McColl E, Steen I N, Meadows K A, Hutchinson A, Eccles M P, Hewison J, Fowler P, Blades S M
Centre for Health Services Research, University of Newcastle upon Tyne, England.
Soc Sci Med. 1995 Nov;41(10):1339-48. doi: 10.1016/0277-9536(95)00120-v.
Increasing emphasis is now being placed on the assessment of patient outcomes, both in evaluating medical interventions and in quality assurance initiatives. Clinicians, purchasers, managers and researchers need outcome measures that are valid, reliable and responsive. This paper describes the theory and practice underlying the development of outcome measures for two chronic conditions, asthma and diabetes, for application in ambulatory settings. Existing generic and condition-specific health status and health-related quality-of-life measures were administered to almost 1300 patients. The psychometric properties of these measures were examined to identify those that were of adequate validity and reliability in these population groups. Step-wise regression procedures were then used to identify a core set of scales that best predicted patients' general health perceptions, which could be used in measuring general health outcomes for each of these groups. These core sets consist of up to 40 items, spanning physical function, energy and vitality, emotional well-being and condition-specific aspects of health such as symptom control. Further analysis is being carried out to assess the responsiveness to change of these core item sets.
现在，在评估医疗干预措施和质量保证举措时，人们越来越重视对患者治疗结果的评估。临床医生、采购方、管理人员和研究人员需要有效、可靠且具有反应性的结果测量指标。本文描述了为两种慢性病（哮喘和糖尿病）制定门诊环境中应用的结果测量指标所依据的理论和实践。对近1300名患者进行了现有的通用和特定疾病的健康状况及与健康相关的生活质量测量指标评估。检查了这些测量指标的心理测量特性，以确定在这些人群组中具有足够有效性和可靠性的指标。然后使用逐步回归程序来确定一组最能预测患者总体健康认知的核心量表，这些量表可用于测量这些群体中每一组的总体健康结果。这些核心量表由多达40个项目组成，涵盖身体功能、能量与活力、情绪健康以及健康的特定疾病方面，如症状控制。正在进行进一步分析，以评估这些核心项目集对变化的反应性。
