Development and testing of a utility measure for major, unipolar depression (McSad)
Development and testing of a utility measure for major, unipolar depression (McSad)
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DOI：
10.1023/a:1008952602494
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发表时间：
2000-02-01
影响因子：
3.5
通讯作者：
Moran, LA
中科院分区：
文献类型：
--
作者：
Bennett, KJ;Torrance, GW;Moran, LA
目的：建立和检验单相抑郁症的直接效用量表（McSad）。研究方法：抑郁症的具体，多属性的健康状态分类系统的创建，临床有效性进行了评估，由专家使用专门设计的结构化练习，进行横断面调查，以获得直接测量的实用程序抑郁症的健康状态。设置：三级保健，大学医学中心。研究对象：3名精神科医师、3名精神科护士和3名社会工作者评估抑郁症健康状况的临床效度。调查参与者由精神科医生介绍，由105名门诊患者组成，他们在过去两年中至少有一次严重的单相抑郁症发作，目前处于缓解期。调查结果：被调查者自我健康状态效用（均值和95%可信区间（CI））为0.79（0.74-0.83）。假设的、未经治疗的抑郁症健康状态的效用是：轻度抑郁症，0.59（0.55-0.62）;中度抑郁症，0.32（0.29-0.34）;重度抑郁症，0.04（0.01-0.07）。五十六%的受访者认为严重抑郁症比死亡更糟糕。假设健康状态的效用与自我健康效用不相关。类内相关系数（ICC）是令人满意的14个健康状态评估的13。结论：McSad在有严重单相抑郁症病史的患者中是可行和可接受的。轻度、中度和重度未经治疗的抑郁症的效用显示与抑郁症相关的低健康相关生活质量。重测信度和效度的初步评估取得了令人满意的结果，但需要进一步的研究，以扩大我们的知识的测量性能的麦克萨德。
Objective: To develop and test a direct utility measure (McSad) for major, unipolar depression. Methods: A depression specific, multi-attribute health state classification system was created; clinical validity was evaluated by experts using specially designed structured exercises; a cross-sectional survey was conducted to obtain directly measured utilities for depression health states. Setting: Tertiary care, university medical centre. Participants: Three psychiatrists, 3 psychiatric nurses and 3 social workers assessed depression health state clinical validity. Survey participants were referred by psychiatrists and consisted of 105 out-patients, currently in remission with at least one episode of major, unipolar depression in the past two years. Survey results: Respondent self-health state utility (mean and 95% confidence interval (CI)) was 0.79 (0.74-0.83). Utilities for hypothetical, untreated depression health states were: mild depression, 0.59 (0.55-0.62); moderate depression, 0.32 (0.29-0.34); severe depression, 0.04 (0.01-0.07). Fifty-six percent of respondents rated severe depression worse than being dead. Utilities for the hypothetical health states were not correlated with self-health utility. The intra-class correlation coefficient (ICC) was satisfactory for 13 of the 14 health states assessed. Conclusions: McSad was feasible and acceptable in patients with a history of major unipolar depression. The utilities for mild, moderate and severe untreated depression show the low health-related quality of life associated with depression. Initial assessments of test-retest reliability and validity yielded satisfactory results but further studies are needed to extend our knowledge of the measurement properties of McSad.