Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany.
Value Health. 2011 Mar-Apr;14(2):329-38. doi: 10.1016/j.jval.2010.10.005.
To analyze the change in health-related quality-of-life (HRQoL) in patients with Parkinson's disease (PD) and to identify different classes of HRQoL decline.
A longitudinal cohort study was performed to assess clinical parameters (unified PD rating scale, Beck Depression Inventory) and HRQoL data (EuroQol, Parkinson's Disease Questionnaire [PDQ]-39) at baseline, 3, 6, 12, 24, and 36 months. A total of 145 patients with PD were consecutively recruited in the county of Northern Hessia, Germany, between January and June 2000. A latent growth mixture model was applied to analyse the heterogeneity in HRQoL trajectories.
We successfully applied latent mixture growth modeling in order to identify different classes of HRQoL trajectories in PD. Three growth models were developed and each resulted in a four-class model of distinct patterns using the generic EuroQol instruments' outcomes (EuroQol-5 Dimensions and visual analogue scale) and the disease-specific PDQ-39. The four classes were defined by individual trajectory characteristics. Classes one and two represented trajectories with moderate declines over 36 months, but with different initial intercepts. Class three consisted mainly of patients who passed away during the observation period and therefore had a large HRQoL decline. Class four was characterized by a low level of HRQoL at baseline and a significant subsequent decline.
The findings provide a more elaborate understanding of the variability in HRQoL reduction in PD over time. The classification of different HRQoL subgroups may help to explain the response of PD patients to the natural history of the disease. Future research will enable the identification of HRQoL responder subgroups on different treatment regimens.
分析帕金森病（PD）患者健康相关生活质量（HRQoL）的变化，并确定不同类别的 HRQoL 下降。
进行了一项纵向队列研究，以评估基线时、3、6、12、24 和 36 个月的临床参数（统一 PD 评分量表、贝克抑郁量表）和 HRQoL 数据（EuroQol、帕金森病问卷[PDQ]-39）。2000 年 1 月至 6 月期间，德国黑森州北部县连续招募了 145 名 PD 患者。应用潜在增长混合模型分析 HRQoL 轨迹的异质性。
我们成功地应用了潜在混合增长模型，以确定 PD 中不同的 HRQoL 轨迹类别。使用通用 EuroQol 仪器的结果（EuroQol-5 维度和视觉模拟量表）和疾病特异性 PDQ-39 开发了三个增长模型，每个模型都产生了四个类别的模型，具有不同的模式。四个类别的定义是基于个体轨迹特征。第 1 类和第 2 类代表在 36 个月内有中度下降的轨迹，但初始截距不同。第 3 类主要由在观察期间去世的患者组成，因此 HRQoL 下降幅度较大。第 4 类的特点是基线时 HRQoL 水平较低，随后显著下降。
研究结果提供了对 PD 中随时间推移的 HRQoL 降低变异性的更详细理解。不同 HRQoL 亚组的分类可能有助于解释 PD 患者对疾病自然史的反应。未来的研究将能够确定不同治疗方案的 HRQoL 反应亚组。
