Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
Rheumatology (Oxford). 2018 May 1;57(5):891-899. doi: 10.1093/rheumatology/key008.
To estimate the multi-dimensional health impact of radiographic knee OA and quantify the overall health-related quality of life (HRQoL) burden, using a preference-based health utilities measure.
Data on self-reported HRQoL, measured using the SF-12 multi-dimensional health state instrument, were obtained for 2895 patients with radiographic knee OA (Kellgren-Lawrence grade of at least 2) from the Osteoarthritis Initiative and for a general population sample of 3202 from the National Health Measurement Study. The SF-12 was converted to the six-dimensional SF-6D classification to compute preference-based health utilities. Generalized ordinal regression and multinomial regression were used to estimate the health loss on each SF-6D dimension for Osteoarthritis Initiative participants with radiographic knee OA relative to the general population, adjusted for differences in age, BMI, sex, ethnicity and educational level. Predicted SF-6D profiles were then used to compute the average HRQoL loss attributable to radiographic knee OA.
Radiographic knee OA was associated with substantial health losses on all dimensions of the SF-6D except for social functioning. Health losses increased with the radiographic severity of OA in dimensions related to physical health, while there was no relationship between worse radiographic disease and worse self-assessed health in mental and emotional dimensions of health. Overall, radiographic knee OA was associated with a HRQoL detriment of 0.040-0.044 at Kellgren-Lawrence grade 2, increasing to 0.045-0.050 at grade 3 and 0.073-0.081 at grade 4.
Radiographic knee OA is significantly associated with worse HRQoL across most dimensions of health.
使用偏好加权健康效用衡量标准，估算放射学膝关节骨关节炎的多维健康影响，并量化整体健康相关生活质量（HRQoL）负担。
从骨关节炎倡议中获取了 2895 名放射学膝关节骨关节炎（Kellgren-Lawrence 分级至少为 2 级）患者的自我报告 HRQoL 数据，该数据使用 SF-12 多维健康状态量表进行测量，并从国家健康测量研究中获取了 3202 名一般人群样本的数据。SF-12 被转换为六维度 SF-6D 分类，以计算偏好加权健康效用。使用广义有序回归和多项回归来估计相对于一般人群，骨关节炎倡议中患有放射学膝关节骨关节炎的患者在每个 SF-6D 维度上的健康损失，调整了年龄、BMI、性别、种族和教育水平的差异。然后使用预测的 SF-6D 分布来计算放射学膝关节骨关节炎导致的平均 HRQoL 损失。
放射学膝关节骨关节炎与 SF-6D 的所有维度（除社会功能外）的健康损失都显著相关。健康损失随着 OA 的放射学严重程度在与身体健康相关的维度上增加，而在心理健康和情感维度上，更严重的放射学疾病与自我评估的健康状况较差之间没有关系。总体而言，放射学膝关节骨关节炎与 Kellgren-Lawrence 分级 2 级时的 HRQoL 损害相关，HRQoL 损害为 0.040-0.044，在分级 3 级时增加到 0.045-0.050，在分级 4 级时增加到 0.073-0.081。
放射学膝关节骨关节炎与大多数健康维度的 HRQoL 明显相关。
