Bias in assessment of health-related quality of life in a hemodialysis population: A comparison of self-administered and interviewer-administered surveys in the HEMO study
Bias in assessment of health-related quality of life in a hemodialysis population: A comparison of self-administered and interviewer-administered surveys in the HEMO study
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DOI：
10.1097/01.asn.0000076076.88336.b1
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发表时间：
2003-08-01
影响因子：
13.6
通讯作者：
Meyer, KB
中科院分区：
文献类型：
--
作者：
Unruh, M;Yan, GF;Meyer, KB
检查患者报告的健康相关生活质量（HRQOL）与血液透析研究中调查管理模式的关系。除了评估HRQOL的自我管理调查外，还提供了访谈者管理的调查，以纳入视力不良、手动灵活性下降或强烈偏好的患者。为了检查参与自我管理的调查的预测因素，进行了多元逻辑回归。为了研究HRQOL结果与调查管理模式之间的关系，自我管理组和访谈者管理组之间的调整差异从多元线性回归模型中获得，该模型考虑了社会人口统计学和病例组合因素。血液透析研究的前1000名受试者中共有978名通过访谈（n = 427）或自我管理（n = 55 1）完成了调查。访谈者管理组年龄较大，更可能是黑人，ESRD持续时间较长，糖尿病患病率较高，合并症更严重（均P < 0.01）。在调整这些差异后，访谈者管理组的患者在测量角色-身体、角色-情感和肾脏疾病影响的量表上得分较高（均P < 0.001）。将HRQOL测量限制在能够在没有帮助的情况下完成调查的患者的透析研究将不能准确代表整个血液透析人群的健康状况。使用HRQOL作为结局的临床研究和临床实践应包括访谈者管理，否则会对年龄较大、少数民族和合并症水平较高的受试者产生选择偏倚。未来的调查应包括调查模式的研究，如电话采访，计算机辅助采访，代理管理的低响应负担。
Examined is the relationship of patient-reported health-related quality of life (HRQOL) to the mode of survey administration in the Hemodialysis Study. In addition to self-administered surveys to assess HRQOL, interviewer-administered surveys were made available to include patients with poor vision, decreased manual dexterity, or strong preference. For examining the predictors of participation by self-administration of the survey, multiple logistic regression was performed. For examining the relationship of HRQOL results to mode of survey administration, adjusted differences between the selfadministered and interviewer-administered groups were obtained from multiple linear regression models accounting for sociodemographic and case-mix factors. A total of 978 of the first 1000 subjects in the Hemodialysis Study completed the survey by interview (n = 427) or by self-administration (n = 55 1). The interviewer-administered group was older, was more likely black, had longer duration of ESRD, had a higher prevalence of diabetes, and had more severe comorbidity (all P < 0.01). After adjustment for these differences, patients in the interviewer-administered group had higher scores on scales that measured Role-Physical, Role-Emotional, and Effects of Kidney Disease (all P < 0.001). Dialysis studies that restrict HRQOL measurement to patients who are able to complete surveys without assistance will not accurately represent the health of the overall hemodialysis population. Clinical studies and clinical practices using HRQOL as an outcome should include interviewer administration or risk a selection bias against subjects with older age, minority status, and higher level of comorbidity. Future investigation should include research of survey modalities with a low response burden such as telephone interview, computer-assisted interview, and proxy administration.