Germain Nicola, Kymes Steven, Löf Elin, Jakubowska Anna, François Clément, Weatherall James
a Creativ-Ceutical , Paris , France.
b Lundbeck , Deerfield , IL , USA.
J Med Econ. 2019 May;22(5):403-413. doi: 10.1080/13696998.2019.1576694. Epub 2019 Mar 5.
There have been no systematic literature reviews (SLRs) evaluating the identified association between outcomes (e.g. clinical, functional, adherence, societal burden) and Quality-of-Life (QoL) or Healthcare Resource Utilization (HCRU) in schizophrenia. The objective of this study was to conduct a SLR of published data on the relationship between outcomes and QoL or HCRU.
Electronic searches were conducted in Embase and Medline, for articles which reported on the association between outcomes and QoL or HCRU. Inclusion and exclusion criteria were applied to identify the most relevant articles and studies and extract their data. A summary table was developed to illustrate the strength of associations, based on p-values and correlations.
One thousand and two abstracts were retrieved; five duplicates were excluded; 997 abstracts were screened and 95 references were retained for full-text screening. Thrirty-one references were included in the review. The most commonly used questionnaire, which also demonstrated the strongest associations (defined as a p < 0.0001 and/or correlation ±0.70), was the Positive and Negative Syndrome Scale (PANSS) associated with HCRU and QoL (the SF-36, the Schizophrenia Quality-of-Life questionnaire [S-QOL-18], the Quality-of-Life Scale [QLS]). Other robust correlations included the Clinical Global Impression-Severity (CGI-S) with QoL (EQ5D), relapse with HCRU, and remission with QoL (EQ5D). Lastly, functioning (Work Rehabilitation Questionnaire [WORQ] and Personal and Social Performance Scale [PSP]) was found to be associated to QoL (QLS and Subjective Well-being under Neuroleptics Questionnaire [SWN]).
This study included data from an 11-year period, and other instruments less frequently used may be further investigated.
The evidence suggests that the PANSS is the clinical outcome that currently provides the most frequent and systematic associations with HCRU and QoL endpoints in schizophrenia.
尚无系统性文献综述（SLR）评估已确定的精神分裂症患者结局（如临床、功能、依从性、社会负担）与生活质量（QoL）或医疗资源利用（HCRU）之间的关联。本研究的目的是对已发表的关于结局与QoL或HCRU之间关系的数据进行系统性文献综述。
在Embase和Medline中进行电子检索，查找报告结局与QoL或HCRU之间关联的文章。应用纳入和排除标准来确定最相关的文章和研究，并提取其数据。基于p值和相关性编制了一个汇总表，以说明关联的强度。
检索到1002篇摘要；排除5篇重复摘要；筛选997篇摘要，保留95篇参考文献进行全文筛选。31篇参考文献纳入综述。最常用的问卷，同时也显示出最强的关联（定义为p < 0.0001和/或相关性±0.70），是与HCRU和QoL相关的阳性和阴性症状量表（PANSS）（SF - 36、精神分裂症生活质量问卷[S - QOL - 18]、生活质量量表[QLS]）。其他显著相关性包括临床总体印象严重程度（CGI - S）与QoL（EQ5D）、复发与HCRU、缓解与QoL（EQ5D）。最后，发现功能（工作康复问卷[WORQ]和个人及社会表现量表[PSP]）与QoL（QLS和抗精神病药物治疗下主观幸福感问卷[SWN]）相关。
本研究纳入了11年期间的数据，其他较少使用的工具可能需要进一步研究。
证据表明，PANSS是目前与精神分裂症患者HCRU和QoL终点最频繁且系统关联的临床结局。
