Generic and condition-specific outcome measures for people with osteoarthritis of the knee
Generic and condition-specific outcome measures for people with osteoarthritis of the knee
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DOI：
10.1093/rheumatology/38.9.870
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发表时间：
1999-09-01
期刊：
影响因子：
5.5
通讯作者：
Snaith, ML
中科院分区：
文献类型：
--
作者：
Brazier, JE;Harper, R;Snaith, ML
目标.本研究的目的是评估两个条件特定的和两个通用的健康状况问卷测量膝关节骨关节炎（OA）患者的健康相关的生活质量，并提供指导，临床医生和研究人员之间的选择。患者从两种环境中招募：118例来自膝关节手术等待名单，112例来自风湿病诊所。4份自我完成问卷[西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、健康评估问卷（HAQ）、简明健康状况调查表-36（SF-36）和欧洲生活质量量表]分别发送给受试者，间隔6个月。采用初步的非参数方法检验了结构效度、聚合效度、内部一致性和反应性。所有器械在易用性、患者可接受性、内部一致性和可靠性方面均令人满意。在手术组中，OA特异性WOMAC在有效性和对变化的反应性方面优于HAQ和通用测量，而在风湿病组中SF-36的反应性更高。WOMAC是评价OA膝关节置换术结局的首选工具。SE-36提供了对患者健康的更全面的了解，并且在异质性风湿病临床人群中可能比WOMAC对变化更敏感。希望进行经济评估的研究人员可能会考虑将EQ-5D用于外科手术，而不是风湿病临床组。
Objectives. The aims of this study were to evaluate two condition-specific and two generic health status questionnaires for measuring health-related quality of life in patients with osteoarthritis (OA) of the knee, and to offer guidance to clinicians and researchers in choosing between them.Methods. Patients were recruited From two settings: 118 from knee surgery waiting lists and 112 from rheumatology clinics. Four self-completion questionnaires [Western Ontario and McMaster University Osteoarthritis Index(WOMAC), Health Assessment Questionnaire (HAQ), Short Form-36 (SF-36) and Euroqol] were sent to subjects on two occasions 6 months apart. Construct validity, convergent validity, internal consistency and responsiveness were examined using primarily non-parametric methods.Results. Ail instruments proved satisfactory in terms of ease of use, acceptability to patients, internal consistency and reliability. In the surgical group, the OA-specific WOMAC performed better than the HAQ and the generic measures in terms of validity and responsiveness to change, whereas in the rheumatology group the SF-36 was more responsive.Conclusion. WOMAC is the instrument of choice for evaluating the outcome of knee replacement surgery in OA. The SE-36 provides a more general insight into patients' health and may be more responsive to change than the WOMAC in a heterogeneous rheumatology clinic population. Researchers wishing to undertake an economic evaluation might consider the EQ-5D for a surgical, but not a rheumatology clinic group.