Detecting improvement in quality of life and symptomatology in schizophrenia
Detecting improvement in quality of life and symptomatology in schizophrenia
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DOI：
10.1093/oxfordjournals.schbul.a006869
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发表时间：
2001-01-01
影响因子：
6.6
通讯作者：
Charney, D
中科院分区：
文献类型：
--
作者：
Cramer, J;Rosenheck, R;Charney, D
基于工具的评分通常用作结果测量。然而，就改善或恶化的临床评估而言，很少有人知道分数的变化意味着什么。本报告的目的是确定标准器械评分的变化在多大程度上代表临床可检测的改善或恶化。退伍军人事务（VA）合作研究对423例使用氯氮平或氟哌啶醇治疗的难治性精神分裂症患者进行了评估。在基线时完成症状和生活质量量表；6周;3、6、12个月。在临床医生判断为“改善”的患者中，在所有随访期间，阳性和阴性综合征量表（PANSS）得分平均百分比变化为下降21%，生活质量量表（QLS）得分增加26%。平均七分项目得分的变化分别为-0.46 （PANSS）和0.23 （QLS）。临床评估改善到“好得多”的主要收获与PANSS评分下降45%和QLS评分增加50%相关（平均7分项目得分变化分别为-0.88和0.92）。因此，评估症状和生活质量的心理测量量表的适度变化反映了临床可检测到的改善。
Instrument-based scores are often used as outcome measures. However, little is known about what changes in scores mean in terms of a clinical assessment of improvement or deterioration. The purpose of this report was to determine how much change in standard instrument scores represents a clinically detectable improvement or deterioration. The Veterans Affairs (VA) Cooperative Study of Clozapine in Refractory Schizophrenia evaluated 423 patients on clozapine or haloperidol. Symptoms and quality of life scales were completed at baseline; 6 weeks; and 3, 6, and 12 months. Among patients judged as "improved" by clinicians, the average percentage changes were a 21 percent decrease in Positive and Negative Syndrome Scale (PANSS) scores and a 26 percent increase in Quality of Life Scale (QLS) scores across all followup periods. The change in mean seven-point item scores were -0.46 (PANSS) and 0.23 (QLS). A major gain in clinically assessed improvement to "much better" was associated with a 45 percent decline in PANSS scores and 50 percent increase in QLS scores (change in mean seven-point item scores -0.88 and 0.92, respectively). Thus, modest changes in psychometric scales assessing symptoms and quality of life reflect clinically detectable improvement.