| BackgroundWith the development of the economy and society,the people's material life is constantly enriched,and it has become an important part of today's livelihood that the people's demand for high-quality and comprehensive health services.The main task of health care is no longer the cure of the disease and not even the extension of life.Instead,it should focus on the effective control of the symptoms of the disease,promote the recovery and maintenance of the patient's function,in order to enable the patients to have a certain ability to daily life and reduce pain.Ultimately improve the quality of life and life satisfaction of patients.As the idea of "patient-centered" is continuously developed,the concept of "Patient-Reported Outcomes" is deeply rooted in the hearts of the people and attracts attention from all sectors of society.It is also an inevitable trend for future social development to pay attention to patients' feelings and changes in an all-round and multi-dimensional manner,and to measure through scientific methods.In health decision-making,for the study of the health-related quality of life,on the one hand,how to choose a suitable instrument and measurement method to accurately report the results,and on the other how to reasonably interpret the clinical important changes in its score.It is an important challenge to reasonably explain the clinical significance of the differences in the health-related quality of life scores,and it has become a current research hotspot.By measuring Patient-Reported Outcomes and health-related quality of life,and reasonably explaining their clinical significance,the effects of medical interventions can be assessed,enabling timely feedback on medical service outcomes and patient needs,and further optimizing social resources.ObjectivesThe purpose of this study is to comprehensively and systematically measure the acne patient's performance and health-related quality of life from the perspective of patient-reported outcomes,by applying multiple assessment tools such as the preference-based quality of life instruments and the skin disease-specific quality of life instruments based on non-preferences.Through follow-up data,to measure the changes in health-related quality of life of acne patients after treatment and intervention,and to provide basic data support for patient diagnosis and treatment services.Anchor-based method and the distributional-based method were used to explore and formulate the MCID of preference-based(EQ-5D)and non-preference-based skin disease-specific instrument(DLQI)for acne patients.MethodsThis was a prospective longitudinal study.The survey subjects were acne patients treated in the dermatology clinic of Qilu Hospital of Shandong University from March 2017 to January 2019.Newly diagnosed patients were included in the baseline survey,and the follow-up were at the 2nd week and the 4th week after treatment,respectively.A total of 1,263 acne patients were investigated and 1,169 were eventually included in the analysis.The sociodemographic and clinical information from acne patients were collected through a questionnaire survey,and the preference-based instruments(EQ-5D-5L,EQ-5D-3L)and non-preference-based skin disease-specific quality of life(CADI,DLQI)were used to measure the HRQoL of patients and the changes in health-related quality of life before and after treatment.MCID values of EQ-5D and DLQI were estimated based on the anchor-based method and distribution-based method.The descriptive analysis,non-parametric tests,Spearman's correlation,etc.methods were used.ResultsA total of 1169 valid acne patients were included in this study.980 were in the first visit,130 were in the first follow-up,and 57 were in the second follow-up.The proportion of women in the three survey nodes was more than 50%.The sample population as a whole was relatively young.The median of age was about 20-21 years old,which was mainly a group of students.The overall level of education was high,and the vast majority were unmarried.In terms of geographical distribution,the vast majority of patients lived in urban areas,and only about 30%of patients lived in rural areas.More than 80%of acne patients had acne more than 1 year.The proportion of patients with mild acne in the study was about 80%.The number of patients with severe acne had greatly reduced after treatment.At the three survey phases,the mean scores of EQ-5D was above 0.95.The mean scores of the EQ-5D-5L were 0.96±0.064,0.97±0.043,and 0.97±0.056,respectively.The mean scores of the DLQI scale were 6.89±4.917,5.95±4.929,and 5.37±3.876,respectively.The mean scores of the CADI scale were 5.74±2.841,5.11±2.734,and 5.04±2.679,respectively.The MCID range estimation of the EQ-5D-5L was 0.02 to 0.03 and 0.022 to 0.039 based on the anchor-based and distribution-based approaches,respectively.The MCID range estimation of the DLQI was 1.591 to 4.462 and 1.501 to 2.465 based on the anchor-based and distribution-based approaches,respectively.ConclusionsIn addition to the EQ-5D-3L,the scores of EQ-5D-5L,DLQI and CADI scale were improved after treatment.According to the results of anchor-based method and the distribution-based method,the MCID value of the EQ-5D-5L in the acne population ranges from 0.020 to 0.039.The MCID value of DLQI scale in the acne population ranges from 1.501 to 4.462. |
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