Smith-Olinde Laura, Grosse Scott D, Olinde Frank, Martin Patti F, Tilford John M
Department of Audiology and Speech Pathology, College of Health Related Professions, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Qual Life Res. 2008 Aug;17(6):943-53. doi: 10.1007/s11136-008-9358-x. Epub 2008 May 17.
The aim of this study was to compare two preference-weighted, caregiver-reported measures of health-related quality of life for children with permanent childhood hearing loss to determine whether cost-effectiveness analysis applied to deaf and hard of hearing populations will provide similar answers based on the choice of instrument.
Caregivers of 103 children in Arkansas, USA, with documented hearing loss completed the Quality of Well-Being Scale (QWB) and the Health Utilities Index Mark 3 (HUI3) to describe the health status of their children. Audiology and other clinical measures were abstracted from medical records. Mean scores were compared overall and by degree of hearing loss. Linear regression was used to correlate preference scores with a four-frequency pure-tone average, cochlear implant status, and other factors.
Mean preference scores for the QWB and HUI3 were similar (0.601 and 0.619, respectively) although the HUI3 demonstrated a wider range of values (-0.132 to 1.000) compared to the QWB (0.345-0.854) and was more sensitive to mild hearing loss. Both measures correlated with the pure-tone average, were negatively associated with comorbid conditions and positively associated with cochlear implant status. In the best fitting regression models, similar estimates for cochlear implant status and comorbid conditions were obtained from the two measures.
Despite considerable differences in the HUI3 and the QWB scale, we found agreement between the two instruments at the mean, but clinically important differences across a number of measures. The two instruments are likely to yield different estimates of cost-effectiveness ratios, especially for interventions involving mild to moderate hearing loss.
本研究旨在比较两种由照料者报告的、针对永久性儿童听力损失患儿的健康相关生活质量的偏好加权测量方法，以确定应用于聋人和听力障碍人群的成本效益分析是否会因测量工具的选择而得出相似的结果。
美国阿肯色州103名有听力损失记录的儿童的照料者完成了幸福感量表（QWB）和健康效用指数Mark 3（HUI3），以描述其子女的健康状况。听力和其他临床测量数据从医疗记录中提取。总体上以及按听力损失程度比较了平均得分。采用线性回归将偏好得分与四频率纯音平均、人工耳蜗植入状态及其他因素进行关联。
QWB和HUI3的平均偏好得分相似（分别为0.601和0.619），尽管与QWB（0.345 - 0.854）相比，HUI3显示出更广泛的值域（-0.132至1.000），并且对轻度听力损失更敏感。两种测量方法均与纯音平均相关，与合并症呈负相关，与人工耳蜗植入状态呈正相关。在最佳拟合回归模型中，从这两种测量方法中获得了关于人工耳蜗植入状态和合并症的相似估计值。
尽管HUI3和QWB量表存在相当大的差异，但我们发现这两种工具在均值上一致，但在许多测量指标上存在临床重要差异。这两种工具可能会得出不同的成本效益比估计值，特别是对于涉及轻度至中度听力损失的干预措施。
