目标:患者报告的结局指标,虽然有价值,可能与诊断测试结果无关。为了更好地理解这种潜在的差异,我们的目的是确定心理健康是否是患者报告的过敏结局评分和过敏测试结果之间关联的效应调节剂.
方法:前瞻性结局研究。
方法:三级护理医院和社区诊所。
方法:这项研究包括600名年龄在18岁以上的患者,这些患者出现了与过敏性鼻炎相关的症状,并完成了相关的鼻窦结局测试(SNOT)。其中包括经过验证的鼻腔,过敏,和心理领域。利用比值比和Spearman相关系数的分层分析来评估心理状态对效果的影响。
结果:在心理健康较好的患者中,患者报告的变应性鼻炎症状与变态反应试验结果(比值比[OR]1.69,95%置信区间[CI]1.22-2.34,P=0.002)显著相关。相比之下,心理健康较差的患者没有相关性(OR1.06,95%CI0.36-3.10,P=0.92)。相关性评估证实了这些发现:在心理健康较好的患者中,过敏领域得分与过敏测试得分呈正相关(Spearmanrho0.18,95%CI0.10-0.25,P<.001)。而心理健康较差的患者没有相关性(-0.02,95%CI-0.16-0.12,P=0.77)。
结论:心理状态是变态反应领域与变态反应测试数据之间关联的效应调节因子。在评估主观测量之间的关系时,如鼻窦验证的仪器,和客观措施,比如过敏测试结果,考虑心理状态等效应调节剂可以提供临床和研究相关的见解。
OBJECTIVE: Patient-reported outcome measures, while valuable, may not correlate with diagnostic test results. To better understand this potential discrepancy, our objective was to determine whether psychological health is an effect modifier of the association between patient-reported allergy outcome scores and allergy test results.
METHODS: Prospective outcomes study.
METHODS: Tertiary care hospital and community-based clinic.
METHODS: This study included 600 patients at least 18 years of age who presented for symptoms related to allergic rhinitis and completed the related sinonasal outcome test (SNOT), which includes validated nasal, allergy, and psychological domains. Stratified analyses of odds ratios and Spearman correlation coefficients were utilized to assess for effect modification by psychological status.
RESULTS: Worse patient-reported allergic rhinitis symptoms were significantly associated with positive allergy test results (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.22-2.34, P = .002) in patients with better psychological health. In contrast, there was no association in patients with worse psychological health (OR 1.06, 95% CI 0.36-3.10, P = .92). These findings were corroborated by assessments of correlation: allergy domain scores were positively correlated with allergy testing scores (Spearman rho 0.18, 95% CI 0.10-0.25, P < .001) in patients with better psychological health, while there was no correlation in patients with worse psychological health (-0.02, 95% CI -0.16-0.12, P = .77).
CONCLUSIONS: Psychological status was an effect modifier of the association between allergy domain and allergy testing data. When assessing the relationship between subjective measures, such as sinonasal validated instruments, and objective measures, such as allergy test results, accounting for effect modifiers such as psychological state can provide clinical and research-related insights.