中国全科医学 ›› 2022, Vol. 25 ›› Issue (28): 3579-3586.DOI: 10.12114/j.issn.1007-9572.2022.0084

所属专题: 全民健康最新文章合集

• 医学循证 • 上一篇    

国内外不孕不育患者健康相关生命质量量表的系统综述与评价研究

史钊1,2,3, 李顺平1,2,3,*(), 吴小燕1,2,3, 刘嘉琪1,2,3, 杜慧敏1,2,3   

  1. 1250012 山东省济南市,山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心
    2250012 山东省济南市,国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学)
    3250012 山东省济南市,山东大学健康偏好研究中心
  • 收稿日期:2022-02-14 修回日期:2022-06-12 出版日期:2022-10-05 发布日期:2022-07-14
  • 通讯作者: 李顺平
  • 史钊,李顺平,吴小燕,等.国内外不孕不育患者健康相关生命质量量表的系统综述与评价研究[J].中国全科医学,2022,22(28):3579-3586.[www.chinagp.net]
    作者贡献:史钊、李顺平进行文章的构思与设计,史钊、吴小燕、刘嘉琪、杜慧敏负责文献筛选及质量控制与审校;史钊、吴小燕、刘嘉琪进行数据收集及整理;史钊、李顺平负责结果的分析与解释,撰写论文;史钊、李顺平、吴小燕、刘嘉琪、杜慧敏进行论文的修订;李顺平负责文章的可行性分析,对文章整体负责,监督管理。
  • 基金资助:
    山东省自然科学基金面上项目(ZR2021MG010)

Health-related Quality of Life Instruments in Infertility Patients: a Systematic Review and Evaluation

Zhao SHI1,2,3, Shunping LI1,2,3,*(), Xiaoyan WU1,2,3, Jiaqi LIU1,2,3, Huimin DU1,2,3   

  1. 1Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
    2NHC Key Lab of Health Economics and Policy Research (Shandong University) , Jinan 250012, China
    3Center for Health Preference Research, Shandong University, Jinan 250012, China
  • Received:2022-02-14 Revised:2022-06-12 Published:2022-10-05 Online:2022-07-14
  • Contact: Shunping LI
  • About author:
    SHI Z, LI S P, WU X Y, et al. Health-related quality of life instruments in infertility patients: a systematic review and evaluation[J]. Chinese General Practice, 2022, 22 (28) : 3579-3586.

摘要: 背景 健康相关生命质量(HRQoL)是用于评价临床疗效的重要指标。目前,不孕不育患者HRQoL量表得到了广泛应用,但尚不确定这些量表应用于临床时是否具有良好的测量性能,缺乏对量表的质量评价。 目的 系统综述与评价不孕不育患者HRQoL量表,为合理选择健康结果测量工具提供参考。 方法 于2020年10月,计算机检索PubMed、Web of Science、the Cochrane Library、EmBase、中国知网、万方数据知识服务平台、维普中文科技期刊全文数据库和中国生物医学文献数据库,获取国内外公开发表的有关不孕不育患者HRQoL的研究,检索时限均为建库至2020-10-05。由两名研究者独立筛选文献和提取资料后,采用健康测量工具遴选标准(COSMIN)对不孕不育患者HRQoL特异性量表开发研究的方法学质量,以及量表的测量性能进行评价,采用描述分析法对评价结果进行汇总、分析。 结果 共纳入229篇文献,涉及19个不孕不育患者HRQoL量表,其中4个为不孕不育患者HRQoL特异性量表〔TLMK、生育生活质量量表(FertiQoL)、QOLICQ及中医肝郁型不孕症生命质量量表〕,4个为用于测评癌症及其他疾病患者HRQoL的特异性量表,11个为普适性HRQoL量表,FertiQoL量表在现有不孕不育患者HRQoL相关研究中被使用的频次最高〔39.1%(91/233)〕。PROMs开发方面,除FertiQoL量表开发的总体质量为"有问题的"外,其余3个量表开发的总体质量均为"不合格"。内容效度方面,FertiQoL、QOLICQ量表开发研究的方法学质量分别为"非常好""有问题的",TLMK、中医肝郁型不孕症生命质量量表开发研究的方法学质量均为"合格"。结构效度方面,除QOLICQ量表开发研究方法学质量为"有问题的"外,其余3个量表开发研究的方法学质量为"合格";4个量表的结构效度均为"不确定"。内部一致性方面,4个量表开发研究的方法学质量均为"非常好",4个量表的内部一致性均为"足够"。重测信度方面,QOLICQ量表开发研究的方法学质量为"有问题的",量表的重测信度为"不确定"。效标效度方面,中医肝郁型不孕症生命质量量表开发研究的方法学质量为"非常好",量表的效标效度为"足够"。建构效度方面,TLMK量表开发研究的方法学质量为"非常好",量表的建构效度为"足够"。反应度/灵敏度方面,FertiQoL量表开发研究的方法学质量为"非常好",量表的反应度/灵敏度为"足够"。 结论 现存的不孕不育患者HRQoL特异性量表中,FertiQoL量表开发研究的方法学质量及量表的测量性能相对较高。中国不孕不育患者HRQoL特异性量表研究数量相对不足,未来应开展更多的研究。

