早期儿童口腔健康影响量表（ECOHIS - 4D）与欧洲五维健康量表 - 儿童版（EuroQol - 5D - Y）在测量儿童口腔健康相关生活质量效用方面的比较。
Comparison of the early childhood oral health impact scale (ECOHIS-4D) and EuroQol-5D-Y for measuring oral health-related quality of life utility in children.
作者信息
Amarasinghe Gayani Shashikala, Kularatna Sanjeewa, Weerasuriya Sucharitha R, Arrow Peter, Jamieson Lisa, Tonmukayakul Utsana, Senanayake Sameera
机构信息
Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
出版信息
Qual Life Res. 2025 Feb;34(2):385-393. doi: 10.1007/s11136-024-03816-8. Epub 2024 Nov 10.
PURPOSE
The psychometric properties of the Early Childhood Oral Health Impact Scale (ECOHIS-4D), an oral health-related quality-of-life tool for children, and EuroQol 5D-Young (EQ-5D-Y), a commonly used generic quality-of-life tool for children, were compared across a clinical severity index to determine which tool is better for measuring oral health-related quality of life in children.
METHODS
Delayed and filled surfaces score (dfs) was calculated for under six-year-old children at the recruitment and one year later. ECOHIS-4D and EQ-5D were filled out on both occasions. The following properties were examined: (i) Content validity by comparing mean utility values using the Wilcoxson Signed Rank Test and Bland Altman Test, (ii) Construct validity (ability to discriminate between groups of different clinical severity) by examining effect size between severity groups (iii) Responsiveness (for changes in health status) using floor and ceiling effect, standard response mean and linear regression (iv) Correlation between the utilities and dfs.
RESULTS
Respectively, 287 and 189 children were examined at the baseline and follow-up. Mean utility estimates from the tools were significantly different. All items of EQ-5D-Y showed high ceiling effects compared to items of ECOHIS-4D. Only the utility scores of ECOHIS-4D showed a significant association with the dfs score (β=-0.003, 95%CI=-0.004 to -0.002) in the linear regression models. Utility values form ECOHIS-4D, but not EQ-5D-Y correlated with the dfs (spearman's r=-0.33, 95%CI -0.43 to -0.23).
CONCLUSION
ECOHIS-4D performs better than EQ-5D-Y in assessing young children's oral health-related quality of life.
目的
比较儿童口腔健康相关生活质量工具幼儿口腔健康影响量表（ECOHIS - 4D）和儿童常用的一般生活质量工具欧洲五维健康量表 - 青年版（EQ - 5D - Y）在临床严重程度指数方面的心理测量特性，以确定哪种工具更适合测量儿童口腔健康相关生活质量。
方法
在招募时及一年后计算6岁以下儿童的龋失补牙面得分（dfs）。在这两个时间点均填写ECOHIS - 4D和EQ - 5D。检查以下特性：（i）通过使用威尔科克森符号秩检验和布兰德 - 奥特曼检验比较平均效用值来评估内容效度；（ii）通过检查严重程度组之间的效应大小来评估结构效度（区分不同临床严重程度组的能力）；（iii）使用地板效应和天花板效应、标准反应均值和线性回归来评估反应度（针对健康状况变化）；（iv）效用值与dfs之间的相关性。
结果
在基线和随访时分别检查了287名和189名儿童。两种工具的平均效用估计值有显著差异。与ECOHIS - 4D的项目相比，EQ - 5D - Y的所有项目都显示出较高的天花板效应。在线性回归模型中，只有ECOHIS - 4D的效用得分与dfs得分有显著关联（β = -0.003，95%CI = -0.004至 -0.002）。ECOHIS - 4D的效用值与dfs相关（斯皮尔曼r = -0.33，95%CI -0.43至 -0.23），但EQ - 5D - Y的效用值与dfs不相关。
结论
在评估幼儿口腔健康相关生活质量方面，ECOHIS - 4D比EQ - 5D - Y表现更好。
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