Wolfe F, Hawley D J
Arthritis Research and Clinical Center, University of Kansas School of Medicine, Wichita, USA.
Br J Rheumatol. 1997 Jul;36(7):786-93. doi: 10.1093/rheumatology/36.7.786.
The EuroQol is a validated quality of life (QOL) scale that has been used in population and clinical studies, and has been reported in patients with rheumatoid arthritis (RA). It is short, simple to complete, and might be suitable for surveys of rheumatic disease patients. The properties of this instrument were investigated in a postal survey of 1372 rheumatic disease patients, including 537 with RA, 319 with osteoarthritis (OA) and 516 with fibromyalgia. In addition, simultaneous measurements of functional disability, pain, psychological status, global severity and demographic characteristics were made. EuroQol scores (0.57) were significantly lower than VAS health state scores (0.67) and arthritis-related global severity scores (0.62). QOL was similar in RA and OA, but lower in fibromyalgia, across all instruments. The distribution of EuroQol scores had many gaps and was not continuous. EuroQol did not reflect VAS QOL scores at EuroQol levels below 0.5, and the mean score difference between the instruments below that level was 0.43. Many patients with low EuroQol scores (including some with health states that were 'worse than death') had high VAS scores. These differences appear to have arisen because disability, pain and depression questions ask about mild or moderate problems, but not both, thereby forcing scale compression in the mid ranges. In addition, the 'severe' value is so extremely abnormal that few patients endorse it. Finally, penalty scores are applied to those with at least one maximally abnormal score. The scoring properties and distributional aspects of the EuroQol indicate substantial problems in its use in rheumatic disease patients.
欧洲五维健康量表（EuroQol）是一种经过验证的生活质量（QOL）量表，已用于人群和临床研究，并且已有关于类风湿关节炎（RA）患者的报道。它简短，易于填写，可能适用于对风湿病患者的调查。在一项对1372名风湿病患者的邮寄调查中研究了该工具的特性，其中包括537名类风湿关节炎患者、319名骨关节炎（OA）患者和516名纤维肌痛患者。此外，还同时测量了功能残疾、疼痛、心理状态、整体严重程度和人口统计学特征。欧洲五维健康量表得分（0.57）显著低于视觉模拟量表（VAS）健康状态得分（0.67）和关节炎相关的整体严重程度得分（0.62）。在所有工具中，类风湿关节炎和骨关节炎患者的生活质量相似，但纤维肌痛患者的生活质量较低。欧洲五维健康量表得分的分布存在许多间隙，并不连续。在欧洲五维健康量表得分低于0.5时，它不能反映视觉模拟量表生活质量得分，且在该水平以下两种量表的平均得分差异为0.43。许多欧洲五维健康量表得分较低的患者（包括一些健康状态“比死亡还差”的患者）视觉模拟量表得分却很高。这些差异似乎是因为残疾、疼痛和抑郁问题询问的是轻度或中度问题，而非两者皆问，从而导致量表在中间范围出现压缩。此外，“严重”值非常异常，很少有患者认可。最后，惩罚分数适用于至少有一项得分极度异常的患者。欧洲五维健康量表的计分特性和分布情况表明其在风湿病患者中的使用存在重大问题。