关键词: 不孕不育, 健康相关生命质量, 量表, 系统评价, 健康测量工具遴选标准

Abstract:

Background

Health-related quality of life (HRQoL) is a key indicator that is used for evaluating clinical outcomes. Infertility-specific HRQoL instruments have been widely used, but it is uncertain whether these instruments have good measurement properties in clinical application, and there is a lack of quality evaluation for them.

Objective

To perform a systematical review and evaluation of HRQoL instruments in infertility patients, offering a rational reference for the selection of these instruments.

Methods

In October 2020, PubMed, Web of Science, the Cochrane Library, EmBase, CNKI, WanFang Data, CQVIP, and SinoMed databases were searched from inception to October 5, 2020 to identify studies on HRQoL instruments designed for or assess HRQoL for patients with infertility. Two reviewers independently implemented literature screening, data extraction, and methodological quality assessment of the included studies in terms of the process of developing infertility-specific HRQoL instruments and measurement properties of the instruments using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Descriptive analysis was used to summarize and analyze the assessment results.

Results

We included 229 studies on 19 HRQoL instruments, including 4 infertility-specific HRQoL instruments〔TLMK (Tübinger Lebensqualit?tsfragebogen für M?nner mit Kinderwunsch) , the Fertility Quality of Life (FertiQoL) , Quality of Life in Infertile Couples Questionnaire (QOLICQ) , Quality of Life in People with Infertility Induced by Liver Qi Stagnation Identified by Chinese Medicine Theory〕, 4 cancer-specific or other disease-specific HRQoL instruments and 11 generic HRQoL instruments. The FertiQoL was the most frequently used in existing studies〔39.1% (91/233) 〕. Regarding the development of PROMs, of the 4 infertility-specific HRQoL instruments, except for the FertiQoL instrument, whose overall development quality was considered "doubtful", the overall development quality of the other three instruments was considered "inadequate". In terms of the content validity, the methodological quality of the studies on FertiQoL and QOLICQ development was rated "very good" and "doubtful", respectively, while that of the study on the TLMK or Quality of Life in People with Infertility Induced by Liver Qi Stagnation Identified by Chinese Medicine Theory scale development was rated "adequate". In terms of the construct validity, except for the study on QOLICQ development, which was of "doubtful" methodological quality, the methodological quality of studies on the other three instruments development was considered "adequate". And the construct validity was rated "indeterminate" for all these 4 instruments. In terms of the internal consistency, the methodological quality of studies on the development of the 4 instruments was rated "very good", and the internal consistency of the 4 instruments was rated "sufficient". Regarding the test-retest reliability, the methodological quality of the study on QOLICQ development was considered "doubtful" and the test-retest reliability of the instrument was rated "indeterminate". The methodological quality of studies on the Quality of Life in People with Infertility Induced by Liver Qi Stagnation Identified by Chinese Medicine Theory scale development was rated "very good" in terms of criterion validity, and the criterion validity of the instrument was rated "sufficient". The methodological quality of the study on TLMK instrument development was rated "very good" in terms of criterion validity, and the criterion validity of this instrument was rated "sufficient". As for responsiveness/sensitivity, the methodological quality of the study on FertiQoL development was rated "very good", and the responsiveness/sensitivity of the instrument was rated "sufficient".

Conclusion

The methodological quality of the study on the development of FertiQoL and the measurement properties of the instrument were much higher. The number of Chinese infertility-specific HRQoL instruments is insufficient and needs more relevant studies.

Key words: Infertility, Health-related quality of life, Instruments, Systematic review, COSMIN