Longitudinal Analysis of Health-Related Quality of Life in an Aging Population

描述(由申请人提供)：与健康相关的生活质量测量是医疗保健干预的临床试验和公共卫生计划评估中的重要结果指标。人们对与健康相关的生活质量的效用(基于偏好)指标的兴趣与日俱增。效用度量提供反映健康状态值的单个汇总分数，其中0.00表示死亡，1.00表示完全健康。这些措施可以综合死亡率和发病率来总结人口健康状况，在经济评估中是至关重要的。然而，很少(如果有的话)长期研究考察大量人群中健康效用随时间的变化。因此，关于衰老和效用的预期信息很少。此外，目前尚不清楚公用事业随时间的变化是否类似于自评健康等广泛可用的指标随时间的变化。此外，随着时间的推移，健康领域(如疼痛)的变化也存在不确定性，这些变化有助于健康效用。此外，重要的是，主要的死亡风险因素(如吸烟或肥胖)对效用的影响尚未得到纵向审查。拟议的项目将利用卫生实用程序指数3(HUI3)衡量的生活质量十年跟踪数据来解决这些问题。在过去的十年中，HUI3作为与健康相关的生活质量的多维衡量标准得到了广泛的使用。HUI3评估了八个领域：视觉、听力、言语、行走、灵巧、情感、认知和疼痛。该指数使用基于人口的偏好，将几个领域合并为符合效用衡量要求的一维加权平均。拟议的纵向二级数据分析项目将(A)检查HUI3(及其组成部分)在整个生命过程中随时间的变化，(B)对自我评估健康随时间的变化进行类似的检查，(C)调查HUI3随时间变化的预测因素，以及(D)比较加拿大和美国的HUI3得分。该项目将利用加拿大国家人口健康调查，该调查包括十年的后续访谈，包括每隔一年的HUI3措施和2003年加拿大-美国联合健康调查。该项目将为今后的工作奠定基础，在这些工作中，根据医疗和公共卫生干预措施(如降低风险因素方案)对与健康相关的生活质量的影响进行评估。

DESCRIPTION (provided by applicant): Health-related quality of life measures are important outcome indicators in clinical trials of healthcare interventions and in evaluations of public health programs. There has been growing interest in utility (preference-based) measures of health-related quality of life. A utility measure provides a single summary score reflecting the value of a health state where 0.00 represents dead and 1.00 is perfect health. These measures permit the integration of mortality and morbidity to summarize population health and are crucial in economic evaluations. However, there are few (if any) long-term studies examining changes in health utility over time in large populations. Consequently, there is little prospective information about aging and utility. Moreover, it is unclear if changes over time in utility are similar to or different from changes over time in widely available measures such as self-rated health. In addition, there are uncertainties about the changes over time in health domains (e.g., pain) that contribute to health utility. Also, and importantly, the impacts on utility of major risk factors for mortality (such as smoking or obesity) have yet to be examined longitudinally. The proposed project will address these issues using ten years of follow-up data on quality of life measured by the Health Utilities Index Mark 3 (HUI3). In the last decade, HUI3 has come into widespread use as a multidimensional measure of health-related quality of life. HUI3 assesses eight domains: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain. The index uses population-based preferences to combine the several domains into a single-dimensional weighted average consistent with the requirements for a utility measure. The proposed longitudinal secondary data analysis project will (a) examine change over time in the HUI3 (and its components) across the life course, (b) conduct similar examinations of change over time in self-rated health, (c) investigate predictors of change over time in HUI3, and (d) compare HUI3 scores between Canada and the United States. The project will utilize the Canadian National Population Health Survey which contains ten years of follow-up interviews including HUI3 measures every other year and the 2003 Joint Canada-United States Survey of Health. The project will lay the foundations for future work in which medical and public health interventions (such as risk factor reduction programs) are evaluated according to their impact on health-related quality of life.