• 【EQ-5D-5L与EQ-5D-3L在八个患者组中的测量特性:一项多国研究。】 复制标题 收藏 收藏
    DOI:10.1007/s11136-012-0322-4 复制DOI
    作者列表:Janssen MF,Pickard AS,Golicki D,Gudex C,Niewada M,Scalone L,Swinburn P,Busschbach J
    BACKGROUND & AIMS: PURPOSE:The aim of this study was to assess the measurement properties of the 5-level classification system of the EQ-5D (5L), in comparison with the 3-level EQ-5D (3L). METHODS:Participants (n = 3,919) from six countries, including eight patient groups with chronic conditions (cardiovascular disease, respiratory disease, depression, diabetes, liver disease, personality disorders, arthritis, and stroke) and a student cohort, completed the 3L and 5L and, for most participants, also dimension-specific rating scales. The 3L and 5L were compared in terms of feasibility (missing values), redistribution properties, ceiling, discriminatory power, convergent validity, and known-groups validity. RESULTS:Missing values were on average 0.8% for 5L and 1.3% for 3L. In total, 2.9% of responses were inconsistent between 5L and 3L. Redistribution from 3L to 5L using EQ dimension-specific rating scales as reference was validated for all 35 3L-5L-level combinations. For 5L, 683 unique health states were observed versus 124 for 3L. The ceiling was reduced from 20.2% (3L) to 16.0% (5L). Absolute discriminatory power (Shannon index) improved considerably with 5L (mean 1.87 for 5L versus 1.24 for 3L), and relative discriminatory power (Shannon Evenness index) improved slightly (mean 0.81 for 5L versus 0.78 for 3L). Convergent validity with WHO-5 was demonstrated and improved slightly with 5L. Known-groups validity was confirmed for both 5L and 3L. CONCLUSIONS:The EQ-5D-5L appears to be a valid extension of the 3-level system which improves upon the measurement properties, reducing the ceiling while improving discriminatory power and establishing convergent and known-groups validity.
    背景与目标: 目的:本研究的目的是评估EQ-5D(5L)的5级分类系统与3级EQ-5D(3L)的测量性能。
    方法:来自六个国家的参与者(n = 3,919),包括八个患有慢性病(心血管疾病,呼吸系统疾病,抑郁症,糖尿病,肝病,人格障碍,关节炎和中风)的患者组和一个学生队列,完成了3L和5L,对于大多数参与者,还包括特定于维度的等级量表。比较了3L和5L的可行性(缺失值),重新分配属性,上限,区分能力,收敛效度和已知群体效度。
    结果:5升漏失平均值平均为3升,漏失值为1.3%。总计2.9%的响应在5L和3L之间不一致。对于所有35种3L-5L级组合,均使用EQ尺寸特定等级量表作为参考,从3L重新分配到5L。对于5升,观察到683个独特的健康状态,而对于3升则观察到124个。上限从20.2%(3L)降低到16.0%(5L)。绝对判别力(Shannon指数)在5L时有显着提高(5L平均值为1.87,3L为1.24),相对判别力(Shannon均匀度指数)略有提高(5L分别为0.81和3L分别为0.78)。证实了与WHO-5的收敛效度,并与5L相比略有改善。 5L和3L均确认了已知组的有效性。
    结论:EQ-5D-5L似乎是三级系统的有效扩展,它改善了测量性能,降低了上限,同时提高了鉴别能力,并建立了收敛性和已知群体的有效性。
  • 【EQ-5D在患有和不患有痴呆症的墨西哥城市老年人群中的价值(SADEM研究)。】 复制标题 收藏 收藏
    DOI:10.1002/gps.4030 复制DOI
    作者列表:Sanchez-Arenas R,Vargas-Alarcon G,Sanchez-Garcia S,Garcia-Peña C,Gutierrez-Gutierrez L,Grijalva I,Garcia-Dominguez A,Juárez-Cedillo T
    BACKGROUND & AIMS: BACKGROUND:The EuroQoL-5D (EQ-5D) is a brief, multi-attribute, preference-based health status measurement. The objective of this study was to assess the validity and reliability of EQ-5D in older adults with and without dementia in Mexico City. METHODS:The Study on Aging and Dementia in Mexico (SADEM) was a survey of 3101, Mexican adults (60 + years old). An in-home face-to-face interview was administered. EQ-5D using ranking to rate states on a 100-point visual analogue scale; Daily Living Activities (ADL), Instrumental Activities of Daily Living (IADL), Mini Mental State Examination (MMSE), Short Form of the quality of life survey (SF-36), and Charlson comorbility index were used for comparison. The validity and reliability of EQ-5D were tested. We identified states of health for direct valuation; state 11111 ("no problems") had to be included because it was essential to the reseating (onto a 0-1 scale) of the visual analogue scale data. We included all plausible combinations of levels across each of the five EQ-5D dimensions and evaluated any significant interaction effects and factorial designs, based on balanced complete blocks. RESULTS:The EQ-5D was applied to 3101 older people, of whom 109 (3.4%) had dementia. The general reliability of EQ-5D for cases was 0.80 and for controls 0.76, for each dimension. We had a total of 103 combinations for controls and 45 for cases. The percentage for the state of health "no problems" (11111) for controls was 30.4%, and had the highest percentage of cases (8.8%). CONCLUSION:The resulting valuations form the basis for clinical use and facilitate the interpretation and evaluation of health care.
