Department of Neurology, Baycrest Geriatric Hospital, Toronto, Ontario, Canada.
Health Qual Life Outcomes. 2010 Aug 30;8:91. doi: 10.1186/1477-7525-8-91.
To apply a scaled, preference-based measure to the evaluation of health-related quality of life (HRQoL) in Parkinson's disease (PD); to evaluate the relationship between disease-specific rating scales and estimated HRQoL; and to identify predictors of diminished HRQoL.
Scaled, preference-based measures of HRQoL ("utilities") serve as indices of impact of disease, and can be used to generate quality-adjusted estimates of survival for health-economic evaluations. Evaluation of utilities for PD and their correlation with standard rating scales have been limited.
Utilities were generated using the Health Utilities Index Mark III (HUI-III) on consecutive patients attending a PD Clinic between October 2003 and June 2006. Disease severity, medical, surgical (subthalamic nucleus deep brain stimulation (STN-DBS)), and demographic information were used as model covariates. Predictors of HUI-III utility scores were evaluated using the Wilxocon rank-sum test and linear regression models.
68 men with a diagnosis of PD and a mean age of 74.0 (SD 7.4) were included in the data analysis. Mean HUI-III utility at first visit was 0.45 (SD 0.33). In multivariable models, UPDRS-II score (r2 = 0.56, P < 0.001) was highly predictive of HRQoL. UPDRS-III was a weaker, but still significant, predictor of utility scores, even after adjustment for UPDRS-II (P = 0.01).
Poor self-care in PD reflected by worsening UPDRS-II scores is strongly correlated with low generic HRQoL. HUI-III-based health utilities display convergent validity with the UPDRS-II. These findings highlight the importance of measures of independence as determinants of HRQoL in PD, and will facilitate the utilization of existing UPDRS data into economic analyses of PD therapies.
将一种经过标准化、基于偏好的衡量标准应用于帕金森病（PD）相关健康相关生活质量（HRQoL）的评估；评估疾病特异性评定量表与估计 HRQoL 之间的关系；并确定 HRQoL 降低的预测因素。
HRQoL 的标准化、基于偏好的衡量标准（“效用”）可作为疾病影响的指标，并且可用于为健康经济评估生成生存质量调整估计值。PD 中效用的评估及其与标准评定量表的相关性研究有限。
在 2003 年 10 月至 2006 年 6 月期间，连续对在 PD 诊所就诊的患者使用健康效用指数 III （HUI-III）生成效用。疾病严重程度、医疗、手术（丘脑底核深部脑刺激（STN-DBS））和人口统计学信息被用作模型协变量。使用 Wilcoxon 秩和检验和线性回归模型评估 HUI-III 效用得分的预测因素。
68 名男性确诊为 PD，平均年龄为 74.0（标准差 7.4），纳入数据分析。首次就诊时的平均 HUI-III 效用为 0.45（标准差 0.33）。在多变量模型中，UPDRS-II 评分（r2=0.56，P<0.001）对 HRQoL 具有高度预测性。即使在调整 UPDRS-II 后，UPDRS-III 仍然是效用评分的一个较弱但仍然显著的预测因素（P=0.01）。
UPDRS-II 评分恶化反映的 PD 中自我护理能力差与通用 HRQoL 低密切相关。基于 HUI-III 的健康效用与 UPDRS-II 具有一致性。这些发现突出了独立性措施作为 PD 中 HRQoL 决定因素的重要性，并将有助于将现有 UPDRS 数据纳入 PD 治疗的经济分析中。
