Black J Andrew, Sharman James E, Chen Gang, Palmer Andrew J, de Graaff Barbara, Nelson Mark, Chapman Niamh, Campbell Julie A
Department of Cardiology, Royal Hobart Hospital, 48 Liverpool Street, Hobart, TAS, Australia.
College of Health and Medicine, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, Australia.
BMC Health Serv Res. 2025 Jan 2;25(1):8. doi: 10.1186/s12913-024-12135-0.
To evaluate the impact of absolute cardiovascular risk counselling on quality-of-life indices within a chest pain clinic.
Primary data was collected at the Royal Hobart Hospital, Australia, between 2014 and 2020.
Patients attending an Australian chest pain clinic were randomised into a prospective, open-label, blinded-endpoint study over a minimum 12-months follow-up.
DATA COLLECTION / EXTRACTION METHODS: The SF-36 questionnaire was completed at baseline/follow-up and SF-6D multi-attribute utility instrument's health state utilities (HSU) were generated using SF-36 responses and the SF-6D's Australian tariff. SF-6D minimal important difference was 0.04 points. Absolute cardiovascular risk was also stratified into high/intermediate/low-risk categories for exploratory analysis of summary HSUs and dimensional scores. ANZCTR registration number 12617000615381 (registered 28/4/17).
Of n = 189 patients enrolled, HSUs were generated for 96% at baseline (intervention n = 93, usual care n = 88) and 61% at follow-up. There were no statistical differences in age, sex, absolute cardiovascular risk or mean HSU between groups at baseline. Summary HSUs improved more for the intervention group and the median between-group difference exceeded the minimal important difference threshold (intervention 0.16 utility points, control 0.10 utility points). For Intervention patients with high absolute risk (≥ 15%), HSU did not significantly change.
Absolute cardiovascular risk counselling in a chest pain clinic yielded clinically meaningful improvement in health-related quality of life.
评估绝对心血管疾病风险咨询对胸痛门诊患者生活质量指标的影响。
原始数据于2014年至2020年在澳大利亚皇家霍巴特医院收集。
将在澳大利亚胸痛门诊就诊的患者随机分为一项前瞻性、开放标签、终点设盲的研究，随访期至少为12个月。
数据收集/提取方法：在基线/随访时完成SF-36问卷，并使用SF-36的回答和SF-6D的澳大利亚费率生成SF-6D多属性效用工具的健康状态效用值（HSU）。SF-6D的最小重要差异为0.04分。绝对心血管疾病风险也被分为高/中/低风险类别，用于对汇总HSU和维度得分进行探索性分析。澳大利亚新西兰临床试验注册中心注册号12617000615381（2017年4月28日注册）。
在纳入的n = 189例患者中，96%在基线时生成了HSU（干预组n = 93，常规治疗组n = 88），61%在随访时生成了HSU。两组在基线时的年龄、性别、绝对心血管疾病风险或平均HSU无统计学差异。干预组的汇总HSU改善更大，组间中位数差异超过最小重要差异阈值（干预组0.16效用分，对照组0.10效用分）。对于绝对风险高（≥15%）的干预患者，HSU无显著变化。
胸痛门诊的绝对心血管疾病风险咨询在健康相关生活质量方面产生了具有临床意义的改善。
