Wilson I B, Cleary P D
Primary Care Outcomes Research Institute, New England Medical Center, Boston, MA.
JAMA. 1995 Jan 4;273(1):59-65.
Our model proposes a taxonomy or classification scheme for different measures of health outcome. We divide these outcomes into five levels: biological and physiological factors, symptoms, functioning, general health perceptions, and overall quality of life. In addition to classifying these outcome measures, we propose specific causal relationships between them that link traditional clinical variables to measures of HRQL. As one moves from left to right in the model, one moves outward from the cell to the individual to the interaction of the individual as a member of society. The concepts at each level are increasingly integrated and increasingly difficult to define and measure. AT each level, there are an increasing number of inputs that cannot be controlled by clinicians or the health care system as it is traditionally defined.
我们的模型提出了一种针对不同健康结果衡量指标的分类法或分类方案。我们将这些结果分为五个层次：生物和生理因素、症状、功能、总体健康认知以及整体生活质量。除了对这些结果指标进行分类外，我们还提出了它们之间的特定因果关系，这些关系将传统临床变量与健康相关生活质量的衡量指标联系起来。在模型中，从左向右移动时，范围从细胞扩展到个体，再到作为社会成员的个体之间的相互作用。每个层次的概念越来越综合，越来越难以定义和衡量。在每个层次上，越来越多的因素是临床医生或传统定义的医疗保健系统无法控制的。
