Spertus John A
University of Missouri at Kansas City School of Medicine, Kansas City, Mo., USA.
Circulation. 2008 Nov 11;118(20):2103-10. doi: 10.1161/CIRCULATIONAHA.107.747568.
Patient-centered health status measures-assessments of patients' symptoms, function, and quality of life-have matured substantially over the past 2 decades. Currently, valid, reliable, and sensitive disease-specific measures are available for quantifying the health status of patients with cardiovascular disease. This article briefly reviews the concept of health status measures, with a focus on their interpretation. It then discusses both the rationale and potential applications of health status measures in clinical care. Health status measures are not surrogate measures of outcome but rather highly meaningful outcomes of care. As such, they have important emerging roles as outcomes in clinical trials, as tools for monitoring patients in routine clinical care, as a mechanism for operationalizing and evaluating disease management programs, and as tools for quality assessment/improvement. Over time, it is expected that health status measures will also have an increasingly important role in patient-centered medical decision making. By becoming aware of the evolving roles of health status measures, clinicians can help to accelerate the realization of the Institute of Medicine's vision for a more transparent, evidence-based, patient-centered healthcare system.
以患者为中心的健康状况测量——对患者症状、功能和生活质量的评估——在过去20年中已取得了长足发展。目前，已有有效、可靠且灵敏的针对特定疾病的测量方法可用于量化心血管疾病患者的健康状况。本文简要回顾健康状况测量的概念，重点在于其解读。接着讨论健康状况测量在临床护理中的基本原理和潜在应用。健康状况测量并非结果的替代指标，而是具有高度意义的护理结果。因此，它们在临床试验结果、日常临床护理中监测患者的工具、实施和评估疾病管理项目的机制以及质量评估/改进工具等方面正发挥着重要的新作用。随着时间推移，预计健康状况测量在以患者为中心的医疗决策中也将发挥越来越重要的作用。通过了解健康状况测量不断演变的作用，临床医生可助力加速实现医学研究所对更透明、循证、以患者为中心的医疗保健系统的愿景。
