Barry M J, Fowler F J, O'Leary M P, Bruskewitz R C, Holtgrewe H L, Mebust W K
Medical Practices Evaluation Center, Massachusetts General Hospital, Boston 02114, USA.
Med Care. 1995 Apr;33(4 Suppl):AS145-55.
In preparation for an outcomes study of benign prostatic hyperplasia (BPH), two measures of disease-specific health status were developed to supplement a symptom score and overall health status measures. The symptom problem index (SPI) captures how troublesome patients find their urinary symptoms. The BPH impact index (BII) measures how much their urinary problems affect various domains of health. A prospective revalidation of the refined instruments (N = 108 BPH patients and 50 controls) documented that both indices had good internal consistency (Cronbach's alpha = 0.88 and 0.79, respectively) and test-retest (r = 0.88 for both) reliabilities, correlated strongly with symptom scores (r = 0.86 and 0.77), and discriminated between BPH and control subjects (receiver-operating characteristic areas = 0.87 and 0.85, respectively). These indices were nearly as responsive as symptom scores in 50 men actively treated for BPH, and much more responsive than a non-disease-specific General Health Index (GHI), a Mental Health Index (MHI), and an Activity Index (AI). Finally, these measures capture most of the health status significance of BPH symptoms. In linear regression models constructed to predict scores on the GHI, MHI, and AI, symptom scores added little explanatory power to the SPI and, particularly, to the BII. These measures help clarify how BPH affects overall health status and function. Such measures have an important role to play in studies of the outcomes of treatment for BPH, and probably for other conditions that interfere with health status and function.
为开展一项良性前列腺增生（BPH）的疗效研究，研发了两种疾病特异性健康状况测量方法，以补充症状评分和总体健康状况测量方法。症状问题指数（SPI）反映患者认为其泌尿系统症状的困扰程度。BPH影响指数（BII）衡量其泌尿系统问题对健康各个领域的影响程度。对优化后的工具进行的前瞻性再验证（108例BPH患者和50例对照）表明，这两个指数均具有良好的内部一致性（Cronbach's α分别为0.88和0.79）和重测信度（两者的r均为0.88），与症状评分密切相关（r分别为0.86和0.77），并且能够区分BPH患者和对照对象（受试者工作特征曲线下面积分别为0.87和0.85）。在50例接受积极治疗的BPH男性患者中，这些指数的反应性与症状评分几乎相同，并且比非疾病特异性的一般健康指数（GHI）、心理健康指数（MHI）和活动指数（AI）更具反应性。最后，这些测量方法涵盖了BPH症状在健康状况方面的大部分重要意义。在用于预测GHI、MHI和AI评分的线性回归模型中，症状评分对SPI，尤其是对BII的解释力增加很少。这些测量方法有助于阐明BPH如何影响总体健康状况和功能。此类测量方法在BPH治疗疗效研究以及可能在其他影响健康状况和功能的疾病研究中具有重要作用。
