Nair Rajesh, Kachan Paul
Clinical Project Manager at St Joseph's General Hospital in Comox, BC.
Family physician practising in Victoria, BC, and Clinical Instructor in the Department of Family Medicine at the University of British Columbia.
Can Fam Physician. 2017 Jun;63(6):e310-e315.
To critically review and evaluate the psychometric properties and practical considerations of administering generic and diabetes-specific quality-of-life (QoL) tools in the clinical environment and provide recommendations.
A MEDLINE search was carried out from January 1950 to August 2015 using the MeSH terms and . Four generic and 4 diabetes-specific tools were selected based on the frequency of their use and the existence of published evidence of strong psychometric properties in patients with diabetes (either type 1 or 2). The generic tools included the Short Form-36 (SF-36), Short Form-12 (SF-12), Sickness Impact Profile, and EuroQol EQ-5D instruments. Diabetes-specific tools included the Audit of Diabetes-Dependent Quality of Life, Diabetes Quality of Life, Appraisal of Diabetes Scale (ADS), and Diabetes Health Profile instruments.
The SF-36 is one of the most widely used general health measures in QoL research and it has proven reliability and validity. However, the SF-12 is a better option for a family practice owing to its shorter length. The SF-12 has been shown to be closely correlated with the SF-36. Of the diabetes-specific measures, the ADS is known be valid, short, and relatively straightforward in terms of scoring, thereby increasing its usefulness in routine clinical practice. The Audit of Diabetes-Dependent Quality of Life and Diabetes Quality of Life tools have been widely tested and have generally been found to be more valid and reliable than the ADS, but specific issues with feasibility make them unappealing for the clinical setting. The rationale was to find the most rigorously tested instrument within the scientific literature in terms of validity, reliability, and responsiveness. However, this was not done, as judging the quality of a measure is not simply a matter of determining its psychometric properties but rather requires qualitative judgment about the entirety of the evidence.
Finding ideal tools and procedures for routine data collection in the clinic setting requires organization and groundwork that will eventually assist both clinicians and researchers by providing reliable information on QoL for patients with diabetes. Further research is necessary to assess the validity and responsiveness of these tools specifically relating to evaluation of QoL for those with diabetes.
严格审查和评估在临床环境中使用通用及糖尿病特异性生活质量(QoL)工具的心理测量特性及实际考量因素,并提供建议。
使用医学主题词(MeSH)术语于1950年1月至2015年8月进行了MEDLINE检索。基于使用频率以及已发表的关于糖尿病患者(1型或2型)具有强大心理测量特性的证据,选择了4种通用工具和4种糖尿病特异性工具。通用工具包括简明健康调查问卷36项版本(SF - 36)、简明健康调查问卷12项版本(SF - 12)、疾病影响概况量表和欧洲五维度健康量表(EQ - 5D)。糖尿病特异性工具包括糖尿病相关生活质量评估量表、糖尿病生活质量量表、糖尿病评估量表(ADS)和糖尿病健康概况量表。
SF - 36是生活质量研究中使用最广泛的一般健康测量工具之一,已证明其可靠性和有效性。然而,由于长度较短,SF - 12对于家庭医疗实践是更好的选择。已表明SF - 12与SF - 36密切相关。在糖尿病特异性测量工具中,ADS在评分方面被认为有效、简短且相对简单,从而增加了其在常规临床实践中的实用性。糖尿病相关生活质量评估量表和糖尿病生活质量量表已得到广泛测试,并且总体上被发现比ADS更有效和可靠,但可行性方面的特定问题使其在临床环境中缺乏吸引力。其基本原理是在科学文献中找到在有效性、可靠性和反应性方面经过最严格测试的工具。然而,并未做到这一点,因为判断一项测量工具的质量不仅仅是确定其心理测量特性的问题,还需要对整个证据进行定性判断。
在临床环境中找到用于常规数据收集的理想工具和程序需要组织和基础工作,最终通过为糖尿病患者提供关于生活质量的可靠信息来帮助临床医生和研究人员。有必要进行进一步研究以评估这些工具与糖尿病患者生活质量评估具体相关的有效性和反应性。