Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Neurotrauma. 2012 May 1;29(7):1322-7. doi: 10.1089/neu.2011.2222. Epub 2012 Apr 17.
There has recently been a call for the adoption of comparative effectiveness research (CER) and related research approaches for studying traumatic brain injury (TBI). These methods allow researchers to compare the effectiveness of different therapies in producing patient-oriented outcomes of interest. Heretofore, the only measures by which to compare such therapies have been mortality and rate of poor outcome. Better comparisons can be made if parametric, preference-based quality-of-life (QOL) values are available for intermediate outcomes, such as those described by the Glasgow Outcome Scale Extended (GOSE). Our objective was therefore to determine QOL for the health states described by the GOSE. We interviewed community members at least 18 years of age using the standard gamble method to assess QOL for descriptions of GOSE scores of 2-7 derived from the structured interview. Linear regression analysis was also performed to assess the effect of age, gender, and years of education on QOL. One hundred and one participants between the ages of 18 and 83 were interviewed (mean age 40 ± 19 years), including 55 men and 46 women. Functional impairment and QOL showed a strong inverse relationship, as assessed by both linear regression and the Spearman rank order coefficient. No consistent effect or age, gender, or years of education was seen. As expected, QOL decreased with functional outcome as described by the GOSE. The results of this study will provide the groundwork for future groups seeking to apply CER methods to clinical studies of TBI.
最近有人呼吁采用比较疗效研究（CER）和相关研究方法来研究创伤性脑损伤（TBI）。这些方法使研究人员能够比较不同疗法在产生患者感兴趣的结果方面的有效性。迄今为止，比较此类疗法的唯一方法是死亡率和不良预后发生率。如果有参数化的、基于偏好的生活质量（QOL）值可用于中间结果，例如格拉斯哥结局量表扩展（GOSE）所描述的结果，那么可以进行更好的比较。我们的目的是确定 GOSE 描述的健康状况的 QOL。我们使用标准博弈法对年龄至少为 18 岁的社区成员进行了访谈，以评估来自结构化访谈的 GOSE 评分 2-7 描述的 QOL。还进行了线性回归分析，以评估年龄、性别和受教育年限对 QOL 的影响。我们对 101 名年龄在 18 岁至 83 岁之间的参与者进行了访谈（平均年龄为 40±19 岁），其中包括 55 名男性和 46 名女性。线性回归和斯皮尔曼等级相关系数都表明，功能障碍和 QOL 之间存在很强的负相关关系。未观察到年龄、性别或受教育年限的一致影响。正如预期的那样，随着 GOSE 描述的功能结果的改善，QOL 降低。本研究的结果将为未来寻求将 CER 方法应用于 TBI 临床研究的团体提供基础。
