的目的是评估台湾地区版欧洲五维度健康量表(EQ - 5D)在台湾人群中的信度和效度。 方法:2002年12月,向台湾地区的12923人发放了包含台湾地区版EQ - 5D和简短健康调查问卷(SF - 12)的问卷。通过假设在任何EQ - 5D维度存在问题的受试者其SF - 12得分降低,来分析EQ - 5D的同时效度。通过假设具有以下特征的受试者其EQ - 5D指数和EQ - 5D视觉模拟量表(VAS)得分较低来分析EQ - 5D的区分效度:比其他人患有更多慢性病、患有严重疾病、过去一年比其他人住院次数更多、总体健康状况较差以及门诊就诊次数比其他人更多。通过使用组内相关系数和kappa方法,对在一个月内接受两次评估的受访者子群体进行重测信度分析。 结果:总体调查回复率为12.7%(12923人中的1644人)。报告在EQ - 5D维度存在问题的受试者的SF - 12得分低于没有此类问题的其他受试者(p < 0.01)。健康问题比其他人更多的受试者其EQ - 5D指数和VAS得分更低(p < 0.01)。EQ - 5D的身体维度与SF - 12身体成分总结的相关性比与心理成分总结的相关性更强;这一发现符合先验假设。对于EQ - 5D项目的重测信度,kappa值范围为0.49至1(p < 0.001)。 结论:台湾地区版EQ - 5D工具似乎是一种用于测量台湾地区普通人群健康状况的中度有效且可靠的工具。
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