Utility assessment to measure the impact of dry eye disease
Utility assessment to measure the impact of dry eye disease
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DOI：
10.1016/s1542-0124(12)70043-5
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发表时间：
2006-07-01
期刊：
影响因子：
6.4
通讯作者：
Figueiredo, Francisco C.
中科院分区：
文献类型：
--
作者：
Buchholz, Patricia;Steeds, Carolyn S.;Figueiredo, Francisco C.
效用评估是一种正式的方法，用于量化和了解给定的健康状态或疾病对患者的相对影响。在这篇文章中，效用评估的方法进行了解释和说明，并报告了原始研究的结果。该研究旨在确定与干眼病相关的效用值（患者偏好），并将其与其他疾病效用进行比较，以及比较患者和医生对疾病的评估。通过交互式效用评估软件对英国44例中度至重度干眼症患者进行了调查。效用值通过时间权衡（TTO）和标准赌博（SG）方法测量，并调整为从1.0=完美健康到0.0=死亡的评分。患者报告的效用为：自我报告的当前干眼症状态、自我报告的当前合并症、各种干眼症严重程度、以及双眼和单眼疼痛性失明。患者的干眼严重程度通过患者和医生评估独立分类。相关性分析（皮尔逊）进行患者的当前干眼效用和医生评估的严重程度。分析了自我报告和医生报告的患者严重程度之间的一致性（Kappa）。患者报告其当前干眼症的效用高于单眼和双眼盲（SG：0.84>0.60>0.51; TTO：0.67>0.43>0.38）。使用TTO，无症状干眼的平均评分（0.68）与“一些身体和角色限制伴偶尔疼痛”相似，需要手术的重度干眼评分（0.56）与医院透析（0.56-0.59）和重度心绞痛（0.5）相似。自报为轻度至中度的患者与自报为重度的患者相比，描述的干眼严重程度场景的效用略高。对于目前的干眼症，这些组的平均效用为0.72（自报轻度至中度）和0.61（自报重度）。干眼症的效用在被接受为降低健康效用的条件范围内。严重干眼的效用与透析和严重心绞痛的效用相似，突出了干眼疾病对患者的影响。
Utility assessment is a formal method for quantifying and understanding the relative impact of a given health state or disease on patients. In this article, methodology of utility assessment is explained and illustrated, and results of an original study are reported. The study was conducted to determine utility values (patient preferences) associated with dry eye disease and compare them to other disease utilities, as well as to compare patient and physician assessments of disease. Forty-four patients in the United Kingdom with moderate to severe dry eye were surveyed via interactive utility assessment software. Utility values were measured by the Time Trade-Off (TTO) and Standard Gamble (SG) methods and adjusted to scores from 1.0=perfect health to 0.0=death. Patients reported utilities for: self-reported current dry eye status, self-reported current comorbidities, various dry eye severities, and binocular and monocular painful blindness. Patient's dry eye severity was independently classified by patient and physician assessments. Correlation analyses (Pearson) were performed between patients' current dry eye utilities and the physician-assessed severity. Agreement between self-reported and physician-reported patient severity was analyzed (Kappa). Patients reported higher utilities for their current dry eye condition than for monocular and binocular blindness (SG:0.84>0.60>0.51; TTO:0.67>0.43>0.38). Using TTO, the mean score for asymptomatic dry eye (0.68) was similar to that for "some physical and role limitations with occasional pain" and severe dry eye requiring surgery scored (0.56) similarly to hospital dialysis (0.56-0.59) and severe angina (0.5). Utilities described for scenarios of dry eye severity levels were slightly higher for patients self-reported as mild-to-moderate versus those self-reported as severe. For current dry eye condition, mean utilities for these groups were 0.72 for self-reported mild-to-moderate and 0.61 for self-reported severe. Utilities for dry eye were in the range of conditions accepted as lowering health utilities. Severe dry eye utilities were similar to those reported for dialysis and severe angina, highlighting the impact of dry eye disease on patients.