Phung Olivia J, White C Michael, Baker William L, Coleman Craig I
University of Connecticut/Hartford Hospital Evidence-Based Practice Center, Hartford, CT 06102, USA.
Ann Pharmacother. 2009 Sep;43(9):1496-505. doi: 10.1345/aph.1M211. Epub 2009 Aug 18.
To empower clinicians to discern when health-related quality-of-life (HRQoL) evidence from a single trial, or from constituent trials within a systematic review or meta-analysis, is compelling enough to alter clinical practice.
To determine the criteria that would be most useful in assessing the quality of HRQoL data, recommendation statements or consensus guidelines that offer guidance to those conducting HRQoL trials were located through a MEDLINE search (1950-April 2009) using the search terms health-related quality of life and recommendations or guidelines.
Recommendation statements or consensus guidelines that offer guidance to investigators conducting HRQoL trials were evaluated to determine what criteria would be the most useful in assessing the quality of HRQoL data.
We discuss how quality of HRQoL data may be assessed by evaluating the following broad questions: (1) Is the HRQoL analysis hypothesis-driven? (2) How is HRQoL being measured? (3) Are the HRQoL data being collected adequately and analyzed correctly? and (4) To what extent do investigators discuss the results of HRQoL analyses? Using select examples from the literature on chronic obstructive pulmonary disease, we applied the 4 broad questions in the assessment of their quality. Also, the use of scoring systems for quality rating for HRQoL data is discussed and applied to the example cases.
HRQoL data are an important outcome because they capture treatment impact on physical, social, and psychological well-being. Assessing the quality and usefulness of HRQoL data requires an understanding of the advantages, limitations, and caveats of their use. Because of the potential lack of quality in HRQoL outcomes, clinicians should thoroughly assess the validity and usefulness of the evaluation. Tools are available to aid clinicians and decision-makers in the assessment of HRQoL outcomes, but additional research needs to be conducted on the topic of quality assessment of HRQoL studies to improve the usefulness of these evaluations to clinicians.
使临床医生能够判断来自单项试验、或系统评价或荟萃分析中的组成试验的健康相关生活质量（HRQoL）证据是否足以令人信服，从而改变临床实践。
为确定在评估HRQoL数据质量时最有用的标准，通过使用检索词“健康相关生活质量”和“推荐意见或指南”在MEDLINE数据库（1950年至2009年4月）中进行检索，查找为开展HRQoL试验的人员提供指导的推荐声明或共识指南。
对为开展HRQoL试验的研究者提供指导的推荐声明或共识指南进行评估，以确定在评估HRQoL数据质量时哪些标准最为有用。
我们讨论如何通过评估以下几个宽泛的问题来评估HRQoL数据的质量：（1）HRQoL分析是否以假设为驱动？（2）HRQoL是如何测量的？（3）HRQoL数据的收集是否充分且分析是否正确？以及（4）研究者在多大程度上讨论了HRQoL分析的结果？我们使用慢性阻塞性肺疾病文献中的精选实例，将这4个宽泛的问题应用于其质量评估。此外，还讨论了HRQoL数据质量评分系统的使用，并将其应用于实例。
HRQoL数据是一项重要的结果，因为它们反映了治疗对身体、社会和心理健康的影响。评估HRQoL数据的质量和实用性需要了解其使用的优点、局限性和注意事项。由于HRQoL结果可能存在质量问题，临床医生应全面评估评估的有效性和实用性。有工具可帮助临床医生和决策者评估HRQoL结果，但关于HRQoL研究质量评估这一主题还需要开展更多研究，以提高这些评估对临床医生的实用性。
