目的:幼年特发性关节炎(JIA)是儿童中最常见的关节炎类型。它会导致关节疼痛和永久性身体损伤,影响流动性和日常活动。EQ-5D-Y-3L自报告版本已在JIA中验证,但EQ-5D-Y-5L的有效性仍然未知。我们检查了JIA儿童中EQ-5D-Y-5L父母代理版本的心理测量特性。
方法:我们使用了来自“了解儿童关节炎网络”加拿大-荷兰合作研究队列的数据,包括新发JIA的患者,以及那些开始或停止生物制品的人。收集临床数据以及儿童健康评估问卷(CHAQ)和EQ-5D-Y-5L的父母代理版本。我们评估了上限和下限效应;使用Spearman的等级相关性评估的收敛和发散效度;使用单向ANOVA(方差分析)和效应大小的已知群体效度;以及使用Shannon的均匀度指数的信息性。
结果:分析了467例患者就诊,代表407例患者。EQ-5D-Y-5L没有天花板/地板效应。EQ-5D-Y-5L显示出良好的收敛性(例如,EQ-5D-Y-5L疼痛/不适尺寸与CHAQ疼痛指数(Spearman\sr=0.74,95%置信区间(C.I.):0.69-0.79)),发散的(例如,EQ-5D-Y-5L疼痛/不适尺寸与CHAQ进食维度(Spearman\sr=0.19,95%C.I.:0.09-0.29)和已知组有效性(例如,非活动性与活动性疾病状态患者的平均EQ-5D-Y-5L水平汇总评分,6.34vs.10.52(p<0.001,效应大小=1.20(95%C.I.:0.95-1.45))。香农的均匀度指数范围为0.52至0.88,表明大多数维度具有相对均匀的分布。
结论:在该患者样本中,EQ-5D-Y-5L父代理版本表现出结构有效性和信息性,提示EQ-5D-Y-5L可用于测量JIA儿童的生活质量。
幼年特发性关节炎是影响儿童的最常见的关节炎类型。它会导致关节疼痛和永久性身体损伤,并影响活动和日常活动。虽然还没有治愈方法,像生物制剂这样的新疗法是有效的。然而,生物制剂价格昂贵,而且会有副作用。决定何时是使用这些生物制剂的最佳时机,我们需要了解它们的成本和对患者的影响。EQ-5D-Y-5L是测量疾病如何影响患者生活的常用工具。目前尚不清楚EQ-5D-Y-5L对幼年特发性关节炎患者是否有效。在这项研究中,我们将EQ-5D-Y-5L与另一种测量疾病如何影响功能能力的工具进行了比较.我们看看EQ-5D-Y-5L是否能分辨出或多或少生病的孩子之间的区别。我们还评估了EQ-5D-Y-5L是否能够描述不同严重程度的患者的健康状况。这项研究表明,EQ-5D-Y-5L是测量幼年特发性关节炎患者健康状况的良好工具。这项研究的结果支持在未来的临床试验和研究中在该患者人群中使用EQ-5D-Y-5L。
OBJECTIVE: Juvenile idiopathic arthritis (JIA) is the most common type of arthritis among children. It can cause joint pain and permanent physical damage, which affects mobility and daily activities. The EQ-5D-Y-3L self-report version has been validated in JIA, but the validity of EQ-5D-Y-5L remains unknown. We examined the psychometric properties of the EQ-5D-Y-5L parent-proxy version among children with JIA.
METHODS: We used data from the Understanding Childhood Arthritis Network Canadian-Dutch collaboration study cohort, including patients with new-onset JIA, and those starting or stopping biologics. Clinical data and the parent-proxy version of the childhood health assessment questionnaire (CHAQ) and EQ-5D-Y-5L were collected. We evaluated the ceiling and floor effect; convergent and divergent validity using Spearman\'s rank correlation; known-group validity using one-way ANOVA (Analysis of Variance) and effect size; and informativity using Shannon\'s evenness index.
RESULTS: 467 patient visits representing 407 patients were analyzed. The EQ-5D-Y-5L had no ceiling/floor effect. The EQ-5D-Y-5L showed good convergent (e.g., EQ-5D-Y-5L pain/discomfort dimension vs. CHAQ pain index (Spearman\'s r = 0.74, 95% confidence interval (C.I.): 0.69-0.79)), divergent (e.g., EQ-5D-Y-5L pain/discomfort dimension vs. CHAQ eating dimension (Spearman\'s r = 0.19, 95% C.I.: 0.09-0.29)) and known-group validity (e.g., mean EQ-5D-Y-5L level summary score for patients with inactive versus active disease status, 6.34 vs. 10.52 (p < 0.001, effect size = 1.20 (95% C.I.: 0.95-1.45)). Shannon\'s evenness index ranged from 0.52 to 0.88, suggesting most dimensions had relatively even distributions.
CONCLUSIONS: In this patient sample, EQ-5D-Y-5L parent-proxy version exhibited construct validity and informativity, suggesting the EQ-5D-Y-5L can be used to measure the quality of life of children with JIA.
Juvenile idiopathic arthritis is the most common type of arthritis affecting children. It can cause pain and permanent physical damage to joints and affects mobility and daily activities. While there is no cure yet, new therapies like biologics are effective. However, biologics are expensive and can have side effects. To decide when is the best time to use these biologics, we need to understand their cost and impact on patients. EQ-5D-Y-5L is a common tool to measure how the disease affects a patient’s life. It is unclear whether EQ-5D-Y-5L works well for patients with juvenile idiopathic arthritis. In this study, we compared the EQ-5D-Y-5L to another tool that measures how the illness impacts functional ability. We looked to see if the EQ-5D-Y-5L could tell the difference between children who were more or less sick. We also assessed whether the EQ-5D-Y-5L has the ability to describe patients with different severity in health status. This study indicates that the EQ-5D-Y-5L is a good tool to measure the health of patients with juvenile idiopathic arthritis. Findings from this study support the use of the EQ-5D-Y-5L among this patient population in future clinical trials and research studies.