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杜旭东, 朱萍, 李宓儿等. EQ-5D和SF-6D测量脑卒中患者健康效用值的比较[J]. koko体育app 学报（医学版）, 2018, 49(2): 252-257.
引用本文: 杜旭东, 朱萍, 李宓儿等. EQ-5D和SF-6D在线测量脑卒中病患绿色效益值的较为[J]. 安徽一本大学学报（医疗版）, 2018, 49(2): 252-257.
DU Xu-dong, ZHU Ping, LI Mi-er. et al. Health Utility of Patients with Stroke Measured by EQ-5D and SF-6D[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(2): 252-257.
Citation: DU Xu-dong, ZHU Ping, LI Mi-er. et al. Health Utility of Patients with Stroke Measured by EQ-5D and SF-6D[J]. Journal of Sichuan University (Medical Sciences), 2018, 49(2): 252-257.

EQ-5D和SF-6D测量脑卒中患者健康效用值的比较

Health Utility of Patients with Stroke Measured by EQ-5D and SF-6D

  • 摘要: 目的采用6维健康调查简表(SF-6D)和欧洲5维健康量表(EQ-5D)测量我国脑卒中患者健康效用值，并对两种方法进行比较，为今后开展相关成本效用分析提供支持。方法对596例在2010年1月至2016年6月入住koko体育app 华西医院的首发卒中患者进行前瞻性随访调查，在患者住院期间进行面对面问卷调查，并在出院后每3个月进行一次电话随访。每次调查采用EQ-5D和SF-6D量表评估患者健康效用值。采用Bland-Altman plot分析和组内相关系数(intraclass correlation coefficient, ICC)评价两量表的一致性；采用logistic回归分析健康效用值的影响因素。结果EQ-5D和SF-6D测量脑卒中患者的平均健康效用值及其95%可信区间分别为0.78（0.76，0.80）和0.74（0.73，0.76），中位数及四分位数间距分别为0.86(0.68,1.00)和0.73(0.62,0.86)；ICC为0.67(95%可信区间：0.62，0.71)，Bland-Altman plot分析示95%一致性区间为-0.28~0.35，两量表测量结果不一致；EQ-5D具有较强的天花板效应；脑卒中患者发病后效用值在急性期内（<3月）变化明显，急性期后几无变化。无论是EQ-5D还是SF-6D，疾病严重程度都是健康效用值的主要影响因素。结论SF-6D是较为合适的我国脑卒中患者健康效用值测量工具。  
    Abstract: Objective To compare EQ-5D and SF-6D for measuring health utility of stroke patients in health economic evaluation studies. MethodsA prospective cohort study was conducted on 596 stroke patients in the West China Hospital of Sichuan University from 2010 to 2016. Data were collected at baseline through face to face interviews and at the follow-up stages through telephone interviews with a three-month interval. EQ-5D and SF-6D were used for measuring health utility scores of the participants. The consistency of the two instruments was assessed using Bland-Altman plot and Intraclass correlation coefficient （ICC）. Logistic regression models were established to identify predictors of health utility. ResultsThe participants had a mean utility score of 0.78 (95% confidence interval:0.76,0.80) in EQ-5D, compared with 0.74 (95% confidence interval: 0.73,0.76) in SF-6D, and a median (interquartile range) of 0.86 (0.68,1.00) in EQ-5D and 0.73 (0.62,0.86) in SF-6D. The 95% limits of agreement between the two instruments ranged from -0.28 to 0.35, with an ICC of 0.67 (95% confidence interval: 0.62, 0.71). EQ-5D had a higher ceiling effect. The health utility score of stroke patients changed there rapidly in acute phase (less than 3 months) but barely changed there after.Severity of stroke was a major predictor of health utility scores. Conclusion The two instruments generate inconsistent results in health utility. SF-6D is better for measuring health utility in patients with stroke in China.  
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