To compare the performance of three-level EuroQol five-dimensions (EQ-5D-3L) and five-level EuroQol five-dimensions (EQ-5D-5L) among common cancer patients in urban China.
MethodsA hospital-based cross-sectional survey was conducted in three provinces from 2016 to 2018 in urban China. Patients with breast cancer, colorectal cancer, or lung cancer were recruited to complete the EQ-5D-3L and EQ-5D-5L questionnaires. Response distribution, discriminatory power (indicator: Shannon index [H′] and Shannon evenness index [J′]), ceiling effect (the proportion of full health state), convergent validity, and health-related quality of life (HRQoL) were compared between the two instruments.
ResultsA total of 1802 cancer patients (breast cancer: 601, colorectal cancer: 601, lung cancer: 600) were included, with the mean age of 55.6 years. The average inconsistency rate was 4.4%. Compared with EQ-5D-3L (average: H′?=?1.100, J′?=?0.696), an improved discriminatory power was observed in EQ-5D-5L (H′?=?1.473, J′?=?0.932), especially contributing to anxiety/depression dimensions. The ceiling effect was diminished in EQ-5D-5L (26.5%) in comparison with EQ-5D-3L (34.5%) (p?<?0.001), mainly reflected in the pain/discomfort and anxiety/depression dimensions. The overall utility score was 0.790 (95% CI 0.778–0.801) for EQ-5D-3L and 0.803 (0.790–0.816) for EQ-5D-5L (p?<?0.001). A similar pattern was also observed in the detailed cancer-specific analysis.
ConclusionsWith greater discriminatory power, convergent validity and lower ceiling, EQ-5D-5L may be preferable to EQ-5D-3L for the assessment of HRQoL among cancer patients. However, higher utility scores derived form EQ-5D-5L may also lead to lower QALY gains than those of 3L potentially in cost-utility studies and underestimation in the burden of disease.
相似文献目的:系统评价国产小牛血去蛋白提取物眼凝胶对准分子激光角膜屈光手术后角膜上皮修复的临床疗效和安全性。
方法:计算机检索Pubmed、Embase、Cochrane Library、维普中文科技期刊数据库、中国知网、万方数据库,查找国内外采用国产小牛血去蛋白提取物眼凝胶治疗准分子激光角膜屈光手术患者上皮修复的随机对照试验(RCT),检索时限2007-01/2016-12。由 2 位研究成员根据纳入与排除标准独立筛选文献、提取资料和评价质量后,采用 Review Manager 5.3软件进行 Meta分析。
结果:最终纳入7个 RCT,共计患者1 042眼,其中治疗组523眼,对照组519眼。Meta分析结果显示:准分子激光角膜屈光术后应用国产小牛血去蛋白提取物眼凝胶在临床疗效、症状评分、角膜愈合时间方面均优于对照组,其差异均有统计学意义:临床疗效:OR=1.81,95%CI(1.39~2.35),P<0.001; 准分子激光术后角膜损伤症状评分WMD = -0.33,95%CI(-0.45~-0.21),P<0.001; 角膜愈合时间WMD =-1.26,95%CI(-1.56~-0.97),P<0.001。
结论:应用国产小牛血去蛋白提取物眼凝胶可使准分子激光屈光术后患者不适症状减轻、角膜上皮恢复快、治疗有效率提高。受纳入研究质量和数量所限,上述结论尚需进一步开展严格设计的随机双盲对照试验加以验证。 相似文献