Utility-based quality of life measures in Alzheimer's disease

被引:98
作者
Naglie, Gary
Tomlinson, George
Tansey, Catherine
Irvine, Jane
Ritvo, Paul
Black, Sandra E.
Freedman, Morris
Silberfeld, Michel
Krahn, Murray
机构
[1] Toronto Rehabil Inst, Geriatr Program, Toronto, ON M5G 2A2, Canada
[2] Univ Hlth Network, Div Gen Internal Med & Clin Epidemiol, Toronto, ON, Canada
[3] Univ Toronto, Clin Epidemiol & Hlth Care Res Program, Toronto, ON, Canada
[4] Univ Toronto, Dept Med, Toronto, ON, Canada
[5] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada
[6] Univ Hlth Network, Dept Med, Toronto, ON, Canada
[7] Univ Toronto, Dept Publ Hlth Sci, Toronto, ON, Canada
[8] York Univ, Dept Psychol, Toronto, ON M3J 2R7, Canada
[9] Univ Toronto, Inst Med Sci, Toronto, ON, Canada
[10] Sunnybrook & Womens Coll Hlth Sci Ctr, Div Neurol, Toronto, ON, Canada
[11] Mt Sinai Hosp, Div Neurol, Toronto, ON M5G 1X5, Canada
[12] Baycrest Ctr Geriatr Care, Behav Neurol Program, Toronto, ON, Canada
[13] Baycrest Ctr Geriatr Care, Rotman Res Inst, Toronto, ON, Canada
[14] Canc Care Ontario, Toronto, ON, Canada
[15] Ontario Canc Inst, Toronto, ON M4X 1K9, Canada
[16] Univ Hlth Network, Div Neurol, Toronto, ON, Canada
[17] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
Alzheimers; dementia; quality of life; utility measurement;
D O I
10.1007/s11136-005-4364-8
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives: To explore whether Alzheimer's disease patients could rate their quality of life (QOL) using utility-based health indexes, and to provide new knowledge about the measurement properties of these instruments for patient and caregiver proxy ratings. Methods: A convenience sample of 60 mild-moderate AD patients and their caregivers were randomized to complete the Quality of Well-Being Scale (QWB), Health Utilities Index (HUI3) or EQ-5D and visual analogue scale (VAS) on two occasions. Test-retest reliability (intraclass correlation coefficients) and convergent validity (Spearman correlations) of utility scores with global health status, activities of daily living, comorbidity, mood, cognition and other utility measures were assessed. Results: Completion time was shortest for the combined EQ-5D and VAS. For patients with mild dementia and for proxies, reliability was >= 0.70 for the EQ-5D, QWB and HUI3. The EQ-5D had a ceiling effect for patient ratings. Convergent validity was demonstrated for patient and proxy ratings, with the strongest validity for EQ-5D ratings and the weakest validity for HUI3 patient ratings. Mean patient utility scores were significantly higher than mean proxy scores for all measures (p < 0.001). Conclusions: For patient and proxy ratings, the EQ-5D had the best combination of measurement properties, although it had a substantial ceiling effect for patient ratings. Proxy QOL ratings did not accurately reflect patients' ratings.
引用
收藏
页码:631 / 643
页数:13
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