Kuopio University Hospital, Heart Center C9, P.O. Box 100, 70029, Kuopio, Finland.
University of Helsinki, Helsinki, Finland.
Health Qual Life Outcomes. 2021 Aug 28;19(1):206. doi: 10.1186/s12955-021-01841-6.
Patient-reported outcome (PRO) instruments measure health gains, including changes in health-related quality of life (HRQoL). Previous studies have assessed the reliability and relationship of multiple HRQoL instruments in search of the optimal instrument for feasible measurement of PROs. Although the 15D instrument was shown to have the best sensitivity and construct validity among cardiac patients, it is unknown how well it captures relevant disease-specific information scores compared to instruments included in the International Consortium for Health Outcomes Measurement (ICHOM) standard set. The aim of this study was to investigate whether the disease-specific PRO instruments and a generic HRQoL instrument capture disease related symptoms in coronary artery disease (CAD) patients.
Health status and HRQoL were assessed with the instruments included in the ICHOM standard set: Seattle Angina Questionnaire short-form (SAQ-7), Rose Dyspnea Scale (RDS), two-item Patient Health Questionnaire (PHQ-2), and with the 15D HRQoL instrument at baseline and 1 year from the treatment in a university hospital setting. Spearman correlation and explanatory factor analysis were used to assess the relationship of baseline scores and 1-year change in scores of 297 patients.
At baseline, the overall 15D score and SAQ-physical limitation (SAQ-PL), 15D "breathing" and SAQ-PL, as well as "breathing" and RDS showed moderately strong correlations. The factor interpreted to reflect "Breathing-related physical activity", based on high loadings of "breathing", RDS, SAQ-PL, "mobility", "vitality", and "usual activities", explained 19.2% of the total variance. Correlations between 1-year changes in scores were fair. The factor of "Breathing-related physical activity", with significant loading of RDS, SAQ-PL, "breathing, "usual activities", "vitality", "sexual activity", "mobility", and disease-specific quality of life explained 20.5% of the total variance in 1-year change in scores. The correlation of angina frequency measured by SAQ-7 and the 15D instrument was poor.
The 15D detects dyspnea and depression similarly to RDS and PHQ-2 but not angina similarly to the SAQ-7. This may call for supplementing the 15D instrument with a disease-specific instrument when studying CAD patients.
患者报告的结果（PRO）工具可衡量健康收益，包括与健康相关的生活质量（HRQoL）的变化。先前的研究已经评估了多种 HRQoL 工具的可靠性和相关性，以寻找用于可行的 PRO 测量的最佳工具。尽管在心脏患者中，15D 工具表现出最佳的敏感性和结构有效性，但与国际健康结果测量联合会（ICHOM）标准集包括的工具相比，它在多大程度上能捕获相关疾病特异性信息评分尚不清楚。本研究的目的是调查特定疾病的 PRO 工具和通用 HRQoL 工具是否能在冠状动脉疾病（CAD）患者中捕获与疾病相关的症状。
在一所大学医院环境中，使用 ICHOM 标准集包括的工具评估健康状况和 HRQoL：西雅图心绞痛问卷短表（SAQ-7）、玫瑰呼吸困难量表（RDS）、两项患者健康问卷（PHQ-2）和 15D HRQoL 工具。使用 Spearman 相关性和解释性因子分析评估 297 例患者的基线得分和 1 年得分变化的相关性。
基线时，总体 15D 评分和 SAQ-生理限制（SAQ-PL）、15D“呼吸”和 SAQ-PL 以及“呼吸”和 RDS 之间显示出中度强相关性。基于“呼吸”、RDS、SAQ-PL、“移动性”、“活力”和“日常活动”的高负荷，解释为反映“与呼吸相关的体力活动”的因子，解释了总方差的 19.2%。得分变化的相关性为中等。与“与呼吸相关的体力活动”相关的因子，RDS、SAQ-PL、“呼吸”、“日常活动”、“活力”、“性行为”、“移动性”和特定疾病的生活质量具有显著负荷，解释了 1 年变化中总方差的 20.5%。SAQ-7 测量的心绞痛频率与 15D 仪器的相关性较差。
15D 可检测呼吸困难和抑郁，与 RDS 和 PHQ-2 相似，但与 SAQ-7 相似，不能检测心绞痛。当研究 CAD 患者时，这可能需要用特定疾病的工具补充 15D 工具。
