Bulpitt Christopher J, Fletcher Astrid E
Division of Geriatric Medicine Department of Medicine Royal Postgraduate Medical School, Hammersmith Hospital, W12 OHS, London, UK.
Cardiovasc Drugs Ther. 1988 Nov;2(Suppl 1):419-424. doi: 10.1007/BF00633423.
In cardiovascular diseases such as hypertension, drug therapy may improve survival and the drug of choice is the one that interferes least with health-related well-being, otherwise known as the quality of life. However, in angina, and possibly congestive heart failure, a drug may improve well-being but not survival. In this instance, the measurement of the quality of life is the endpoint in any therapeutic intervention. When selecting dimensions of quality of life and the methods to measure these dimensions, the key issue is the detection of a response to treatment during the trial. The sensitivity of a variety of methods appropriate to hypertension, angina, and congestive heart failure are considered. Overall, the quality of life should be assessed by double-blind, randomized, controlled trials, with a health index included to take account of any mortality and morbidity that occurs during the trial. Validity and repeatability of measures are most important, both within populations and across cultures. Observer bias must be avoided.
在诸如高血压等心血管疾病中，药物治疗可能会提高生存率，而首选药物是对与健康相关的幸福感（即生活质量）干扰最小的药物。然而，在心绞痛以及可能的充血性心力衰竭中，一种药物可能会改善幸福感，但不会提高生存率。在这种情况下，生活质量的衡量是任何治疗干预的终点。在选择生活质量维度和测量这些维度的方法时，关键问题是在试验期间检测到对治疗的反应。考虑了适用于高血压、心绞痛和充血性心力衰竭的各种方法的敏感性。总体而言，生活质量应由双盲、随机、对照试验进行评估，并纳入健康指数以考虑试验期间发生的任何死亡率和发病率。测量的有效性和可重复性在人群内部和不同文化之间都是最重要的。必须避免观察者偏差。
