Kaplan R M, Anderson J P, Wu A W, Mathews W C, Kozin F, Orenstein D
Division of Health Care Sciences, University of California, San Diego, La Jolla 92093.
Med Care. 1989 Mar;27(3 Suppl):S27-43. doi: 10.1097/00005650-198903001-00003.
The Quality of Well-being (QWB) Scale combines preference-weighted measures of symptoms and functioning to provide a numerical point in-time expression of well-being that ranges from zero (0) for death to 1.0 for asymptomatic optimum functioning. The QWB includes three scales of function: mobility, physical activity, and social activity. Each step of these scales is associated with preference weights. Preference adjustments for symptoms are also included. This paper describes how this general system was used to evaluate outcomes in three different clinical conditions: acquired immune deficiency syndrome (AIDS), cystic fibrosis, and arthritis. In one study, the QWB was administered to 31 patients participating in evaluation of azidothymidine (AZT) treatment for AIDS. The QWB system demonstrated substantial benefits of AZT treatment in comparison to placebo. In a second study, the QWB and a series of pulmonary function measures were administered to 44 patients with cystic fibrosis. The QWB was demonstrated to be significantly correlated with measures of pulmonary function, including FEV1 and maximal midexpiratory flow rate (MMEFR). In addition, there were significant associations between the QWB and measures of exercise tolerance. In the third study, the QWB and an arthritis-specific measure were administered to 83 arthritis patients before and after their treatment. The QWB was at least as capable of detecting clinical change in this population as was the disease-specific measure. For all three conditions, the QWB considered side effects and benefits of treatment in a common unit. Clinical trial data are cited to suggest that the QWB is a valuable outcome measure in arthritis treatment evaluation. We conclude that the QWB has substantial validity as a general health outcome measure and that the system can be used with different populations.
幸福质量（QWB）量表结合了对症状和功能的偏好加权测量，以提供一个幸福程度的即时数值表达，范围从死亡时的零（0）到无症状最佳功能时的1.0。QWB包括三个功能量表：行动能力、身体活动和社交活动。这些量表的每一步都与偏好权重相关。还包括对症状的偏好调整。本文描述了这个通用系统如何用于评估三种不同临床状况的结果：获得性免疫缺陷综合征（艾滋病）、囊性纤维化和关节炎。在一项研究中，对31名参与艾滋病叠氮胸苷（AZT）治疗评估的患者进行了QWB测量。与安慰剂相比，QWB系统显示出AZT治疗的显著益处。在第二项研究中，对44名囊性纤维化患者进行了QWB和一系列肺功能测量。结果表明，QWB与包括第一秒用力呼气容积（FEV1）和最大呼气中期流速（MMEFR）在内的肺功能测量显著相关。此外，QWB与运动耐量测量之间也存在显著关联。在第三项研究中，对83名关节炎患者在治疗前后进行了QWB和一项关节炎特异性测量。在检测该人群的临床变化方面，QWB至少与疾病特异性测量一样有效。对于所有这三种状况，QWB在一个通用单位中考虑了治疗的副作用和益处。引用的临床试验数据表明，QWB在关节炎治疗评估中是一种有价值的结果测量方法。我们得出结论，QWB作为一种总体健康结果测量方法具有相当的有效性，并且该系统可用于不同人群。
