Patrick D L, Deyo R A
Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle 98195.
Med Care. 1989 Mar;27(3 Suppl):S217-32. doi: 10.1097/00005650-198903001-00018.
Application of generic and specific measures of health status and quality of life to different diseases, conditions, states, and populations is increasing. Four strategies for using these measures are separate generic and specific measures, modified generic measures, disease-specific supplements, and batteries. The preferred strategy depends on project aims, methodological concerns, and practical constraints. Generic measures are necessary to compare outcomes across different populations and interventions, particularly for cost-effectiveness studies. Disease-specific measures assess the special states and concerns of diagnostic groups. Specific measures may be more sensitive for the detection and quantification of small changes that are important to clinicians or patients. Comparison studies are needed of the validity, reliability, and responsiveness of generic and disease-specific measures in the same population and in minority and age-specific groups.
将健康状况和生活质量的通用及特定指标应用于不同疾病、状况、状态和人群的情况日益增多。使用这些指标的四种策略分别是单独的通用和特定指标、修改后的通用指标、疾病特异性补充指标以及指标组合。首选策略取决于项目目标、方法学考量和实际限制。通用指标对于比较不同人群和干预措施的结果至关重要，尤其是在成本效益研究中。疾病特异性指标评估诊断组的特殊状态和关注点。特定指标对于检测和量化对临床医生或患者重要的微小变化可能更为敏感。需要在同一人群以及少数群体和特定年龄组中对通用和疾病特异性指标的有效性、可靠性和反应性进行比较研究。
