Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
PLoS One. 2022 Apr 1;17(4):e0266101. doi: 10.1371/journal.pone.0266101. eCollection 2022.
Generic health-related quality of life (HRQoL) and disease-specific instruments measure HRQoL from different aspects, although generic instruments often contain dimensions that reflect common symptoms. We evaluated how the change in 15D HRQoL and Canadian Cardiovascular Society (CCS) grading of angina severity correlate among coronary artery disease patients during 12-month follow-up.
Altogether 1 271 patients scheduled for coronary angiography between June 2015 and February 2017 returned the 15D HRQoL and CCS questionnaires before angiography and after one-year follow-up as a part of routine clinical practice. Spearman correlations between one-year changes in the CCS and the 15D and its dimensions were evaluated. Changes in 15D were classified into 5 categories based on the reported minimal important difference (MID) for the instrument.
Change in the CCS grade correlated moderately with the MID-based change in the 15D (r = 0.33, 95% confidence interval 0.27-0.39). Correlations between these instruments were similar in different age groups, between sexes and treatment modalities. Of the individual 15D dimensions, changes in breathing (r = 0.40) and vitality (r = 0.30) had the strongest correlations with CCS change.
The symptom-based evaluation of the change in the CCS grade may not catch the full benefit or harm of the treatment and vice versa, a generic instrument, such as 15D, likely does not fully capture change in disease-specific symptoms. Thus, generic and disease-specific instruments are complementary and should be used in conjunction.
通用健康相关生活质量(HRQoL)和疾病特异性工具从不同方面衡量 HRQoL,尽管通用工具通常包含反映常见症状的维度。我们评估了在 12 个月的随访期间,冠心病患者的 15D HRQoL 和加拿大心血管学会(CCS)心绞痛严重程度分级的变化如何相关。
2015 年 6 月至 2017 年 2 月期间,共有 1271 名计划接受冠状动脉造影的患者在接受冠状动脉造影前和一年随访后作为常规临床实践的一部分返回了 15D HRQoL 和 CCS 问卷。评估了一年中 CCS 变化与 15D 及其维度之间的 Spearman 相关性。根据该仪器报告的最小有意义差异(MID),将 15D 的变化分为 5 类。
CCS 分级的变化与基于 MID 的 15D 变化中度相关(r = 0.33,95%置信区间 0.27-0.39)。这些仪器在不同年龄组、性别和治疗方式之间的相关性相似。在 15D 的各个维度中,呼吸变化(r = 0.40)和活力变化(r = 0.30)与 CCS 变化的相关性最强。
基于症状的 CCS 分级变化的评估可能无法捕捉治疗的全部获益或危害,反之亦然,通用工具(如 15D)可能无法完全捕捉疾病特异性症状的变化。因此,通用和疾病特异性工具是互补的,应结合使用。