Evaluation Of Graves Orbitopathy Quality Of Life And Correlation Analysis Of Its Influencing Factors

Chapter 1 Evaluation of Quality of Life in Graves Orbitopathy Population first diagnosed and correlation analysis of its influencing factorsObjective to assess the life of Graves orbitopathy(GO)though using Graves orbitopathy quality-of-life questionnaire(GO-QOL)and explore the influence factors in connection with the quality of life,so as to provide basis for clinical evaluation of disease.Methods A cross-sectional study was conducted at The Third Affillated Hospital of Southern Medical University,on 145 Graves orbitopathy patients who answered the GO-QOL before undergoing comlete ophthalmic and endocrine assessment.The main outcome measures were the GO-QOL and its 2 subscales,Visual Functioning and Appearance.Based on the EUGOGO classification,the patients were divided into two groups,mild and moderate to severe.Then the scales between these two groups were compared and relevant influencing factors were analyzed.Finally,the floor and ceiling effects were assessed.Results The QOL scores for the subscales Visual Functioning and Appearance were(mean±SD)70.91±27.83 and 61.29±26.37 respectively.Visual Functioning and Appearance were lower in moderate to severe group 62.71±28.77 and 57.52±26.49 than in mild group 85.58±18.77and 68.02±24.99.The QOL scores for the Visual Functioning subscale were significantly correlated with age,Clinical activity scoreand the degree of diplopia(R2=0.373,P<0.05).The QOL scores for the Appearance were significantly correlated with sex and Thyroid-stimulating hormone(R2=0.231,P<0.05).Significant celing effects(>15%at the highest value of the subscale)were observed for Visual Functioning subscale of the GO-QOL.Conclusion With the aggravation of the disease,the quality of life of Graves orbitopathy patients is getting worse and worse.The main influencing factors of the quality of life of Graves orbitopathy patients include age,gender,diploia,Clinical activity scoreand Thyroid-stimulating hormone.The quality of life of Graves orbitopathy patients need attention.Chapter 2 Evaluation of quality of life in patients with Graves Orbitopathy before and after different treatmentObjective To.explore the extent to which the GO-QOL can demonstrate discriminant validity.That is,whether the GO-QOL can distinguish between patient populations based on clinician ratings of improvement so as to provide a basis for clinical efficacy evaluation.Secondly,to assess the changes in quality of life of patients after treatment of Graves orbitopathy.Methods A longitudinal,interventional study in which 38 patients who had intravenous Steroids or the combination of Radiotherapy and intravenous steroids at The Third Affiliated Hospital of Southern Medical University were given the Graves orbitopathy quality of life questionnaire(GO-QOL)before and after treament.The objective indicators of significant improvement in this study were then divided into two groups,the improvement group and the non-improvement group,based on the objectively effective criteria for evaluating the clinical prognosis of the EUGOGO recommendations.The difference of the average scores of GO-QOL changes between these groups was analyzed.Finally,the quality of life of Graves Orbitopathy patients after treatment was analyzed.Results The GO-QOL showed discriminant validity with the Visual function subscale being able to detect changes in groups identified by clinicians(using EUGOGO recommendations for assessing response to intervention in clinical trials).A significant,long-term,improvement in quality of life after two Two treatment groups was noted(P<0.05).In the group with intravenous Steroids,the QOL-scores increased 17.05(mean)on the Appearance subscale(P<0.01).In the group with the combination of Radiotherapy and intravenous steroids,the QOL-scores increased 16.27(mean)on the Visual functioning subscale.Both two treatment groups has a positive effect on quality of life for patients with severe GO.The GO-QOL score of 84.6%of the patients after treatment was lower than 90,with impaired quality of life.Conclusion In the clinical treatment process,the GO-QOL scale is in the same direction as the improvement of clinical objective indicators.It provide support for the Chinese translation of the GO-QOL as an outcome measure for patients with moderately severe active Graves orbitopathy.Both intravenous Steroids or the combination of Radiotherapy and intravenous steroids treatment can improve the quality of life of patients with Graves orbitopathy,and most of them still suffer from different degrees of quality of life impairment after treatment.