ADVANCES IN METHODS FOR ASSESSING THE IMPACT OF EPILEPSY AND ANTIEPILEPTIC DRUG-THERAPY ON PATIENTS HEALTH-RELATED QUALITY-OF-LIFE

被引:83
作者
WAGNER, AK
KELLER, SD
KOSINSKI, M
BAKER, GA
JACOBY, A
HSU, MA
CHADWICK, DW
WARE, JE
机构
[1] HARVARD UNIV,SCH PUBL HLTH,BOSTON,MA 02115
[2] UNIV NEWCASTLE UPON TYNE,CTR HLTH SERV RES,NEWCASTLE TYNE NE1 7RU,TYNE & WEAR,ENGLAND
[3] SCHERING PLOUGH CORP,KENILWORTH,NJ
[4] UNIV LIVERPOOL,WALTON HOSP,DEPT NEUROSCI,LIVERPOOL L69 3BX,ENGLAND
关键词
EPILEPSY; HEALTH-RELATED QUALITY OF LIFE; HEALTH STATUS ASSESSMENT; MOS SF-36 HEALTH SURVEY; SEIZURE CONTROL; SEIZURE SEVERITY; SYMPTOMS; VALIDITY;
D O I
10.1007/BF01833606
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
We studied 31 previously validated and newly developed generic and epilepsy-specific scales to evaluate their usefulness for assessing the impact of epilepsy and anti-epileptic drug (AED) therapy on health-related quality of life (HRQOL). Included were the MOS SF-36 Health Survey, additional measures of mental health, cognition, epilepsy-specific perception of control, behavioural problems, distress, worries and experiences, the Liverpool Epilepsy Impact and Seizure Severity scales, and a patient-completed symptom checklist. Questionnaires were completed twice by 136 patients on AED therapy in a multicentre study in the UK. Validity was assessed in relation to disease severity, defined as time since last seizure, and to patient-reported symptoms. Statistical analyses to estimate the contribution of HRQOL information of each scale relative to that of others were conducted. The 171-item questionnaire could be completed by out-patients with epilepsy with good data quality. With few exceptions, generic and epilepsy-specific measures satisfied psychometric tests of hypothesized item groupings and scale score reliability (internal consistency and test-retest reliability) and differentiated well between groups of patients differing in time since last seizure and in symptom impact, regardless of time since last seizure. However, scales differed widely in their validity in discriminating between groups of patients known to differ clinically. The SF-36 Role Physical scale best discriminated among groups differing in disease severity. The epilepsy-specific Mastery, Impact, Experience, Worry, Distress, and Agitation scales were among the 10 best measures in discriminating among groups differing in disease severity. Generic measures, especially measures of social and role functioning and mental health, were best at differentiating groups of patients differing in symptom impact. Recommendations are offered for concepts and specific scales most likely to be useful in future studies of the HRQOL burden of epilepsy and the HRQOL benefits of AED therapy.
引用
收藏
页码:115 / 134
页数:20
相关论文
共 60 条
  • [1] [Anonymous], 1981, EPILEPSIA, V22, P489
  • [2] THE DEVELOPMENT OF A SEIZURE SEVERITY SCALE AS AN OUTCOME MEASURE IN EPILEPSY
    BAKER, GA
    SMITH, DF
    DEWEY, M
    MORROW, J
    CRAWFORD, PM
    CHADWICK, DW
    [J]. EPILEPSY RESEARCH, 1991, 8 (03) : 245 - 251
  • [3] THE INITIAL DEVELOPMENT OF A HEALTH-RELATED QUALITY-OF-LIFE MODEL AS AN OUTCOME MEASURE IN EPILEPSY
    BAKER, GA
    SMITH, DF
    DEWEY, M
    JACOBY, A
    CHADWICK, DW
    [J]. EPILEPSY RESEARCH, 1993, 16 (01) : 65 - 81
  • [4] Baker Gus A., 1993, Epilepsia, V34, P18
  • [5] BEATON DE, 1994, QUAL LIFE RES, V3, P50
  • [6] THE SICKNESS IMPACT PROFILE - DEVELOPMENT AND FINAL REVISION OF A HEALTH-STATUS MEASURE
    BERGNER, M
    BOBBITT, RA
    CARTER, WB
    GILSON, BS
    [J]. MEDICAL CARE, 1981, 19 (08) : 787 - 805
  • [7] VALIDATING THE SF-36 HEALTH SURVEY QUESTIONNAIRE - NEW OUTCOME MEASURE FOR PRIMARY CARE
    BRAZIER, JE
    HARPER, R
    JONES, NMB
    OCATHAIN, A
    THOMAS, KJ
    USHERWOOD, T
    WESTLAKE, L
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1992, 305 (6846): : 160 - 164
  • [8] CHAPLIN JE, 1990, BRIT MED J, V304, P1416
  • [9] Commission on Classification and Terminology of the International League Against Epilepsy, 1989, EPILEPSIA, V30, P389
  • [10] COMREY AL, 1992, FIRST COURSE FACTOR