Bray Nathan, Noyes Jane, Harris Nigel, Edwards Rhiannon Tudor
Centre for Health Economics and Medicines Evaluation, Bangor University, Ardudwy, Normal Site, Bangor, Gwynedd, LL57 2PZ, UK.
School of Social Sciences, Bangor University, Neuadd Ogwen, Bangor, Gwynedd, LL57 2DG, UK.
BMC Res Notes. 2017 Aug 10;10(1):377. doi: 10.1186/s13104-017-2683-9.
The objective of this research project was to evaluate the validity of proxy health-related quality of life measures in the context of paediatric mobility impairment. Accurate health-related quality of life data is essential for quality-adjusted life year calculation; a key outcome in economic evaluation. Thirteen child-parent dyads (13 children with mobility impairments, 13 parent proxies) were asked to complete a range of outcome measures (EQ-5D-Y, VAS and HUI2/3) relating to the child's health. The relationship between respondent outcomes was examined using tests of respondent type effect (Wilcoxon signed-rank), correlation (Spearman's rank-order) and agreement (Bland-Altman plots).
Parent proxies significantly undervalued the health-related quality of life of their mobility-impaired children: children rated their health-related quality of life higher than their parents by proxy on all measures. The VAS had the highest overall mean score for children and proxies (79.50 [SD = 15.01] and 75.77 [SD = 14.70] respectively). Child and proxy results were significantly different (p < 0.05) for all measures besides the VAS (p = 0.138). Strong correlation and acceptable agreement were observed for equivalent child/proxy VAS and HUI measures. The EQ-5D-Y exhibited the least agreement between children and proxies. Sufficient association between child/proxy VAS and HUI measures indicated a degree of interchangeability.
本研究项目的目的是评估在儿童行动障碍背景下代理健康相关生活质量测量的有效性。准确的健康相关生活质量数据对于质量调整生命年的计算至关重要；质量调整生命年是经济评估中的一个关键结果。13对儿童-家长二元组（13名行动障碍儿童，13名家长代理）被要求完成一系列与儿童健康相关的结局测量（EQ-5D-Y、视觉模拟量表[VAS]和健康效用指数2/3[HUI2/3]）。使用应答者类型效应检验（Wilcoxon符号秩检验）、相关性分析（Spearman等级相关）和一致性分析（Bland-Altman图）来研究应答者结果之间的关系。
家长代理显著低估了其行动障碍儿童的健康相关生活质量：在所有测量中，儿童对其健康相关生活质量的评分均高于家长代理的评分。儿童和代理的VAS总体平均得分最高（分别为79.50[标准差=15.01]和75.77[标准差=14.70]）。除VAS外（p=0.138），所有测量的儿童和代理结果均存在显著差异（p<0.05）。儿童/代理的等效VAS和HUI测量结果显示出强相关性和可接受的一致性。EQ-5D-Y在儿童和代理之间的一致性最低。儿童/代理VAS和HUI测量之间有足够的关联，表明存在一定程度的可互换性。