    背景与目标: 背景:EuroQoL-5D(EQ-5D)是一种简短的,基于属性的基于偏好的健康状况测量。这项研究的目的是评估在墨西哥城患有或不患有痴呆症的老年人中,EQ-5D的有效性和可靠性。
    方法:墨西哥衰老和痴呆研究(SADEM)是对3101名墨西哥成年人(60岁)进行的一项调查。进行了在家中面对面的采访。 EQ-5D使用排名以100点视觉模拟量表对状态进行评分;对比了日常生活活动(ADL),日常生活工具活动(IADL),小精神状态检查(MMSE),生活质量调查的简短形式(SF-36)和查尔森可穿戴性指数。测试了EQ-5D的有效性和可靠性。我们确定了健康状况以进行直接评估;必须包含状态11111(“没有问题”),因为它对于重新生成(以0-1比例为单位)视觉模拟比例数据至关重要。我们包括了五个EQ-5D维度中每个维度的所有可能的水平组合,并基于平衡的完整块评估了任何重大的交互作用和阶乘设计。
    结果:EQ-5D用于3101位老年人,其中109位(3.4%)患有痴呆症。对于每个尺寸,EQ-5D的总体可靠性为0.80,案例为0.76。我们总共有103个对照组合和45个病例组合。对照组的健康状况为“没有问题”的比例为(11111),为30.4%,其中病例百分比最高(8.8%)。
    结论:由此产生的估值构成临床使用的基础,并有助于对医疗保健的解释和评估。
  • 【将“ Q”置于抑郁QALY中:使用EQ-5D和SF-6D健康相关生活质量衡量指标进行公用事业衡量的比较。】 复制标题 收藏 收藏
    DOI:10.1007/s00127-008-0463-5 复制DOI
    作者列表:Mann R,Gilbody S,Richards D
    BACKGROUND & AIMS: BACKGROUND:Generic health preference measures that capture quality of life improvements in depression are important for economic analysis of new technologies. AIM:To compare two widely used preference measures, the EQ-5D and SF-6D, in terms of their dimensions and health utility values. METHOD:EQ-5D and SF-6D data collected from 114 patients with depression, who participated in a cluster, randomised controlled trial to evaluate a collaborative care intervention in UK, primary care practices. Utilities were examined across the whole sample and by level of depression severity using the PHQ-9. RESULTS:Depression was associated with disutility at baseline. At 3 month follow-up mean utility increased 0.147 for EQ-5D and 0.082 for SF-6D. Health gains were observed in patients in remission from depression and those with the mildest level of depression severity. CONCLUSIONS:Both generic preference measures were sensitive to health gains in depression within a relatively short follow-up period; larger health gain was observed for the EQ-5D.
    背景与目标: 背景:捕捉抑郁症患者生活质量改善的通用健康偏好措施对于新技术的经济分析非常重要。
    目的:比较两种广泛使用的优惠措施,即EQ-5D和SF-6D,它们的尺寸和卫生实用价值都很高。
    方法:从114例抑郁症患者中收集的EQ-5D和SF-6D数据参加了一项随机对照试验,以评估英国的协作式护理干预措施,初级护理实践。使用PHQ-9对整个样本中的公用事业以及抑郁症严重程度进行了检查。
    结果:抑郁症与基线的无效性有关。在3个月的随访中,EQ-5D的平均效用提高了0.147,SF-6D的平均效用提高了0.082。抑郁症缓解患者和抑郁症轻度患者的健康状况得到改善。
    结论:这两种通用偏爱措施都在相对较短的随访期内对抑郁症的健康状况敏感。 EQ-5D观察到更大的健康收益。
  • 【家庭成员中疾病溢出的证据:来自美国样本的EQ-5D分数。】 复制标题 收藏 收藏
    DOI:10.1177/0272989X12464434 复制DOI
    作者列表:Wittenberg E,Ritter GA,Prosser LA
    BACKGROUND & AIMS: BACKGROUND/OBJECTIVES:The effects of illness extend beyond the individual to caregivers and family members. This study identified evidence of spillover of illness onto household members' health-related quality of life. METHODS:Medical Expenditures Panel Survey (MEPS) data from 2000-2003 were analyzed using multivariable regression to identify spillover of household members' chronic conditions onto individuals' health-related quality of life as measured by the EuroQol-5D (EQ-5D) score (N = 24,188). Spillover was assessed by disease category, timing of occurrence (preexisting or new conditions), and age of the household member (adult or child). RESULTS:Controlling for an individual's own health conditions and other known predictors of EQ-5D scores, the authors found that the odds of an individual reporting full health (an EQ-5D score of 1.0, relative to <1.0) were lower with the presence of existing mental (odds ratio 0.71; 95% confidence interval, 0.64-0.79), respiratory (0.85; 0.75-0.97), and musculoskeletal (0.83; 0.75-0.93) conditions among adults and with mental (0.72; 0.62-0.82) and respiratory (0.80; 0.81-0.96) conditions among children in the household. The odds of an individual reporting full health were also lower for newly occurring chronic conditions in the household, including adults' mental (0.79; 0.65-0.97), nervous/sensory system (0.76; 0.61-0.96), and musculoskeletal (0.78; 0.65-0.95) conditions and children's mental conditions (0.64; 0.48-0.86). EQ-5D dimensions may be unsuited to fully capture spillover utility among household members, and MEPS lacks condition severity and caregiver status among household members. CONCLUSIONS:Evidence from a US sample suggests that individuals who live with chronically ill household members have lower EQ-5D scores than those who live either alone or with healthy household members. Averting spillover effects may confer substantial additional benefit at the population level for interventions that prevent or alleviate conditions that incur such effects.
