用于效用评估的五项健康相关生活质量测量的潜在维度：来自国家健康测量研究的证据。
Underlying dimensions of the five health-related quality-of-life measures used in utility assessment: evidence from the National Health Measurement Study.
机构信息
Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA.
出版信息
Med Care. 2010 Aug;48(8):718-25. doi: 10.1097/MLR.0b013e3181e35871.
BACKGROUND
Preference-weighted health-related quality-of-life (HRQoL) indexes produce a summary score from discrete health states determined by questions falling into several attributes, such as pain and mobility. Values of HRQoL are used alongside other health outcomes to monitor the health of populations.
OBJECTIVE
The purpose of this study was to examine among US adults, the underlying factor structure of HRQoL attribute scores across 5 indexes of HRQoL: EuroQol-5 Dimension, Health Utilities Index Mark 2, Health Utilities Index Mark 3, Short Form-6 Dimension, and Quality of Well-Being Scale Self-Administered form.
METHODS
The National Health Measurement Study surveyed a nationally representative sample of 3844 noninstitutionalized adults aged 35 to 89 years residing in the continental US. Simultaneous data on all 5 indexes were collected cross-sectionally from June 2005 to August 2006. Exploration of underlying dimensions of HRQoL was done by categorical exploratory factor analysis of HRQoL indexes' attribute scores. Item response theory was applied to explore the amount of information HRQoL attributes contribute to the underlying latent dimensions.
RESULTS
Three main dimensions of HRQoL emerged: physical, psychosocial, and pain. Most HRQoL index attributes contributed to the physical or psychosocial dimension. The 3 dimensions were correlated: 0.47 (physical and psychosocial), 0.57 (physical and pain), 0.46 (psychosocial and pain). Some HRQoL index attributes displayed relatively more unique variance: HUI3 hearing, speech, and vision, and some contributed to more than 1 dimension The identified factor structure fit the HRQoL data well (Comparative Fit Index = 0.98, Tucker-Lewis Index = 0.98, and Root Mean Square Error of Approximation = 0.042).
CONCLUSIONS
The attributes of 5 commonly used HRQoL indexes share 3 underlying latent dimensions of HRQoL, physical, psychosocial, and pain.
背景
偏好加权健康相关生活质量（HRQoL）指数从通过属于几个属性（如疼痛和活动能力）的问题确定的离散健康状态产生综合评分。HRQoL 值与其他健康结果一起用于监测人群的健康状况。
目的
本研究旨在检验美国成年人 5 种 HRQoL 指数（EuroQol-5D、健康效用指数 Mark 2、健康效用指数 Mark 3、简短形式-6 维度和自我管理的健康幸福感量表）的 HRQoL 属性评分的潜在因素结构。
方法
国家健康测量研究调查了居住在美国大陆的 3844 名年龄在 35 至 89 岁之间的非机构化成年人的全国代表性样本。从 2005 年 6 月至 2006 年 8 月，同时收集了所有 5 个指数的横截面数据。通过对 HRQoL 指数的属性评分进行分类探索性因子分析来探索 HRQoL 的潜在维度。应用项目反应理论来探索 HRQoL 属性对潜在潜在维度的信息量。
结果
出现了 3 个主要的 HRQoL 维度：身体、心理社会和疼痛。大多数 HRQoL 指数属性都有助于身体或心理社会维度。这 3 个维度相互关联：0.47（身体和心理社会）、0.57（身体和疼痛）、0.46（心理社会和疼痛）。一些 HRQoL 指数属性显示出相对更多的独特方差：HUI3 的听力、言语和视力，有些属性有助于多个维度。确定的因子结构很好地符合 HRQoL 数据（比较拟合指数=0.98，塔克-刘易斯指数=0.98，均方根误差逼近=0.042）。
结论
5 种常用 HRQoL 指数的属性共享 HRQoL 的 3 个潜在潜在维度，身体、心理社会和疼痛。
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