测量 5 种健康效用指标在整个健康范围内的标准误差，用于估计可靠性和反应度。
Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness.
机构信息
Department of Population Health Sciences, University of Wisconsin, Madison (MP, DGF)
Center for Urban Population Health, Milwaukee, Wisconsin (H-YC)
出版信息
Med Decis Making. 2011 Mar-Apr;31(2):260-9. doi: 10.1177/0272989X10380925. Epub 2010 Oct 8.
BACKGROUND
Standard errors of measurement (SEMs) of health-related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics, and is a component of reliability.
PURPOSE
To estimate the SEM of 5 HRQoL indexes.
DESIGN
The National Health Measurement Study (NHMS) was a population-based survey. The Clinical Outcomes and Measurement of Health Study (COMHS) provided repeated measures.
SUBJECTS
A total of 3844 randomly selected adults from the noninstitutionalized population aged 35 to 89 y in the contiguous United States and 265 cataract patients.
MEASUREMENTS
The SF6-36v2™, QWB-SA, EQ-5D, HUI2, and HUI3 were included. An item-response theory approach captured joint variation in indexes into a composite construct of health (theta). The authors estimated 1) the test-retest standard deviation (SEM-TR) from COMHS, 2) the structural standard deviation (SEM-S) around theta from NHMS, and 3) reliability coefficients.
RESULTS
SEM-TR was 0.068 (SF-6D), 0.087 (QWB-SA), 0.093 (EQ-5D), 0.100 (HUI2), and 0.134 (HUI3), whereas SEM-S was 0.071, 0.094, 0.084, 0.074, and 0.117, respectively. These yield reliability coefficients 0.66 (COMHS) and 0.71 (NHMS) for SF-6D, 0.59 and 0.64 for QWB-SA, 0.61 and 0.70 for EQ-5D, 0.64 and 0.80 for HUI2, and 0.75 and 0.77 for HUI3, respectively. The SEM varied across levels of health, especially for HUI2, HUI3, and EQ-5D, and was influenced by ceiling effects. Limitations. Repeated measures were 5 mo apart, and estimated theta contained measurement error.
CONCLUSIONS
The 2 types of SEM are similar and substantial for all the indexes and vary across health.
背景
健康相关生活质量（HRQoL）指标的测量标准误差（SEM）尚未得到很好的描述。SEM 用于估计反应性统计数据，是可靠性的组成部分。
目的
估计 5 个 HRQoL 指标的 SEM。
设计
国家健康测量研究（NHMS）是一项基于人群的调查。临床结果和健康测量研究（COMHS）提供了重复测量。
受试者
来自美国大陆 35 至 89 岁的非机构化人群中随机选择的 3844 名成年人和 265 名白内障患者。
测量
包括 SF6-36v2™、QWB-SA、EQ-5D、HUI2 和 HUI3。一种基于项目反应理论的方法将指标的联合变化纳入健康（theta）的综合结构。作者估计了 1）来自 COMHS 的测试-重测标准偏差（SEM-TR），2）来自 NHMS 的围绕 theta 的结构标准偏差（SEM-S），3）可靠性系数。
结果
SF-6D、QWB-SA、EQ-5D、HUI2 和 HUI3 的 SEM-TR 分别为 0.068、0.087、0.093、0.100 和 0.134，而 SEM-S 分别为 0.071、0.094、0.084、0.074 和 0.117。这分别产生了 SF-6D 的可靠性系数 0.66（COMHS）和 0.71（NHMS）、QWB-SA 的 0.59 和 0.64、EQ-5D 的 0.61 和 0.70、HUI2 的 0.64 和 0.80，以及 HUI3 的 0.75 和 0.77。SEM 因健康水平而异，尤其是 HUI2、HUI3 和 EQ-5D，且受到天花板效应的影响。局限性：重复测量相隔 5 个月，估计的 theta 包含测量误差。
结论
2 种 SEM 对于所有指标都相似且较大，且因健康状况而异。
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