    背景与目标: 背景/目的:疾病的影响范围从个人扩展到照顾者和家庭成员。这项研究确定了疾病蔓延到家庭成员健康相关生活质量的证据。
    方法:使用多变量回归分析2000-2003年的医疗支出面板调查(MEPS)数据,以通过EuroQol-5D(EQ-5D)得分来确定家庭成员的慢性病对个人与健康相关的生活质量的溢出(N = 24,188)。通过疾病类别,发生时间(既有疾病或新疾病)和家庭成员(成人或儿童)的年龄对溢出进行评估。
    结果:控制个人自身的健康状况和其他已知的EQ-5D得分预测因素后,作者发现,存在健康状况的个人报告EQ-5D得分的机率(EQ-5D得分为1.0,相对于<1.0)较低成人和精神疾病(0.72; 0.62-0.82)的现有精神状况(比值0.71; 95%置信区间为0.64-0.79),呼吸道(0.85; 0.75-0.97)和肌肉骨骼(0.83; 0.75-0.93)和家庭中儿童的呼吸(0.80; 0.81-0.96)状况。对于家庭中新出现的慢性疾病,包括成年人的精神疾病(0.79; 0.65-0.97),神经/感觉系统(0.76; 0.61-0.96)和肌肉骨骼(0.78; 0.65)的人报告完全健康的几率也较低。 -0.95)状况和儿童的心理状况(0.64; 0.48-0.86)。 EQ-5D尺寸可能不适合完全捕获住户成员之间的溢出效用,而MEPS缺乏住户成员之间的病情严重程度和看护者状态。
    结论:来自美国的证据表明,与长期居住的家庭成员生活的个体相比,与单独居住或与健康家庭成员生活的个体相比,其EQ-5D得分较低。避免溢出效应可在人群一级为预防或减轻引起这种效应的条件的干预措施带来实质性的额外收益。
  • 【健康状态公用事业的转型要比死亡更糟:EQ-5D价值集估算的后果。】 复制标题 收藏 收藏
    DOI:10.1097/01.mlr.0000252166.76255.68 复制DOI
    作者列表:Lamers LM
    BACKGROUND & AIMS: BACKGROUND:Utilities for health are measured on an interval scale, where 1 refers to full health and 0 refers to death. No theoretical lower boundary on the utilities for states worse than death exists. As a consequence, negative values receive greater weight in the calculation of mean utilities. To avoid this, negative values often are bound at -1. OBJECTIVE:The objective of this study was to compare the effect of 3 methods to bound negative values at -1 on the estimation of EQ-5D value sets: truncation, monotonic, and linear transformation. METHOD:Data of the Dutch EQ-5D valuation study were used. A total of 298 respondents directly valued 17 EQ-5D health states using the time trade-off (TTO) method. Random effects regression analysis was used to interpolate TTO values for all possible EQ-5D states. In the regression analysis the dependent variable is 1 minus the TTO value and the independent variables describe the health state. Two widely used models to estimate EQ-5D value were applied after truncation of negative values and monotonic and linear transformation of negative values. Both models also were estimated on medians. RESULTS:Truncation of negative values gave the largest mean absolute error (MAE); the linear transformation resulted in the smallest MAE. When medians were used for estimation, the MAEs were comparable with the estimation on means. CONCLUSION:The choice of a method to bound negative values is arbitrary and affects the resulting value set. For the estimation of EQ-5D value sets from a societal perspective the use of medians should be considered.
    背景与目标: 背景:卫生实用程序是按时间间隔量度的,其中1表示完全健康,0表示死亡。没有比死亡更糟的国家效用的理论下界。因此,负值在平均效用计算中的权重更大。为避免这种情况,负值通常绑定在-1处。
    目的:本研究的目的是比较截断,单调和线性变换对EQ-5D值集的估计的三种方法在-1处绑定负值的影响。
    方法:使用荷兰EQ-5D评估研究的数据。共有298位受访者使用时间权衡(TTO)方法直接评估了17个EQ-5D健康状态。随机效应回归分析用于内插所有可能的EQ-5D状态的TTO值。在回归分析中,因变量为1减去TTO值,而自变量描述健康状况。在截断负值并进行负值的单调线性变换之后,应用了两个广泛使用的模型来估计EQ-5D值。两种模型均以中位数估算。
    结果:截断负值给出最大的平均绝对误差(MAE);线性变换产生最小的MAE。当使用中位数进行估计时,MAE与平均值估计值具有可比性。
    结论:绑定负值的方法的选择是任意的,并且会影响结果集。从社会角度评估EQ-5D值集时,应考虑使用中位数。
  • 【鉴定三个家族中5D型远端关节置换术中的三个新的ECEL1突变。】 复制标题 收藏 收藏
    DOI:10.1111/cge.12226 复制DOI
    作者列表:Shaheen R,Al-Owain M,Khan AO,Zaki MS,Hossni HA,Al-Tassan R,Eyaid W,Alkuraya FS
    BACKGROUND & AIMS: :Arthrogryposis refers to congenital contracture in at least two different body parts. When distal joints are primarily involved, the term distal arthrogryposis (DA) is used. The recognition of clinically distinct subtypes of DA has proven very useful in mapping the disease genes for this genetically heterogeneous condition. DA5D is characterized by ocular involvement usually in the form of ptosis and incomitant strabismus, but extraocular manifestations have also been reported. In a multiplex consanguineous family with DA5D, we combined autozygosity mapping and exome sequencing to identify a novel mutation in ECEL1. This was followed by targeted sequencing of this gene in another two extended consanguineous family with the same phenotype, which revealed two additional novel homozygous mutations. Our results support the recent identification of mutations in ECEL1 as a disease gene in DA5D and expand the clinical and allelic spectrum of this condition.
