Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter?
Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter?
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DOI：
10.1016/j.pain.2014.07.001
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发表时间：
2014-10
期刊：
影响因子：
7.4
通讯作者：
Smith BH
中科院分区：
文献类型：
--
作者：
Torrance N;Lawson KD;Afolabi E;Bennett MI;Serpell MG;Dunn KM;Smith BH
具有神经性特征的慢性疼痛与EQ-5D和简表6D健康效用评分显著降低相关，17%的患者报告健康状况“比死亡更糟”。EQ-5D和简表（SF）12是广泛使用的通用健康相关生活质量（HRQoL）问卷。它们可以用来得出健康效用指数分数，在一个尺度上，0相当于死亡，1代表完全健康，分数小于零代表“比死亡更糟糕”的状态。我们比较了无慢性疼痛、慢性疼痛伴和不伴神经病理特征（NC）患者的EQ-5D或SF-6D健康效用指数评分，并探讨其对疼痛严重程度的判别能力。收集自我报告的健康和慢性疼痛状态作为英国一般人群调查的一部分（n = 4451）。我们发现EQ-5D和SF-6D的个体维度之间存在中度一致性，其中最高度相关的维度为心理健康和焦虑/抑郁、角色限制和日常活动以及疼痛和疼痛/不适。总体而言，43%的人在EQ-5D中报告完全健康，而SF-6D中仅为4.2%。NC组慢性疼痛的平均效用（EQ-5D 0.47 vs SF-6D 0.62）存在显著差异，尤其是重度疼痛（EQ-5D 0.33 vs SF-6D 0.58）。在EQ-5D中，17%的慢性疼痛NC患者和3%的非NC患者评分为“比死亡更糟”，这是使用SF-6D无法达到的状态。来自EQ-5D和SF-12/36的健康效用可以区分慢性疼痛伴和不伴NC和更严重疼痛的组间差异。然而，这些工具为相同的患者组生成了差异很大的HRQoL评分。在估计疾病负担时，使用EQ-5D或SF-6D之间的选择非常重要。
Chronic pain with neuropathic characteristics is associated with significantly lower EQ-5D and Short Form 6D health utilities scores, with 17% reporting health states “worse than death”. The EQ-5D and Short Form (SF)12 are widely used generic health-related quality of life (HRQoL) questionnaires. They can be used to derive health utility index scores, on a scale where 0 is equivalent to death and 1 represents full health, with scores less than zero representing states “worse than death.” We compared EQ-5D or SF-6D health utility index scores in patients with no chronic pain, and chronic pain with and without neuropathic characteristics (NC), and to explore their discriminant ability for pain severity. Self-reported health and chronic pain status was collected as part of a UK general population survey (n = 4451). We found moderate agreement between individual dimensions of EQ-5D and SF-6D, with most highly correlated dimensions found for mental health and anxiety/depression, role limitations and usual activities, and pain and pain/discomfort. Overall 43% reported full health on the EQ-5D, compared with only 4.2% on the SF-6D. There were significant differences in mean utilities for chronic pain with NC (EQ-5D 0.47 vs SF-6D 0.62) and especially for severe pain (EQ-5D 0.33 vs SF-6D 0.58). On the EQ-5D, 17% of those with chronic pain with NC and 3% without NC scored “worse than death,” a state which is not possible using the SF-6D. Health utilities derived from EQ-5D and SF-12/36 can discriminate between group differences for chronic pain with and without NC and greater pain severity. However, the instruments generate widely differing HRQoL scores for the same patient groups. The choice between using the EQ-5D or SF-6D matters greatly when estimating the burden of disease.
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