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用于从精神分裂症临床问卷估计效用的预测模型:欧洲精神分裂症研究(EuroSC)的结果

Predictive models to estimate utility from clinical questionnaires in schizophrenia: findings from EuroSC.

作者信息

Siani Carole, de Peretti Christian, Millier Aurélie, Boyer Laurent, Toumi Mondher

机构信息

Research Laboratory in Knowledge Engineering (ERIC, EA3083), Institute of Pharmaceutical and Biological Sciences (ISPB), University Claude Bernard Lyon 1, 11 Rue Guillaume Paradin, 69372, Lyon Cedex 08, France.

Laboratory of Actuarial and Financial Sciences (SAF, EA2429), Institute of Financial and Insurance Sciences (ISFA School), University Claude Bernard Lyon 1, 50 Avenue Tony Garnier, 69366, Lyon Cedex 7, France.

出版信息

Qual Life Res. 2016 Apr;25(4):925-34. doi: 10.1007/s11136-015-1120-6. Epub 2015 Sep 18.

Abstract

OBJECTIVE

The clinical symptoms of schizophrenia are associated with serious social, quality of life and functioning alterations. Typically, data on health utilities are not available in clinical studies in schizophrenia. This makes the economic evaluation of schizophrenia treatments challenging. The purpose of this article was to provide a mapping function to predict unobserved utility values in patients with schizophrenia from the available clinical and socio-demographic information.

METHODS

The analysis was performed using data from EuroSC, a 2-year, multi-centre, cohort study conducted in France (N = 288), Germany (N = 618), and the UK (N = 302), totalling 1208 patients. Utility was calculated based on the EQ-5D questionnaire. The relationships between the utility values and the patients' socio-demographic and clinical characteristics (Positive and Negative Syndrome Scale--PANSS, Calgary Depression Scale for Schizophrenia--CDSS, Global Assessment of Functioning--GAF, extra-pyramidal symptoms measured by Barnes Akathisia Scale-BAS, age, sex, country, antipsychotic type) were modelled using a random and a fixed individual effects panel linear model.

RESULTS

The analysis demonstrated the prediction ability of the used parameters for estimating utility measures in patients with schizophrenia. Although there are small variations between countries, the same variables appear to be the key predictors. From a clinical perspective, age, gender, psychopathology, and depression were the most important predictors associated with the EQ-5D.

CONCLUSION

This paper proposed a reliable, robust and easy-to-apply mapping method to estimate EQ-5D utilities based on demographic and clinical measures in schizophrenia.

摘要

目的

精神分裂症的临床症状与严重的社会、生活质量及功能改变相关。通常,精神分裂症临床研究中缺乏健康效用数据。这使得对精神分裂症治疗的经济评估具有挑战性。本文旨在提供一种映射函数,根据现有的临床和社会人口学信息预测精神分裂症患者未观察到的效用值。

方法

分析使用了来自欧洲精神分裂症研究(EuroSC)的数据,这是一项在法国(N = 288)、德国(N = 618)和英国(N = 302)进行的为期2年的多中心队列研究,共计1208例患者。效用基于EQ - 5D问卷计算。使用随机和固定个体效应面板线性模型对效用值与患者的社会人口学和临床特征(阳性和阴性症状量表——PANSS、精神分裂症卡尔加里抑郁量表——CDSS、功能总体评定量表——GAF、用巴恩斯静坐不能量表——BAS测量的锥体外系症状、年龄、性别、国家、抗精神病药物类型)之间的关系进行建模。

结果

分析证明了所使用参数对估计精神分裂症患者效用测量值的预测能力。尽管各国之间存在细微差异,但相同的变量似乎是关键预测因素。从临床角度来看,年龄、性别、精神病理学和抑郁是与EQ - 5D相关的最重要预测因素。

结论

本文提出了一种基于精神分裂症患者人口统计学和临床测量来估计EQ - 5D效用的可靠、稳健且易于应用的映射方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b45/4830865/733769ab20ae/11136_2015_1120_Fig1_HTML.jpg

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