    背景与目标: 甲状旁腺病是指至少两个不同身体部位的先天性挛缩。当主要涉及远端关节时,将使用术语远端关节固定术(DA)。事实证明,DA的临床独特亚型的识别对于针对这种遗传异质性疾病的疾病基因作图非常有用。 DA5D的特点是眼部受累通常以上睑下垂和斜视性斜视的形式出现,但也有眼外表现的报道。在具有DA5D的多重血缘家族中,我们结合了纯合子作图和外显子组测序来鉴定ECEL1中的新突变。然后在具有相同表型的另外两个近亲家族中对该基因进行靶向测序,这揭示了另外两个新的纯合突变。我们的结果支持了最近鉴定出DA5D中ECEL1作为疾病基因的突变,并扩大了这种疾病的临床和等位基因谱。
  • 【使用多发性硬化症影响量表评估健康状态效用值:从MSIS-29版本2到EQ-5D和SF-6D的映射。】 复制标题 收藏 收藏
    DOI:10.1016/j.jval.2012.07.007 复制DOI
    作者列表:Hawton A,Green C,Telford C,Zajicek J,Wright D
    BACKGROUND & AIMS: OBJECTIVES:The 29-item Multiple Sclerosis Impact Scale (MSIS-29) is a psychometrically validated patient-reported outcome measure increasingly used in trials of treatments for multiple sclerosis. However, it is non-preference-based and not amenable for use across policy decision-making contexts. Our objective was to statistically map from the MSIS-29, version 2, to the EuroQol five-dimension (EQ-5D) and the six-dimension health state short form (derived from short form 36 health survey) (SF-6D) to estimate algorithms for use in cost-effectiveness analyses. METHODS:The relationships between MSIS-29, version 2, and EQ-5D and SF-6D scores were estimated by using data from a cohort of people with multiple sclerosis in South West England (n=672). Six ordinary least squares (OLS), Tobit, and censored least adjusted deviation (CLAD) regression analyses were conducted on estimation samples, including the use of subscale and item scores, squared and interaction terms, and demographics. Algorithms from models with the smallest estimation errors (mean absolute error [MAE], root mean square error [RMSE], normalized RMSE) were then assessed by using separate validation samples. RESULTS:Tobit and CLAD. For the EQ-5D, the OLS models including subscale squared terms, and item scores and demographics performed comparably (MAE 0.147, RMSE 0.202 and MAE 0.147, RMSE 0.203, respectively), and estimated scores well up to 3 years post-baseline. Estimation errors for the SF-6D were smaller (OLS model including squared terms: MAE 0.058, RMSE 0.073; OLS model using item scores and demographics: MAE 0.059, RMSE 0.08), and the errors for poorer health states found with the EQ-5D were less pronounced. CONCLUSIONS:We have provided algorithms for the estimation of health state utility values, both the EQ-5D and SF-6D, from scores on the MSIS-29, version 2. Further research is now needed to determine how these algorithms perform in practical decision-making contexts, when compared with observed EQ-5D and SF-6D values.
    背景与目标: 目的:29项多发性硬化症影响量表(MSIS-29)是一种经心理计量学验证的患者报告的结局指标,越来越多地用于治疗多发性硬化症的试验中。但是,它不是基于首选项的,并且不适合在决策决策环境中使用。我们的目标是从MSIS-29(版本2)到EuroQol五维(EQ-5D)和六维健康状态简表(来自于36卫生调查的简表)(SF-6D)进行统计映射,估算用于成本效益分析的算法。
    方法:使用来自英格兰西南部多发性硬化症人群的数据(n = 672),估计MSIS-29(版本2)与EQ-5D和SF-6D评分之间的关​​系。对估计样本进行了六个普通最小二乘(OLS),Tobit和删失最小调整偏差(CLAD)回归分析,包括使用小数和项目得分,平方和交互作用项以及人口统计学。然后,通过使用单独的验证样本评估来自估计误差最小(平均绝对误差[MAE],均方根误差[RMSE],归一化RMSE)的模型中的算法。
    结果:Tobit和CLAD。对于EQ-5D,OLS模型(包括次级量表平方项)以及项目得分和人口统计数据具有可比性(分别为MAE 0.147,RMSE 0.202和MAE 0.147,RMSE 0.203),并且估计分数在基线后长达3年。 SF-6D的估计误差较小(OLS模型包括平方项:MAE 0.058,RMSE 0.073; OLS模型使用项目评分和人口统计:MAE 0.059,RMSE 0.08),而EQ-5D发现的较差健康状态误差不太明显。
    结论:我们提供了根据MSIS-29版本2的得分估算健康状态效用值(EQ-5D和SF-6D)的算法,现在需要进一步研究以确定这些算法在实际决策中的性能与观察到的EQ-5D和SF-6D值进行比较时。
  • 【[德国疗养院的生活质量-使用EQ-5D问卷调查的结果]。】 复制标题 收藏 收藏
    DOI:10.1055/s-0030-1267946 复制DOI
    作者列表:Alagic V,Staudinger B
    BACKGROUND & AIMS: :In the course of reformation of the health-care system the impact of measuring the quality of life steadily rises. The current study reports the disease-comprehensive quality of life of the elderly who live in nursing homes and compares these results with the reference value of the German population. Furthermore, the results from the different nursing homes are compared with one another in order to prove the direct influence of the nursing home itself on the subjective quality of life of the habitants. The survey was conducted with the generic questionnaire EQ-5D which is an approved index-instrument for health-related quality of life measurement and has been translated into 102 languages so far. In total 342 persons from 8 different nursing homes took part in the survey, at least 25 persons from each nursing home. On the one hand the results show interesting divergences in the quality of life level between habitants and the German population. Differences of at least 2- up to 10-fold values have been proved. For example, there was a discrepancy in the fields of problems related to the habitant's sex, which was not documented in the study of German population. On the other hand high discrepancies when comparing the nursing homes among each other could be proved, although the age structure as well as the distribution between the sexes in at least 7 nursing homes was identical. So it seems that a direct impact of the nursing home on the quality of life of the habitants could be shown. The present study raises many new questions which implicate the need for further surveys. These findings may have a proximate effect on the future health-care system, which will have to involve age-based health-care provision as well as innovative concepts of caring.
