采用欧洲五维健康量表问卷和简明健康状况调查量表（36项）评估20至69岁股骨颈骨折患者的良好反应性：对182例患者进行的为期2年的前瞻性随访研究。
Good responsiveness with EuroQol 5-Dimension questionnaire and Short Form (36) Health Survey in 20-69 years old patients with a femoral neck fracture: A 2-year prospective follow-up study in 182 patients.
作者信息
Honkavaara Niklas, Al-Ani Amer N, Campenfeldt Pierre, Ekström Wilhelmina, Hedström Margareta
机构信息
Karolinska Institutet, Department of Clinical Science Intervention and Technology (CLINTEC), Department of Orthopaedics, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Karolinska Institutet, Department of Clinical Science Intervention and Technology (CLINTEC), Department of Orthopaedics, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
出版信息
Injury. 2016 Aug;47(8):1692-7. doi: 10.1016/j.injury.2016.05.021. Epub 2016 May 17.
BACKGROUND
EQ-5D and SF-36 are two questionnaires used to measure health related quality of life (HRQoL). The responsiveness of these instruments has previously been evaluated in elderly populations with hip fracture but not in a younger population. The purpose was to evaluate the responsiveness of SF-36 and EQ-5D in a younger population with femoral neck fracture.
METHODS
182 patients aged 20-69 were consecutively included. HRQoL was measured by EQ-5D and SF-36 at 4, 12 and 24 months. Pain and function were measured by Harris Hip Score (HHS) on the same occasions. The responsiveness of EQ-5D and SF-36 was evaluated by calculation of two effect sizes; standardized effect size (SES) and standardized response mean (SRM), and by analysing how changes in score correlated to changes in function and subjective state of health. External responsiveness was also evaluated by calculating receiver operating characteristic curve and area under the curve.
RESULTS
SES was large at four months for both EQ-5D and SF-36 (1.09 and 0.83 respectively) and moderate at the 12- and 24-month follow-ups. The correlation between changes (4-24 months) in HHS and changes in HRQoL were 0.44 for EQ-5D and 0.37 for SF-36. EQ-5D and SF-36 were both more sensitive than HHS in their ability to predict subjective improvements after a hip fracture.
CONCLUSIONS
The effect sizes and the ability to follow and predict the external standard indicates that both EQ-5D and SF-36 have good internal and external responsiveness in this younger population with femoral neck fracture. The generic HRQoL questionnaires were superior to a hip-specific instrument in predicting the patients' subjective feelings of an improved state of health. EQ-5D is simple to administer and shows similar responsiveness as SF-36 and may be sufficient to use as an outcome measure in clinical trials.
背景
EQ-5D和SF-36是用于测量健康相关生活质量（HRQoL）的两份问卷。此前已在老年髋部骨折人群中评估了这些工具的反应度，但未在年轻人群中进行评估。目的是评估SF-36和EQ-5D在年轻股骨颈骨折人群中的反应度。
方法
连续纳入182例年龄在20至69岁之间的患者。在4个月、12个月和24个月时用EQ-5D和SF-36测量HRQoL。在相同时间用Harris髋关节评分（HHS）测量疼痛和功能。通过计算两个效应量来评估EQ-5D和SF-36的反应度；标准化效应量（SES）和标准化反应均值（SRM），并分析分数变化与功能变化和主观健康状态变化之间的相关性。还通过计算受试者工作特征曲线和曲线下面积来评估外部反应度。
结果
EQ-5D和SF-36在4个月时的SES均较大（分别为1.09和0.83），在12个月和24个月随访时为中等。EQ-5D的HHS变化（4至24个月）与HRQoL变化之间的相关性为0.44，SF-36为0.37。EQ-5D和SF-36在预测髋部骨折后主观改善方面均比HHS更敏感。
结论
效应量以及跟踪和预测外部标准的能力表明，EQ-5D和SF-36在这个年轻股骨颈骨折人群中均具有良好的内部和外部反应度。通用的HRQoL问卷在预测患者健康状态改善的主观感受方面优于特定于髋关节的工具。EQ-5D易于实施，显示出与SF-36相似的反应度，可能足以用作临床试验的结局指标。
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