Center for Health Research - Kaiser Permanente, 3800 N. Interstate Ave., Portland, OR, 97227, USA.
Department of Economics, McMaster University, Hamilton, ON, Canada.
Qual Life Res. 2018 Feb;27(2):447-454. doi: 10.1007/s11136-017-1728-9. Epub 2017 Nov 17.
To examine the longitudinal construct validity in the assessment of changes in depressive symptoms of widely used utility and generic HRQL instruments in teens.
392 teens enrolled in the study and completed HRQL and diagnostic measures as part of the baseline interview. HRQL measures included EuroQol (EQ-5D-3L), Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3), Quality of Well-Being Scale (QWB), Pediatric Quality of Life Inventory (PEDS-QL), RAND-36 (SF-6D), and Quality of Life in Depression Scale (QLDS). Youth completed follow-up interviews 12 weeks after baseline. Sixteen youth (4.1%) were lost to follow-up. We examined correlations between changes in HRQL instruments and the Children's Depression Rating Scale-Revised (CDRS-R) and assessed clinically meaningful change in multi-attribute utility HRQL measures using mean change (MC) and standardized response mean (SRM) among youth showing at least moderate (20%) improvement in depression symptomology.
Spearman's correlation coefficients demonstrated moderate correlation between changes in CDRS-R and the HUI2 (r = 0.38), HUI3 (r = 0.42), EQ-5D-3L (r = 0.36), SF-6D (r = 0.39), and PEDS-QL (r = 0.39) and strong correlation between changes in CDRS-R and QWB (r = 0.52) and QLDS (r = - 0.71). Effect size results are also reported. Among multi-attribute utility measures, all showed clinically meaningful improvements in the sample of youth with depression improvement (HUI2, MC = 0.20, SRM = 0.97; HUI3, MC = 0.32, SRM = 1.17; EQ-5D-3L, MC = 0.08, SRM = 0.51; QWB, MC = 0.11, SRM = 0.86; and SF-6D, MC = 0.12, SRM = 1.02).
Findings support the longitudinal construct validity of included HRQL instruments for the assessment of change in depression outcomes in teens. Results of this study can help inform researchers about viable instruments to include in economic evaluations for this population.
研究在青少年中，广泛使用的效用和通用健康相关生活质量（HRQL）工具评估抑郁症状变化的纵向构建效度。
392 名青少年参与了这项研究，并在基线访谈中完成了 HRQL 和诊断措施。HRQL 测量包括 EuroQol（EQ-5D-3L）、健康效用指数标记 2 版（HUI2）和标记 3 版（HUI3）、健康良好状况量表（QWB）、儿科生活质量量表（PEDS-QL）、RAND-36（SF-6D）和抑郁生活质量量表（QLDS）。青少年在基线后 12 周完成了随访访谈。有 16 名青少年（4.1%）失访。我们考察了 HRQL 工具变化与儿童抑郁评定量表修订版（CDRS-R）之间的相关性，并使用在抑郁症状学中至少有 20%（中度）改善的青少年的平均变化（MC）和标准化反应均值（SRM）评估了多属性效用 HRQL 测量的临床显著变化。
Spearman 相关系数显示，CDRS-R 变化与 HUI2（r=0.38）、HUI3（r=0.42）、EQ-5D-3L（r=0.36）、SF-6D（r=0.39）和 PEDS-QL（r=0.39）之间存在中度相关性，与 QWB（r=0.52）和 QLDS（r=-0.71）之间存在高度相关性。也报告了效应量结果。在多属性效用测量中，所有指标在抑郁改善青少年样本中均显示出临床显著改善（HUI2，MC=0.20，SRM=0.97；HUI3，MC=0.32，SRM=1.17；EQ-5D-3L，MC=0.08，SRM=0.51；QWB，MC=0.11，SRM=0.86；SF-6D，MC=0.12，SRM=1.02）。
研究结果支持包括 HRQL 工具在内的纵向构建效度，可用于评估青少年抑郁结局的变化。这项研究的结果可以帮助研究人员了解在这一人群中进行经济评估时可用的工具。
