Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, F-54 000, France.
Best Pract Res Clin Rheumatol. 2012 Oct;26(5):627-35. doi: 10.1016/j.berh.2012.08.007.
Co-morbidities can influence generic measurement of health indirect utility. We investigated their impact to assess indirect utility with the Medical Outcomes Study Short Form 6D (SF-6D) in patients with osteoarthritis (OA).
In patients with hip and knee OA from the Knee and Hip Osteo-Arthritis Long-term Assessment (KHOALA) study, co-morbidities were assessed by the Functional Co-morbidity Index. Multivariate linear regressions were used to determine predictors of utility score.
For the 878 patients included, the mean (standard deviation (SD)) utility score for 808 patients was 0.66 (11; range 0.32-1.00) and mean number of co-morbidities 2.05 (1.58). Number of co-morbidities (beta = -0.30; p = 0.002), psychiatric disease (beta = -0.043; p < 0.0001) and degenerative disc disease (beta = -0.014; p = 0.018) were predictors of low utility score. The WOMAC functional score had a higher significant effect (beta = -0.003; p < 0.0001) and explained a higher percentage of the model variance.
Compared to greater negative effect of functional severity of OA, co-morbidities have a negative but relatively marginal impact on indirect utility score. This suggests that, clinically, considering the functional severity of OA remains a first priority.
合并症会影响健康通用测量的间接效用。我们研究了它们的影响，以评估骨关节炎（OA）患者使用医疗结局研究短表 6 维度（SF-6D）的间接效用。
在 KHOALA 研究中，对髋和膝关节 OA 患者进行合并症评估，采用功能合并症指数。采用多元线性回归确定效用评分的预测因素。
纳入 878 例患者，808 例患者的平均（标准偏差（SD））效用评分（范围 0.32-1.00）为 0.66（11），平均合并症数为 2.05（1.58）。合并症数量（β = -0.30；p = 0.002）、精神疾病（β = -0.043；p < 0.0001）和退行性椎间盘疾病（β = -0.014；p = 0.018）是低效用评分的预测因素。WOMAC 功能评分的影响更为显著（β = -0.003；p < 0.0001），对模型方差的解释程度更高。
与 OA 功能严重程度的更大负面影响相比，合并症对间接效用评分的影响呈负相关，但相对较小。这表明，在临床上，首先要考虑 OA 的功能严重程度。