    背景与目标: :在医疗体系改革过程中,衡量生活质量的影响稳步上升。当前的研究报告了住在疗养院的老年人的疾病综合生活质量,并将这些结果与德国人口的参考值进行了比较。此外,将来自不同疗养院的结果相互比较,以证明疗养院本身对居民主观生活质量的直接影响。该调查是使用通用问卷EQ-5D进行的,该问卷是用于健康相关生活质量测量的认可索引仪器,迄今为止已被翻译成102种语言。来自8个不同疗养院的342人参加了调查,每个疗养院至少25人。一方面,结果表明居民与德国人口在生活质量上存在有趣的差异。已证明至少有2到10倍的差异。例如,在与居民性别有关的问题领域中存在差异,这在德国人口研究中并未得到记录。另一方面,尽管至少7个疗养院的年龄结构以及男女之间的分布相同,但在相互比较疗养院时仍可证明存在高度差异。因此,似乎可以看出疗养院对居民生活质量的直接影响。本研究提出了许多新的问题,这些问题意味着需要进行进一步的调查。这些发现可能会对未来的医疗体系产生重大影响,未来的医疗体系必须包括基于年龄的医疗保健以及创新的护理概念。
  • 【中国的人口健康状况:EQ-5D结果按年龄,性别和社会经济状况提供,来自2008年《国家卫生服务调查》。】 复制标题 收藏 收藏
    DOI:10.1007/s11136-010-9762-x 复制DOI
    作者列表:Sun S,Chen J,Johannesson M,Kind P,Xu L,Zhang Y,Burström K
    BACKGROUND & AIMS: PURPOSE:To measure and analyse national EQ-5D data and to provide norms for the Chinese general population by age, sex, educational level, income and employment status. METHODS:The EQ-5D instrument was included in the National Health Services Survey 2008 (n = 120,703) to measure health-related quality of life (HRQoL). All descriptive analyses by socio-economic status (educational level, income and employment status) and by clinical characteristics (discomfort during the past 2 weeks, diagnosed with chronic diseases during the past 6 months and hospitalised during the past 12 months) were stratified by sex and age group. RESULTS:Health status declines with advancing age, and women reported worse health status than men, which is in line with EQ-5D population health studies in other countries and previous population health studies in China. The EQ-5D instrument distinguished well for the known groups: positive association between socio-economic status and HRQoL was observed among the Chinese population. Persons with clinical characteristics had worse HRQoL than those without. CONCLUSIONS:This study provides Chinese population HRQoL data measured by the EQ-5D instrument, based on a national representative sample. The main findings for different subgroups are consistent with results from EQ-5D population studies in other countries, and discriminative validity was supported.
    背景与目标: 目的:测量和分析国家EQ-5D数据,并按年龄,性别,教育程度,收入和就业状况为中国普通人群提供规范。
    方法:EQ-5D仪器被纳入《 2008年美国国家卫生服务调查》(n = 120,703),以测量与健康相关的生活质量(HRQoL)。所有按社会经济状况(教育程度,收入和就业状况)和临床特征(过去2周内的不适,过去6个月内被诊断为慢性疾病并在过去12个月内住院)的描述性分析均按性别进行了分层和年龄段。
    结果:健康状况随着年龄的增长而下降,女性报告的健康状况比男性差,这与其他国家的EQ-5D人口健康研究以及中国以前的人口健康研究一致。 EQ-5D仪器在已知人群中表现出色:在中国人口中,社会经济地位与HRQoL之间呈正相关。具有临床特征的人的HRQoL要比没有此特征的人差。
    结论:本研究基于全国代表性样本,提供了由EQ-5D仪器测量的中国人群HRQoL数据。不同亚组的主要发现与其他国家的EQ-5D人口研究的结果一致,并支持判别效度。
  • 【设计基于4d和5d过渡金属酞菁的分子磁性纽扣。】 复制标题 收藏 收藏
    DOI:10.1038/s41598-017-03920-5 复制DOI
    作者列表:Ferriani P,Heinze S,Bellini V
    BACKGROUND & AIMS: :The field of molecular spintronics exploits the properties of organic molecules possessing a magnetic moment, either native in the form of radicals or induced by the insertion of transition metal magnetic ions. To realize logic or storage molecular spin-tronics devices, molecules with stable different magnetic states should be deposited on a substrate, and switching between the states controllably achieved. By means of a first-principles calculations, we have devised a functional molecule exhibiting different magnetic states upon structural changes induced by current injection. We investigate the prototypical case of non-planar M-Phthalocyanine (MPc), where M is a transition-metal ion belonging to the 4d and 5d series. We find that for ZrPc and HfPc deposited on a graphene decorated Ni(111) substrate, two different structural conformations could be stabilized, for which the molecules attain different magnetic states depending on the position of the M ion - whether above the Pc or between the Pc and the substrate -, acting therefore as molecular magnetic button. Our work indicates an intuitive way to engineer a magnetic molecular switch with tailored properties, starting from the knowledge of the basic atomic properties of elements and surfaces.
