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.

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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。

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