Department of Psychiatry, Hospital Universitario de Salamanca, Salamanca, Spain.
Value Health. 2011 Jun;14(4):564-70. doi: 10.1016/j.jval.2010.11.016. Epub 2011 Apr 30.
To estimate and assess the psychometric properties of a multiattribute utility function (MAUF) for the Spanish version of the Tolerability and Quality of Life (TooL questionnaire).
Balanced data on 243 patients diagnosed with schizophrenia or bipolar disorder were gathered. In addition to the demographic and clinical variables and the usual generic health-related quality of life (HRQoL) questionnaires (EuroQol-5D [EQ-5D] and Short Form-6D [SF-6D]), instruments considered included the Spanish versions of the Positive and Negative Symptoms of Schizophrenia Scale (PANSS), Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), Udvalg for Kliniske Undersogelser (UKU), and Clinical Global Impression Severity (CGIS) scale. MAUF parameters estimation involved a number of visual analogue scale (VAS) and time trade-off (TTO) ratings that proved difficult to be performed by the patients. After checking for inconsistencies in patient responses, the original sample was reduced to a still balanced subsample of 70 individuals. A multiplicative-form MAUF was estimated following the standard methodology.
Good convergent validity was demonstrated because utility estimates from the MAUF presented strong correlations with utilities from the generic HRQoL instruments included: SF-6D (0.66, P < 0.01), EQ-5D (0.69, P < 0.01), and moderate correlations with the rest of instruments considered: PANSS (-0.27, P = 0.10), YMRS (-0.30, P = 0.08), MADRS (-0.48, P < 0.01), UKU (-0.35, P < 0.01). Criterion validity was also met because differences in mean utilities by clinical severity were found (P < 0.01). Utilities from the MAUF covered a wider range of health states [0.04,1.00] than those from the SF-6D [0.53,1.00] and EQ-5D [0.23,0.96].
Utilities from the MAUF showed good psychometric properties, serving as a complement to generic health utilities. If misapplied, however, utilities from this instrument might favor the positive evaluation of drugs showing fewer associated side effects.
评估和估计西班牙语耐受性和生活质量（TooL）问卷多属性效用函数（MAUF）的心理测量特性。
收集了 243 名诊断为精神分裂症或双相情感障碍患者的平衡数据。除了人口统计学和临床变量以及常用的一般健康相关生活质量（HRQoL）问卷（EuroQol-5D [EQ-5D]和简短形式-6D [SF-6D]）外，还考虑了包括西班牙语版本的阳性和阴性症状量表（PANSS），躁狂症评定量表（YMRS），蒙哥马利 - 阿斯伯格抑郁评定量表（MADRS），Udvalg for Kliniske Undersogelser（UKU）和临床总体印象严重程度（CGIS）量表。MAUF 参数估计涉及多个视觉模拟量表（VAS）和时间权衡（TTO）评分，这些评分很难由患者执行。在检查患者反应的不一致性后，原始样本减少到仍保持平衡的 70 人亚样本。按照标准方法估计了乘法形式的 MAUF。
良好的收敛有效性得到证明，因为 MAUF 的效用估计与包括的一般 HRQoL 工具的效用之间存在很强的相关性：SF-6D（0.66，P <0.01），EQ-5D（0.69，P <0.01），并且与其他考虑的工具中度相关：PANSS（-0.27，P = 0.10），YMRS（-0.30，P = 0.08），MADRS（-0.48，P <0.01），UKU（-0.35，P <0.01）。标准效度也得到满足，因为根据临床严重程度的平均值差异发现了效用（P <0.01）。MAUF 的效用涵盖了更广泛的健康状态范围[0.04,1.00]，而 SF-6D[0.53,1.00]和 EQ-5D[0.23,0.96]。
MAUF 的效用具有良好的心理测量特性，可作为一般健康效用的补充。然而，如果应用不当，此工具的效用可能会倾向于积极评估具有较少相关副作用的药物。
