Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease
Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease
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作者：
Younossi, ZM;Guyatt, G;King, D
背景和目的 - 开发和评估一种疾病特异性工具，用于测量慢性肝病 (CLD) 患者的健康相关生活质量 (HRQL)。方法 - 根据 60 名慢性肝病患者、20 名肝脏专家的反应以及 Medline 文献检索，确定了可能影响这些患者 HRQL 的项目。 75 名患者的单独样本确定了他们发现有问题的项目并评估了它们的重要性。使用因子分析探讨结果；选择域并将项目放置在域内。消除了多余的问题，并在 10 名患者中对最终问卷进行了预测试。使用该仪器，对另外 133 名患有不同类型和阶段的肝病的患者进行了 HRQL 评估。结果——患者、专家和文献检索确定了 156 项具有潜在重要性的项目。其中，35 项被证明对项目减少样本中 75 名受访者中超过 50% 的人很重要。因子分析提出了六个领域。消除冗余后，慢性肝病问卷（CLDQ）包括以下领域的29个项目：疲劳、活动、情绪功能、腹部症状、全身症状和担忧。在预测试中，患者发现 CLDQ 清晰且易于在 10 分钟内完成。在另外 133 名患者中，CLDQ 显示无肝硬化患者、Child 型 A 型肝硬化患者以及 Child 型 B 型或 C 型肝硬化患者之间存在梯度。 CLDQ 在六个月时有中等可靠性的证据，并且似乎有反应。结论 - CLDQ 很短，易于管理，产生汇总评分和领域评分，并与肝病的严重程度相关。
Background and aims-To develop and assess a disease specific instrument for measuring health related quality of life (HRQL) in patients with chronic liver disease (CLD).Methods-Based on responses from 60 patients with chronic liver disease, from 20 liver experts, and from a Medline search of the literature, items potentially affecting the HRQL of these patients were identified. A separate sample of 75 patients identified which items they found problematic and rated their importance. Results were explored using factor analysis; domains were chosen and items placed within domains. Redundant questions were eliminated and the final questionnaire was pretested in 10 patients. Using this instrument, HRQL was assessed in a further 133 patients with various types and stages of liver disease.Results-Patients, experts, and the literature search identified 156 items of potential importance. Of these, 35 proved important to over 50% of 75 respondents in the item reduction sample. The factor analysis suggested six domains. After eliminating redundancies, the Chronic Liver Disease Questionnaire (CLDQ) included 29 items in the following domains: fatigue, activity, emotional function, abdominal symptoms, systemic symptoms, and worry. In pretesting, patients found the CLDQ clear and easy to complete in 10 minutes. In another 133 patients, the CLDQ showed a gradient between patients without cirrhosis, Child's A cirrhosis, and those with Child's B or C cirrhosis. CLDQ has evidence for moderate reliability at six months and seems to be responsive.Conclusion-The CLDQ is short, easy to administer, produces both a summary score and domain scores, and correlates with the severity of liver disease.