口吃的疾病负担和健康相关生活质量：两项系统评价。
Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews.
机构信息
Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia.
Australian Institute for Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
出版信息
J Speech Lang Hear Res. 2023 Nov 9;66(11):4414-4431. doi: 10.1044/2023_JSLHR-23-00072. Epub 2023 Sep 26.
PURPOSE
For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness.
METHOD
Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis.
RESULTS
Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall.
CONCLUSIONS
For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending.
SUPPLEMENTAL MATERIAL
目的
对于口吃者来说，言语交流在社交场合通常会受到影响。这可能会引起听众的负面反应和社会的污名化。这些都有可能损害健康相关的生活质量，涉及言语输出、心理健康问题以及未能实现教育和职业潜力等各个领域。这些系统评价旨在从传统的健康经济学角度，使用效用测量和疾病成本来探讨这个问题。
方法
如果研究涉及原发性口吃的儿童、青少年或成年人，则将其纳入研究。生活质量搜索策略共确定了 2607 份报告，其中有 3 份报告纳入了生活质量分析。疾病成本搜索策略共确定了 3778 份报告，其中有 39 份报告纳入了疾病成本分析。
结果
纳入生活质量分析的 3 项研究中有 2 项存在较高的偏倚风险。使用效用评分衡量时，口吃者的生活质量处于糖尿病、心血管疾病和癌症等慢性健康状况报告的范围内。然而，在学龄前阶段，很少有证据表明生活质量受损。纳入疾病成本分析的研究整体存在较大的偏倚风险。
结论
口吃者存在大量直接和间接的疾病成本。这些成本包括一生中许多领域的功能损伤、挑战和痛苦，包括收入、教育、就业和社会功能。使用效用测量方法评估生活质量受损的证据极其有限。如果这种情况得不到纠正，口吃者一生所经历的功能损伤、挑战和痛苦就无法以一种可以用于影响健康政策和医疗支出的形式记录下来。
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