Davis Mellar P, Hui David
Geisinger Medical Center, Danville, PA 17822.
Department of Palliative Care, Rehabilitation and Integrative Medicine, MD D Anderson Cancer Center, Houston, TX, USA, 77030.
Expert Rev Qual Life Cancer Care. 2017;2(6):293-302. doi: 10.1080/23809000.2017.1400911. Epub 2017 Nov 8.
A main goals of palliative care is to improve the health-related quality of life (QOL) of patients with advanced illnesses. The objective of this narrative review is to provide an updated synopsis on the use of QOL questionnaires in the palliative care setting.
Focusing on the palliative cares setting, we will define QOL, discuss how QOL instruments can be used clinically and in research, review approaches to validate these questionnaires, and how they can be used in utility analyses.
EXPERT OPINION/COMMENTARY: Several QOL questionnaires, such as EORTC-QLQ-C30, McGill QOL questionnaire and EQ-5D have been validated in the palliative care setting. However, significant gaps impede their application, including lack of determination of their responsiveness to change and minimal clinically important differences, the need to conduct more psychometric validation on QOL questionnaires among patients at various stages of disease trajectory, and the paucity of studies examining utility and cost-effectiveness. Further research is needed to address these knowledge gaps so QOL questionnaires can be better used to inform clinical practice and research.
姑息治疗的一个主要目标是提高晚期疾病患者与健康相关的生活质量(QOL)。本叙述性综述的目的是提供关于姑息治疗环境中QOL问卷使用情况的最新概述。
聚焦于姑息治疗环境,我们将定义QOL,讨论QOL工具如何在临床和研究中使用,回顾验证这些问卷的方法,以及它们如何用于效用分析。
专家意见/评论:一些QOL问卷,如欧洲癌症研究与治疗组织核心生活质量问卷(EORTC-QLQ-C30)、麦吉尔生活质量问卷和EQ-5D,已在姑息治疗环境中得到验证。然而,一些重大差距阻碍了它们的应用,包括缺乏对其变化反应性和最小临床重要差异的测定,需要在疾病轨迹不同阶段的患者中对QOL问卷进行更多的心理测量学验证,以及研究效用和成本效益的研究匮乏。需要进一步研究以填补这些知识空白,以便QOL问卷能够更好地用于指导临床实践和研究。