Development and validation of a scale to measure symptoms of chronic graft-versus-host disease
Development and validation of a scale to measure symptoms of chronic graft-versus-host disease
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DOI：
10.1053/bbmt.2002.v8.pm12234170
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发表时间：
2002-01-01
影响因子：
4.3
通讯作者：
Antin, JH
中科院分区：
文献类型：
--
作者：
Lee, SJ;Cook, EF;Antin, JH
慢性GVHD（cGVHD）影响30%至90%的存活同种异体移植受者。到目前为止，还没有开发出生活质量工具来衡量这种常见的同种异体移植并发症对患者功能和健康的影响。使用前瞻性队列的107例活动性cGVHD患者完成症状量表在招募和间隔3个月和6个月，我们开发了一个30项症状量表，7个分量表，以捕捉cGVHD特异性症状负担。在横断面分析中，症状量表与患者自评的轻度、中度和重度cGVHD表现高度相关。与医学结局研究简表36（SF-36）和慢性疾病治疗功能评估与BAIT子量表（FACT-BMT）相比，对可靠性（Cronbach α = 0.79-0.90）、重测（r（2）= 0.28-0.93）、收敛效度和判别效度进行了评估，发现是适当的。纵向评估显示，总体健康状况的变化与SF-36和FACT-BAIT测量的生活质量变化相关性最好。相比之下，cGVHD严重程度的变化最好通过症状量表的变化来检测。我们建议将SF-36或FACT-BMT与cGVHD特异性症状量表结合，以衡量cGVHD对患者生活质量的影响，并将该终点纳入检测cGVHD干预措施的临床试验中。cGVHD症状量表是一种简短、简单且有效的cGVHD表现衡量标准，可通过患者自我填写的问卷来跟踪并发症特定症状。
Chronic GVHD (cGVHD) affects 30% to 90% of surviving allogeneic transplant recipients. Thus far, no quality-of-life instruments have been developed to measure the effect of this common complication of allogeneic transplantation on patients' functioning and well-being. Using a prospective cohort of 107 patients with active cGVHD who completed the symptom scale at enrollment and at intervals of 3 and 6 months, we developed a 30-item symptom scale with 7 subscales to capture the cGVHD-specific symptom burden. The symptom scale correlated highly with patients' self-assessed mild, moderate, and severe cGVHD manifestations in cross-sectional analysis. Reliability (Cronbach's alpha = 0.79-0.90), test-retest (r(2) = 0.28-0.93), and convergent and discriminant validity compared to the Medical Outcomes Study Short Form 36 (SF-36) and Functional Assessment of Chronic Illness Therapy with BAIT subscale (FACT-BMT) were assessed and found to be adequate. Longitudinal assessments showed that changes in overall health status correlated best with changes in quality of life as measured by the SF-36 and FACT-BAIT. In contrast, changes in cGVHD severity were best detected by changes in the symptom scale. We recommend that either the SF-36 or the FACT-BMT be combined with a cGVHD-specific symptom scale to measure the impact of cGVHD on patients' quality of life and that this endpoint be included in clinical trials testing cGVHD interventions. The cGVHD symptom scale is a short, simple, and valid measure of cGVHD manifestations and can be used to follow complication-specific symptoms using patient self-administered questionnaires.