Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Spine (Phila Pa 1976). 2011 Dec 1;36(25):2211-6. doi: 10.1097/BRS.0b013e318202a403.
Cross-sectional analysis of the Cervical Spine Research Society Outcomes Study, a longitudinal multicenter cohort study.
To provide a statistical model for estimating health utility from the Cervical Spine Outcomes Questionnaire (CSOQ) domain scores.
There is consensus among health-policy researchers that the results of economic evaluations of health can be reported in quality-adjusted life-years (QALY). The CSOQ is a condition-specific instrument that assesses individuals across several domains, including neck and arm/shoulder pain and psychological distress.
The CSOQ and 36-Item Short Form Health Survey (SF-36) were prospectively administered before surgery (within 4 weeks) and after surgery (at 3, 6, and 24 months) to individuals undergoing anterior cervical decompression and fusion for degenerative disc disease of the cervical spine. Using methods reported by Brazier et al, health utility (SF-6D) was estimated using the SF-36. Regression analyses were used on a training dataset (n = 164) to compute the SF-6D from the domain scores of the CSOQ. A validation dataset (n = 328) was used to estimate the SF-6D for comparison to the calculated health utility from the SF-36. RESULTS.: Domain scores were moderately correlated with health utility (SF-6D) (P < 0.001) with correlation coefficients ranging from 0.48 to 0.70. The regression equation to predict SF-6D on the basis of CSOQ domain scores and patient age using the training dataset accounted for 65% of the variation in health utility. In the validation dataset, predicted SF-6D was positively correlated with observed SF-6D (r = 0.680, P < 0.001).
Our findings show that the CSOQ's domain scores can be used to estimate health-utility scores among those undergoing elective anterior cervical decompression and fusion for cervical degenerative disc disease. The ability to assess health utility, coupled with the psychometric properties of the CSOQ, should increase the clinical utility of this patient-reported outcomes instrument.
颈椎研究学会结果研究的横断面分析，一项纵向多中心队列研究。
提供一种从颈椎结局问卷（CSOQ）领域评分估算健康效用的统计模型。
健康政策研究人员一致认为，经济评估的结果可以用质量调整生命年（QALY）来报告。CSOQ 是一种特定于疾病的工具，可评估包括颈部和手臂/肩部疼痛以及心理困扰等多个领域的个体。
在手术前（4 周内）和手术后（3、6 和 24 个月），对因颈椎退行性椎间盘疾病而行前路颈椎减压融合术的患者前瞻性地进行了 CSOQ 和 36 项简短健康调查问卷（SF-36）。使用 Brazier 等人报告的方法，使用 SF-36 估算健康效用（SF-6D）。在训练数据集（n = 164）上进行回归分析，以从 CSOQ 的领域评分计算 SF-6D。验证数据集（n = 328）用于估计 SF-6D，与 SF-36 计算的健康效用进行比较。
领域评分与健康效用（SF-6D）呈中度相关（P < 0.001），相关系数范围为 0.48 至 0.70。基于 CSOQ 领域评分和患者年龄的训练数据集回归方程可以解释健康效用的 65%的变异。在验证数据集中，预测的 SF-6D 与观察到的 SF-6D 呈正相关（r = 0.680，P < 0.001）。
我们的研究结果表明，CSOQ 的领域评分可用于估算因颈椎退行性椎间盘疾病而行前路颈椎减压融合术的患者的健康效用评分。评估健康效用的能力，加上 CSOQ 的心理计量学特性，应增加该患者报告结局工具的临床实用性。
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