Fisher Lawrence, Tang Tricia, Polonsky William
University of California, San Francisco, CA, USA.
University of British Columbia, Vancouver, Canada.
Diabetes Res Clin Pract. 2017 Apr;126:278-285. doi: 10.1016/j.diabres.2016.10.018. Epub 2016 Nov 1.
The rapid development of new medications and devices in diabetes research and clinical care has led to an increased need to assess their impact on health-related quality of life (HRQOL). Unfortunately, the lack of consensus definitions and guidelines has led to the use of HRQOL measures that are often imprecise and inappropriate. The goal of this report is to provide a practical structure to the definition and measurement of HRQOL in diabetes research and clinical care. Following a brief historical background to provide context, we define HRQOL and provide a three-step framework for scale selection: identify the specific, proximal intervention targets; decide how reaching these targets will affect HRQOL; and select appropriate measures based on sample diversity, the intervention and the targets using a 2×2 grid (generic vs. diabetes specific measures; global vs. component measures). Practical tips for scale selection include: gaining patient input to document important potential HRQOL effects, varying scale selection by patient characteristics, considering common HRQOL measurement problems, and considering the timing of HRQOL assessment. We emphasize the importance of a careful, planned evaluation of HRQOL in diabetes, rather than an "off the shelf" approach.
糖尿病研究与临床护理中新药物和设备的快速发展，使得评估它们对健康相关生活质量（HRQOL）的影响的需求日益增加。不幸的是，缺乏统一的定义和指南导致了HRQOL测量方法的使用往往不准确且不恰当。本报告的目的是为糖尿病研究与临床护理中HRQOL的定义和测量提供一个实用的框架。在简要介绍历史背景以提供背景信息之后，我们定义了HRQOL，并提供了一个三步量表选择框架：确定具体的、直接的干预目标；确定实现这些目标将如何影响HRQOL；以及使用2×2网格（通用量表与糖尿病特异性量表；整体量表与分量表）根据样本多样性、干预措施和目标选择合适的测量方法。量表选择的实用建议包括：征求患者意见以记录重要的潜在HRQOL影响，根据患者特征改变量表选择，考虑常见的HRQOL测量问题，以及考虑HRQOL评估的时机。我们强调在糖尿病中对HRQOL进行仔细、有计划的评估的重要性，而不是采用“现成”的方法。
