Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands -
Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
Eur J Phys Rehabil Med. 2021 Jun;57(3):337-346. doi: 10.23736/S1973-9087.21.06335-8. Epub 2021 Jan 15.
Although the use of patient-reported outcome measures to assess Health-Related Quality of Life (HRQoL) has been advocated, it is still open to debate which patient-reported outcome measure should be preferred to evaluate HRQoL after stroke.
To compare the measurement properties (including concurrent validity and discriminant ability) between the 5-dimensional 5-level EuroQol (EQ-5D-5L) and the Patient-Reported Outcomes Measurement Information System 10-Question Global Health Short Form (PROMIS-10) to evaluate HRQoL 3 months after stroke.
Cross-sectional study.
Neurology outpatient clinics in 6 Dutch hospitals.
The participants 360 consecutive individuals with stroke. Their median age was 71 years, 143 (39.7%) were female and 335 (93.0%) had suffered an ischemic stroke.
The EQ-5D-5L, PROMIS-10, modified Rankin Scale and two items on experienced decrease in health and activities post-stroke were administered by a stroke nurse or nurse practitioner through a telephone interview 3 months after stroke. The internal consistency, distribution, floor/ceiling effects, inter-correlations and discriminant ability (using the modified Rankin Scale and experienced decrease in health and in activities post-stroke as external anchors) were calculated for both the EQ-5D-5L and PROMIS-10.
Ninety-six percent of the participants were living at home and 50.9% experienced minimal or no disabilities (modified Rankin Scale 0-1) 3 months after stroke. A ceiling effect and a non-normal left skewed distribution were observed in the EQ-5D-5L. The PROMIS-10 showed higher internal consistency (α=0.90) compared to the EQ-5D-5L (α=0.75). Both the EQ-5D-5L and the PROMIS-10 were strongly correlated with the modified Rankin Scale (r=0.62 and 0.60 respectively). The PROMIS-10 showed better discriminant ability in less affected individuals with stroke, whereas the EQ-5D-5L showed slightly better discriminant ability in more affected individuals with stroke.
Both EQ-5D-5L and PROMIS-10 prove to be useful instruments to evaluate HRQoL in patients who are living at home 3 months after stroke.
The clinical rehabilitation impact depended on the setting and underlying goal which patient-reported outcome measure is preferred to evaluate HRQoL 3 months after stroke. The PROMIS-10 should be preferred to detect differences in less affected stroke patients, whereas the EQ-5D-5L provides slightly more information in more affected stroke patients.
尽管使用患者报告的结果测量来评估健康相关的生活质量（HRQoL）已得到提倡，但仍存在争议，即哪种患者报告的结果测量应优先用于评估中风后的 HRQoL。
比较 5 维度 5 级欧洲五维健康量表（EQ-5D-5L）和患者报告的结局测量信息系统 10 项全球健康简短量表（PROMIS-10）在评估中风后 3 个月的 HRQoL 方面的测量特性（包括同时效度和区分能力）。
横断面研究。
荷兰 6 家医院的神经病学门诊。
360 名连续的中风患者。他们的中位年龄为 71 岁，143 名（39.7%）为女性，335 名（93.0%）患有缺血性中风。
中风护士或执业护士通过电话访谈在中风后 3 个月对 EQ-5D-5L、PROMIS-10、改良 Rankin 量表和 2 个关于中风后健康和活动下降的项目进行评估。计算 EQ-5D-5L 和 PROMIS-10 的内部一致性、分布、地板/天花板效应、相关性和区分能力（使用改良 Rankin 量表和中风后健康和活动下降的经验作为外部锚点）。
96%的参与者居住在家庭中，50.9%的参与者在中风后 3 个月经历了最小或无残疾（改良 Rankin 量表 0-1）。EQ-5D-5L 存在天花板效应和非正态左偏分布。PROMIS-10 的内部一致性（α=0.90）高于 EQ-5D-5L（α=0.75）。EQ-5D-5L 和 PROMIS-10 均与改良 Rankin 量表呈强相关性（r=0.62 和 0.60）。PROMIS-10 在病情较轻的中风患者中具有更好的区分能力，而 EQ-5D-5L 在病情较重的中风患者中具有稍好的区分能力。
EQ-5D-5L 和 PROMIS-10 均可用于评估中风后 3 个月居住在家中的患者的 HRQoL。
临床康复影响取决于设定和基本目标，即哪种患者报告的结果测量更适合评估中风后 3 个月的 HRQoL。在病情较轻的中风患者中，应优先选择 PROMIS-10 来检测差异，而在病情较重的中风患者中，EQ-5D-5L 提供的信息略多。