    背景与目标: :分子自旋电子学领域利用具有磁矩的有机分子的性质,该分子既可以自由基的形式天然存在,也可以通过过渡金属磁性离子的插入而诱发。为了实现逻辑或存储分子自旋电子器件,应将具有稳定的不同磁态的分子沉积在基板上,并在状态之间进行可控地切换。通过第一性原理计算,我们设计了一种功能分子,该功能分子在电流注入引起的结构变化时表现出不同的磁态。我们调查了非平面M-酞菁(MPc)的典型情况,其中M是属于4d和5d系列的过渡金属离子。我们发现,对于沉积在石墨烯修饰的Ni(111)衬底上的ZrPc和HfPc,可以稳定两种不同的结构构象,根据M离子的位置-分子在Pc之上还是在Pc之间,分子获得不同的磁态。 PC和基板-因此充当分子磁性按钮。我们的工作表明,从对元素和表面的基本原子特性的了解开始,设计具有定制特性的磁性分子开关的直观方法。
  • 【EQ-5D维度的患者和一般人群权重的比较。】 复制标题 收藏 收藏
    DOI:10.1002/hec.1362 复制DOI
    作者列表:Mann R,Brazier J,Tsuchiya A
    BACKGROUND & AIMS: :This paper examines the differences in health state evaluations given by patients when they are asked to value their own current states, and those given by members of the general population who were asked to value hypothetical health states. Patient data consist of 4137 observations on EQ-5D profiles and Visual Analogue Scale (VAS) obtained from 3376 patients, covering eight different conditions. General population data are taken from the EQ-5D valuation set. Two analyses were carried out. In the first, the patient self-rated VAS was compared with population VAS values for the same health states. In the second, the patient self-rated VAS values were modelled, and the regression coefficients were compared with the corresponding coefficients from the general population study. The first analysis resulted in a statistically significant mean difference of -0.012 (0.647 for patient VAS, 0.659 from the population value set). The second analysis found statistically significant differences between the coefficients for the EQ-5D health dimensions Pain/Discomfort, Mobility and Anxiety/Depression. Anxiety/Depression had the largest impact on the patient model compared with Pain/Discomfort in the general population model. A further regression analysis suggests that the magnitude of disagreement between patient self-rated VAS model and the population VAS model depends on the patients' condition.
    背景与目标: :本文探讨了当患者被要求评估自己的当前状态时,患者提出的健康状态评估与被要求评估假设的健康状态的普通人群所进行的健康状态评估之间的差异。患者数据包括从3376名患者中获得的关于EQ-5D概况和视觉模拟量表(VAS)的4137个观察结果,涵盖了八种不同的情况。一般人口数据取自EQ-5D评估集。进行了两次分析。首先,将患者自我评估的VAS与相同健康状态的人群VAS值​​进行比较。第二,对患者的自评VAS值进行建模,并将回归系数与一般人群研究中的相应系数进行比较。首次分析得出的统计学上的平均差异为-0.012(患者VAS为0.647,人群值组为0.659)。第二项分析发现,EQ-5D健康维度疼痛/不适,活动能力和焦虑/抑郁的系数之间存在统计学上的显着差异。与一般人群模型中的疼痛/不适相比,焦虑/抑郁对患者模型的影响最大。进一步的回归分析表明,患者自我评估的VAS模型与总体VAS模型之间的分歧程度取决于患者的状况。
  • 【ECEL1中的突变会导致5D型远端关节炎。】 复制标题 收藏 收藏
    DOI:10.1016/j.ajhg.2012.11.014 复制DOI
    作者列表:
    BACKGROUND & AIMS: :Distal arthrogryposis (DA) syndromes are the most common of the heritable congenital-contracture disorders, and ~50% of cases are caused by mutations in genes that encode contractile proteins of skeletal myofibers. DA type 5D (DA5D) is a rare, autosomal-recessive DA previously defined by us and is characterized by congenital contractures of the hands and feet, along with distinctive facial features, including ptosis. We used linkage analysis and whole-genome sequencing of a multiplex consanguineous family to identify in endothelin-converting enzyme-like 1 (ECEL1) mutations that result in DA5D. Evaluation of a total of seven families affected by DA5D revealed in five families ECEL1 mutations that explain ~70% of cases overall. ECEL1 encodes a neuronal endopeptidase and is expressed in the brain and peripheral nerves. Mice deficient in Ecel1 exhibit perturbed terminal branching of motor neurons to the endplate of skeletal muscles, resulting in poor formation of the neuromuscular junction. Our results distinguish a second developmental pathway that causes congenital-contracture syndromes.
    背景与目标: :远距离关节角膜增生症(DA)综合征是可遗传的先天性挛缩性疾病中最常见的一种,约50%的病例是由编码骨骼肌纤维收缩蛋白的基因突变引起的。 5D型DA(DA5D)是我们先前定义的一种罕见的常染色体隐性DA,其特征是手脚先天性挛缩以及包括上睑下垂在内的独特面部特征。我们使用连锁分析和多重血缘家族的全基因组测序来鉴定内皮素转化酶样1(ECEL1)突变,从而导致DA5D。对总共受DA5D影响的7个家庭的评估显示,有5个家庭的ECEL1突变可解释约70%的病例。 ECEL1编码神经元内肽酶,并在大脑和周围神经中表达。缺乏Ecel1的小鼠表现出运动神经元向骨骼肌终板扰动的末端分支,导致神经肌肉接头形成不良。我们的结果区分了导致先天性收缩综合征的第二条发育途径。
  • 【视觉和健康结局,通过活动清单和EQ-5D进行评估,以评估视力障碍。】 复制标题 收藏 收藏
    DOI:10.1111/aos.13430 复制DOI
    作者列表:Macedo AF,Ramos PL,Hernandez-Moreno L,Cima J,Baptista AMG,Marques AP,Massof R,Santana R
    BACKGROUND & AIMS: PURPOSE:Generic instruments to assess health utilities can be used to express the burden of health problems in widely used indexes. That is in contrast with what can be obtained with condition-specific instruments, outcomes are very specific and difficult to compare across conditions. The purpose of this study was to assess health and visual outcomes and its determinants in patients with visual impairment (VI) using the EQ-5D-3L and the Activity Inventory (AI). METHODS:Participants were recruited in different hospitals during the PCVIP-study. A total of 134 patients with acuity 0.30 logMAR or less in the better eye were interviewed. The AI includes 46 goals split between three objectives: social functioning, recreation and daily living, and was used to measure visual ability. The EQ-5D consists of five questions covering one domain each and was used to provide a measure of health states. Responses to each domain were combined to produce a single individual index. RESULTS:The AI and the EQ-5D-3L showed enough discriminatory power between VI levels (p < 0.001), and their results were strongly correlated r(134) = 0.825, (p < 0.001). Explanatory factors for visual ability were level of VI in better eye, age and gender, R2  = 0.43, (p < 0.001). Explanatory factors for the EQ-5D-3L were level of VI in the better eye, comorbidities and gender, R2  = 0.36, (p < 0.001). CONCLUSION:Our results showed that the EQ-5D-3L is useful when characterizing the burden of VI and to compute, when necessary, quality-adjusted-life-years (QALY) changes due to VI. However, it is important to consider that the EQ-5D-3L uses a coarse response scale, assesses a limited spectrum of domains and is influenced by comorbidities. This might limit its responsiveness to small changes in visual ability.
