MONITORING THE QUALITY-OF-LIFE IN PATIENTS WITH CORONARY-ARTERY DISEASE
MONITORING THE QUALITY-OF-LIFE IN PATIENTS WITH CORONARY-ARTERY DISEASE
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DOI：
10.1016/0002-9149(94)90555-x
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发表时间：
1994-12-15
影响因子：
2.8
通讯作者：
FIHN, SD
中科院分区：
文献类型：
--
作者：
SPERTUS, JA;WINDER, JA;FIHN, SD
监测治疗结果和量化患者的功能状态在临床试验和质量保证计划中都扮演着重要角色。由于冠状动脉疾病（CAD）患者可能患有合并症，并且由于通用健康状况问卷可能不关注冠状动脉疾病特有的症状和损害，因此健康状况的通用测量可能不足以检测患者CAD的重要变化。比较了西雅图心绞痛问卷（SAQ）（CAD疾病特异性测量）与健康状况通用测量简表-36对临床变化的反应性。这两份问卷是连续管理的，间隔3个月，45例患者接受冠状动脉血管成形术和130例稳定的CAD。冠状动脉成形术后，两种问卷的大多数量表均显著改善。SAQ的反应性统计数据超过了简表-36。在130名最初稳定型心绞痛患者中，经过3个月的观察，33名恶化，79名保持稳定，18名改善。在这些组中，平均SAQ评分发生了显著和适当的变化。相比之下，没有一个简表-36量表检测到这些更微妙的变化。虽然在评估整体功能方面有用，但通用健康状态测量（如简表-36）可能不足以检测患者CAD的重要临床变化。疾病特异性工具，如SAQ，可以是临床试验或质量保证计划中重要且相关的结局指标。
Monitoring the outcomes of treatment and quantifying patients' functional status have assumed a prominent role in both clinical trials and quality assurance programs. Because patients with coronary artery disease (CAD) may have comorbid illnesses, and because generic health status questionnaires may not focus on symptoms and impairments unique to coronary disease, a generic measure of health status may not be sufficient to detect important changes in patients' CAD. The responsiveness to clinical change of the Seattle Angina Questionnaire (SAQ), a disease-specific measure for CAD, was compared with that of the Short Form-36, a generic measure of health status. Both questionnaires were serially administered, 3 months apart, to 45 patients undergoing coronary angioplasty and to 130 patients with stable CAD. Most scales of both questionnaires improved significantly after coronary angioplasty. The responsiveness statistics of the SAQ exceeded those of the Short Form-36. Among 130 patients with initially stable angina, 33 deteriorated, 79 remained stable, and 18 improved over 3 months of observation. Mean SAQ scores changed significantly and appropriately in each of these groups. In contrast, none of the Short Form-36 scales detected these more subtle changes. Although useful in assessing overall function, a generic health status measure, such as the Short Form-36, may not be responsive enough to detect important clinical changes in patients' CAD. A disease-specific instrument, such as the SAQ, can be an important and relevant outcome measure in clinical trials or quality assurance programs.