摘要
目的:在北京郊区老年人中对欧洲五维健康量表(European quality of life 5-dimensions,EQ-5D)不同时间权衡(time trade-off,TTO)模型所得的健康效用值进行比较。方法:采用现况调查的方法,利用EQ-5D对北京市房山区青龙湖和周口店两镇65～79岁常住居民的生命质量进行测量;利用基于日本、英国、美国人群的TTO转换模型计算研究对象的健康效用值——健康指数。采用Kruskal-Wallis H检验比较3种模型所得健康指数,采用组内相关系数(intraclass correlations coefficients,ICCs)和Bland-Altman散点图评价3种模型所得效用值的一致性,利用Mann-Whitney U检验比较患病状态对3种健康指数的影响,同时计算3种模型所得健康指数与视觉模拟标尺得分(visual analogue scales,EQ-VAS)以及年龄、性别、患病状态的Spearman rho相关系数。结果:研究共纳入2 406名研究对象,平均年龄为70.3岁,其中男性占34.3%。利用日本、英国、美国TTO转换模型,计算所得健康指数中位数(四分位数间距)分别为1(0.28)、1(0.24)、1(0.29);最大值/最小值分别为-0.06/1、-0.43/1、-0.03/1,美国模型所得指数总体较高,日本模型所得指数居中,英国模型所得健康指数得分最低。3组得分间两两比较,差异均有统计学意义(P<0.005)。日本与美国模型所得指数间组内相关系数最高,为0.987(95%CI,0.986～0.988),其次为英国与美国模型,为0.941(95%CI,0.937～0.946),最小为日本与英国模型,为0.921(95%CI,0.915～0.927),它们分别有96.9%、95.1%和95.0%的差值落在Bland-Altman散点图一致性界限内。英国和美国模型所得健康指数与患病数量存在负相关,而日本模型得分与患病数量不存在相关性。结论:利用不同EQ-5D的TTO转换模型在北京郊区老年人中计算健康效用值所得结果略有不同,应开发基于中国人群健康偏好的EQ-5D TTO转换模型。
Objective ： To evaluate health utility values of the elderly in the outskirts of Beijing by Euro- pean quality of life 5-dimensions （EQ-SD） from the EuroQol Group, and to compare the health utility values by using different translation models. Methods： In the cross-sectional study, EQ-SD was used to measure the quality of life for 65 to 79 year-old usual residents in the town of Qinglonghu and Zhoukoudi- an in Fangshan District of Beijing. The health index which represented the health utility was calculated by using the Japan, the United Kingdom （UK）, the United States （US） population-based time trade-off （TTO） models~ Kruskal-Wallis H test was adopted to compare the health indexes calculated by the different models, and intraclass correlations coefficients （ICCs） and Bland-Altman plot were used to evaluate the consistency of the utility calculated by the three models. Mann-Whitney U test was used to compare the impacts of Cardio-vascular diseasel （CVD） on the 3 kinds of health index. The Spearman rho correlation coefficients between the 3 kinds of health index, EQ-VAS （visual analogue scales） score and age, gender, health status were also calculated. Results： There were 2 406 participants in this analysis, with a mean age of 70.3 years, of whom 34.3 % were male. The median and quantile range of Japan weights, US weights and UK weights health indexes were 1 （0.28）, 1 （0.24） and 1 （0.29）, respectively. The minimum and maximum of the three indexes were - 0.06/1, - 0.43/1 and - 0.03/ 1, respectively. The US weights yielded the highest scores and the UK weights the lowest scores. The Japan, US and UK weight scores differed from each other （ P 〈 0.005）. The Japan and US scores had the highest ICCs （0. 987, 95 % CI O. 986 - 0. 988 ）, followed by the US and UK scores （0.941,95 % CI 0.937 -0.946） and then the Japan and UK scores （0.92l, 95% CI O. 915 -0. 927）. The difference scores of 96.9%, 95. 1% and 95.0% were found between the limits of agreement in Bland-Altmand plot. Negative correlations existed between the US/UK score and the number of CVDs, but not existed between the Japan score and the number of CVDs. Conclusion： The health indexes calculated by using the different EQ-SD Tro transform models were different for the elderly people in the Beijing suburban district, TTO model based on Chinese health preference should be developed.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2012年第3期397-402,共6页
Journal of Peking University:Health Sciences
基金
国家自然科学基金(30671807
30872173)
国家重点基础研究发展计划(973计划
2006CB503903)项目资助~~
关键词
生活质量
健康状况指标
老年人
健康效用
Quality of life
Health status indicators
Aged
Health utility