    背景与目标: 目的:评估健康效用的通用工具可用于在广泛使用的指标中表达健康问题的负担。这与使用特定条件的仪器所获得的结果相反,结果是非常特定的,并且很难在不同条件之间进行比较。这项研究的目的是使用EQ-5D-3L和活动清单(AI)评估视力障碍(VI)患者的健康和视觉结果及其决定因素。
    方法:参加者在PCVIP研究期间被招募到不同的医院。总共对134只视力≤0.30logMAR或更小视力的患者进行了访谈。 AI包括46个目标,分为三个目标:社交功能,娱乐和日常生活,并用于衡量视觉能力。 EQ-5D由五个问题组成,每个问题涵盖一个领域,用于衡量健康状况。合并对每个域的响应以生成单个索引。
    结果:AI和EQ-5D-3L在VI水平之间显示出足够的辨别力(p <0.001),并且它们的结果与r(134)= 0.825(p <0.001)有很强的相关性。视觉能力的解释性因素是更好的眼睛,年龄和性别的VI水平,R2 = 0.43,(p <0.001)。 EQ-5D-3L的解释性因素是更好的眼睛中的VI水平,合并症和性别,R2 = 0.36,(p <0.001)。
    结论:我们的结果表明,EQ-5D-3L在表征VI的负担以及在必要时计算VI导致的质量调整生命年(QALY)变化时非常有用。但是,重要的是要考虑到EQ-5D-3L使用粗略的响应量表,评估有限的域谱并受合并症影响。这可能将其响应能力限制为视觉能力的微小变化。
  • 【评估银屑病中EQ-5D-3L和EQ-5D-5L仪器的心理测量特性。】 复制标题 收藏 收藏
    DOI:10.1007/s00403-017-1743-2 复制DOI
    作者列表:Yfantopoulos J,Chantzaras A,Kontodimas S
    BACKGROUND & AIMS: :The aim of this study was to assess the psychometric properties of the five-level (EQ-5D-5L) in comparison with the standard three-level (EQ-5D-3L) classification systems of the EQ-5D in a sample of psoriatic patients. Psoriatic subjects (n = 396) recruited from 16 private practicing centers from various areas of Greece self-completed the two EQ-5D versions and the Dermatology Life Quality Index, while information was also collected on socio-demographics, clinical characteristics and comorbidities. The EQ-5D-5L and EQ-5D-3L were evaluated in terms of agreement, feasibility, ceiling effects, redistribution properties, inconsistency, informativity, and convergent and known-groups validity. Missing values were negligible in both versions. The agreement between the EQ-5D-5L and the EQ-5D-3L was very high (ICC = 0.94), while the largest differences were identified for subjects with moderate health status. Ceiling effects decreased in the EQ-5D-5L system by 14.08% (p < 0.05), with "anxiety/depression" showing the highest relative reduction (-10.31%; p < 0.05). Overall inconsistency was rather low (1.7%) and respondents preferred to report milder problems in the EQ-5D-5L. Absolute informativity improved by 56.42% in the EQ-5D-5L, while relative informativity declined by 9.24%, with only "anxiety/depression" demonstrating a small increase (6.77%). Both instruments demonstrated good convergent and known-groups validity, with evidence of a slightly better convergent performance and discriminatory efficiency of the EQ-5D-5L. In conclusion, both instruments demonstrated consistency, valid redistribution and good construct validity. The EQ-5D-5L system may be preferable to the EQ-5D-3L in psoriatic patients, as it demonstrated a marginally better performance in terms of reduced ceiling effects, increased informativity, and improved convergent and known-groups validity efficiency, particularly in the domain of "anxiety/depression".
