哮喘联盟

   摘要
   背景：生活质量(QoL)评估是临床研究中重要的患者相关结局评估。咳嗽是最常见的导致患者进行医疗咨询的症状。虽然成人和父母-委托咳嗽特异性QoL问卷已经被认为是有效的咳嗽结局评估，但是目前仍没有适用于慢性咳嗽儿童的QoL问卷。我们报道了一个具有统计学特性的儿童慢性咳嗽特异性QoL(CC-QoL)问卷。
   方法：共130例（年龄中值10岁，IQR8-12岁；65个女孩）儿童纳入研究。通过与慢性咳嗽（＞4周）儿童交流，形成了含有37个条目的最初版本。这些儿童同时完成通用QoL问卷（儿童QoL问卷4.0(PedsQL4.0)，Spence儿童焦虑量表(SCAS)），和咳嗽日记评分。
   结果：在这些条目中，经过临床效应方法剔除后共剩下16个条目具有很好的内部一致性(Cronbach's α=0.94)且能涵盖各个方面。CC-QoL量表与咳嗽评分、PedsQL和SCAS评分建立了很好的构造依据和效标效度。CC-QoL评分对干预后的改变比较敏感，且能发现咳嗽孩子和停止咳嗽孩子的显著差异。总体和CC-QoL的最小重要差别（MID）在0.37-1.36（基于分布函数的方法）和1.11-1.58（基于锚的方法）之间。
   结论：慢性咳嗽显著影响儿童的QoL。CC-QoL是一种能从儿童的角度评估QoL的方法，它能可靠、高效、敏感的反应测量结果的改变。来自可靠队列的数据，推荐使用1.1 CC-QoL的MID评估健康状态改变。


 

（苏欣 审校）
Thorax. 2016 Feb 3. pii: thoraxjnl-2015-207473.doi:10.1136/thoraxjnl-2015-207473. [Epub ahead of print]


 

A child chronic cough-specific quality of life measure: development and validation.
 

Newcombe PA1, Sheffield JK1, Petsky HL2, Marchant JM2, Willis C2, Chang AB3.
 

Abstract
BACKGROUND:Quality of life (QoL) measures are an important patient-relevant outcome measure for clinical studies. Cough is the most common symptom that results in new medical consultations. Although adult and parent-proxy cough-specific QoL instruments have been shown to be a usefulcough outcome measure, no suitable cough-specific QoL measure for children with chronic cough exists. We report on the statistical properties of a chronic cough-specific QoL (CC-QoL) questionnaire for children.
METHOD:130 children (median age 10 years, IQR 8-12 years; 65 girls) participated. A preliminary 37-item version was developed from conversations with children with chronic cough (>4 weeks). Children also completed generic QoL questionnaires (Pediatric QoL Inventory 4.0 (PedsQL4.0), Spence Children's Anxiety Scale (SCAS)) and cough diary scores.
RESULTS:The clinical impact method of item reduction resulted in 16 items that had excellent internal consistency (Cronbach's α=0.94) among these items and also within each domain. Evidence for construct and criterion validity was established with significant correlations between CC-QoL subscales with cough scores, PedsQL and SCAS scores. CC-QoL scores were sensitive to change following an intervention and significant differences were noted between those children coughing and those who had ceased coughing. Minimum important difference (MID) for overall and domain CC-QoL ranged from 0.37-1.36 (distribution-based approach) to 1.11-1.58 (anchor-based approach).
CONCLUSIONS:Chronic cough significantly impacts the QoL of children. The CC-QoL is a reliable, valid and sensitive to change outcome measure that assesses QoL from the child's perspective. Pending data from a confirmatory cohort, a MID for the CC-QoL of 1.1 is recommended when evaluating health status change.
 

Thorax. 2016 Feb 3. pii: thoraxjnl-2015-207473.doi:10.1136/thoraxjnl-2015-207473. [Epub ahead of print]