建立DLQI與EQ-5D-5L轉換公式-以臺灣異位性皮膚炎患者為例

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Title:	建立DLQI與EQ-5D-5L轉換公式-以臺灣異位性皮膚炎患者為例 Developing an Algorithm for Mapping of the DLQI to EQ-5D-5L for Patients with Atopic Dermatitis in Taiwan
Authors:	林奕均 Lin, Yi-Chun
Contributors:	醫務管理學研究所湯澡薰
Keywords:	異位性皮膚炎;DLQI;EQ-5D;健康相關生活品質;Mapping;經濟評估 Atopic Dermatitis;DLQI;EQ-5D;HRQoL;Mapping;Economic evaluation
Date:	2019-06-17
Issue Date:	2020-02-10 13:03:24 (UTC+8)
Abstract:	目的：探討臺灣異位性皮膚炎患者處於不同嚴重度下與皮膚學生活品質量表、EQ-5D之關係，並將DLQI預估出EQ-5D-5L、VAS之效用值。方法：本研究資料蒐集採立意取樣於北、中、南三家醫學中心之皮膚科門診，以20歲以上之異位性皮膚炎成人進行問卷訪視，共回收200份有效問卷。使用SAS 9.4版進行資料處理與統計分析，以單因子變異數（One-way ANOVA）檢定不同疾病嚴重度下DLQI與EQ-5D-5L之關係。DLQI預估EQ-5D-5L、VAS之效用值上使用K-fold將樣本分為五分之四預估模型與五分之一做內部效度測試，以逐步迴歸選取重要變項，並比較廣義線性模型（Generalized Linear Model, GLM）、分數邏輯模型（Fractional logit model）、是否校正異質變異之模型最小平方法（Ordinary Least Squares, OLS）四種模型。結果：受訪者平均年齡為34歲，平均罹病年數為18年，女性與男性比例約為1：1。DLQI、EQ-5D-5L、VAS與疾病嚴重度有顯著相關性（P<0.0001）；DLQI與EQ-5D-5L、VAS具中度負相關（rs=-0.56、rs=-0.44，P<0.0001）；DLQI（總分/構面）分數對EQ-5D-5L、VAS效用值，達統計上顯著意義（P<0.0001）。結論：所建構出mapping轉換公式可將DLQI預估EQ-5D-5L與VAS之效用值，其中fractional logit model為最佳之模型。 OBJECTIVES: The study aims to explore the relationship between DLQI, EQ-5D in different severity levels, and develop an algorithm to predict the utilities from DLQI in AD of Taiwan. METHODS: An in-person survey of 200 adult patients who diagnosed with AD visiting clinic of dermatology at the medical center was conducted. Descriptive statistics were used One-way ANOVA to characterize. Estimates the utilities of EQ-5D-5L and VAS from DLQI was using K-fold technique to divide the sample in four out of five to estimated models and one in five for the internal validation, the explanatory variables were using stepwise regression selection, and compare GLM model, Fractional Logit Model, with or without heteroscedasticity adjustment OLS model to explore the most appropriate model of mapping algorithm. RESULTS: Patients had a mean age of 34 years, and disease duration of 18 years, the ratio of female and male approximately1:1. There was a significant associated with DLQI dimensions, EQ-5D-5L, VAS and disease severity (P<0.0001). DLQI showed a moderate associated with the EQ-5D-5L and with the VAS (rs=-0.56、rs=-0.44，P<0.0001). The DLQI (total /dimensions) scores were statistically significant (P<0.0001) for EQ-5D-5L and VAS utilities. CONCLUSIONS: The mapping algorithm can be used to predict EQ-5D-5L and VAS utilities, the fractional logit model is the most appropriate model.
Description:	碩士指導教授：湯澡薰委員：朱家瑜委員：簡麗年
Data Type:	thesis
Appears in Collections:	[School of Health Care Administration] Dissertations/Theses

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