    背景与目标: :这项研究的目的是评估EQ-5D的标准三级(EQ-5D-3L)分类系统与五级(EQ-5D-5L)的心理测量特性。银屑病患者。从希腊各个地区的16个私人执业中心招募的银屑病受试者(n = 396)自行完成了两个EQ-5D版本和皮肤病生活质量指数,同时还收集了有关社会人口统计学,临床特征和合并症的信息。对EQ-5D-5L和EQ-5D-3L进行了协议,可行性,上限效应,重新分配属性,不一致,信息性以及聚合组和已知组有效性的评估。在两个版本中,缺失值均可以忽略不计。 EQ-5D-5L和EQ-5D-3L之间的协议非常高(ICC = 0.94),而对于中等健康状态的受试者则发现了最大的差异。在EQ-5D-5L系统中,天花板效应降低了14.08%(p <0.05),其中``焦虑/抑郁''相对降低最高(-10.31%; p <0.05)。总体不一致率很低(1.7%),并且受访者更喜欢报告EQ-5D-5L中的轻微问题。 EQ-5D-5L的绝对信息量提高了56.42%,而相对信息量下降了9.24%,只有“焦虑/沮丧”表现出小幅增长(6.77%)。两种工具都表现出良好的收敛性和已知群体的效度,并证明EQ-5D-5L的收敛性和鉴别效率稍好。总之,这两种工具都显示出一致性,有效的重新分配和良好的构造效度。在银屑病患者中,EQ-5D-5L系统可能比EQ-5D-3L更可取,因为在降低天花板效应,增加信息量以及提高会聚和已知人群的有效性方面,该系统表现出略佳的性能,特别是在“焦虑/抑郁”的领域。
  • 【使用多种建模方法从FACT-B映射到EQ-5D-5 L的功能:来自中国乳腺癌患者的数据。】 复制标题 收藏 收藏
    DOI:10.1186/s12955-019-1224-8 复制DOI
    作者列表:Yang Q,Yu XX,Zhang W,Li H
    BACKGROUND & AIMS: BACKGROUND:The Functional Assessment of Cancer Therapy-Breast (FACT-B) is the most commonly used scale for assessing quality of life in patients with breast cancer. The lack of preference-based measures limits the cost-utility of breast cancer in China. The goal of this study was to explore whether a mapping function can be established from the FACT-B to the EQ-5D-5 L when the EQ-5D health-utility index is not available. METHODS:A cross-sectional survey of adults with breast cancer was conducted in China. All patients included in the study completed the EQ-5D-5 L and the disease-specific FACT-B questionnaire, and demographic and clinical data were also collected. The Chinese tariff value was used to calculate the EQ-5D-5 L utility scores. Five models were evaluated using three different modelling approaches: the ordinary least squares (OLS) model, the Tobit model and the two-part model (TPM). Total scores, domain scores, squared terms and interaction terms were introduced into models. The goodness of fit, signs of the estimated coefficients, and normality of prediction errors of the model were also assessed. The normality of the prediction error is determined by calculating the root mean squared error (RMSE), the mean absolute deviation (MAD), and the mean absolute error (MAE). Akaike information criteria (AIC) and Bayes information criteria (BIC) were also used to assess models and predictive performances. The OLS model was followed by simple linear equating to avoid regression to the mean. RESULTS:The performance of the models was improved after the introduction of the squared terms and the interaction terms. The OLS model, including the squared terms and the interaction terms, performed best for mapping the EQ-5D-5 L. The explanatory power of the OLS model was 70.0%. The AIC and BIC of this model were the smallest (AIC = -705.106, BIC = -643.601). The RMSE, MAD and MAE of the OLS model, Tobit model and TPM were similar. The MAE values of the 5-fold cross-validation of the multiple models in this study were 0.07155~0.08509; meanwhile, the MAE of the TPM was the smallest, followed by that of the OLS model. The OLS regression proved to be the most accurate for the mean, and linearly equated scores were much closer to observed scores. CONCLUSIONS:This study establishes a mapping algorithm based on the Chinese population to estimate the EQ-5D-5 L index of the FACT-B and confirms that OLS models have higher explanatory power and that TPMs have lower prediction error. Given the accuracy of the mean prediction and the simplicity of the model, we recommend using the OLS model. The algorithm can be used to calculate EQ-5D scores when EQ-5D data are not directly collected in a study.
    背景与目标: 背景:乳腺癌的功能评估(FACT-B)是评估乳腺癌患者生活质量最常用的量表。缺乏基于优惠的措施限制了中国乳腺癌的成本效用。这项研究的目的是探索当EQ-5D健康效用指数不可用时,是否可以建立从FACT-B到EQ-5D-5 L的映射功能。
    方法:在中国进行了一项成人乳腺癌横断面调查。纳入研究的所有患者均填写了EQ-5D-5 L和针对疾病的FACT-B问卷,并收集了人口统计学和临床​​数据。使用中国关税价值来计算EQ-5D-5 L实用得分。使用三种不同的建模方法评估了五个模型:普通最小二乘(OLS)模型,Tobit模型和两部分模型(TPM)。将总分数,领域分数,平方项和交互项引入模型。还评估了拟合优度,估计系数的符号以及模型的预测误差的正态性。预测误差的正态性是通过计算均方根误差(RMSE),平均绝对偏差(MAD)和平均绝对误差(MAE)来确定的。 Akaike信息标准(AIC)和Bayes信息标准(BIC)也用于评估模型和预测性能。 OLS模型后面是简单的线性等式,以避免回归到均值。
    结果:引入平方项和交互项后,模型的性能得到改善。包含平方项和交互项的OLS模型最适合映射EQ-5D-5 L,OLS模型的解释力为70.0%。该模型的AIC和BIC最小(AIC = -705.106,BIC = -643.601)。 OLS模型,Tobit模型和TPM的RMSE,MAD和MAE相似。本研究中多个模型的5倍交叉验证的MAE值为0.07155〜0.08509;同时,TPM的MAE最小,其次是OLS模型。 OLS回归被证明是最准确的平均值,并且线性方程得分更接近观察到的得分。
    结论:本研究建立了基于中国人口的映射算法,以估计FACT-B的EQ-5D-5 L指数,并确认OLS模型具有较高的解释力,而TPM具有较低的预测误差。鉴于均值预测的准确性和模型的简单性,我们建议使用OLS模型。当未在研究中未直接收集EQ-5D数据时,该算法可用于计算EQ-5D分数。

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