EuroQol-5 Dimension에서 시각아날로그척도 점수에 대한 각 영역들의 영향요인 평가
Effect of EuroQol-5 Dimension on Visual Analogue Scale in Korean Population
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배경: EuroQol-5 Dimension (EQ-5D)은 질 보정 수명측정 같은 비용-효용 분석에서 가장 빈번히 사용되는 도구임에도 개인들의 시각아날로그척도 점수와 EQ-5D 영역들 간의 관계에 대한 연구는 드물었다. 이 연구의 목적은한국 일반인구집단에서 인구사회학적 정보를 보정한 후에시각아날로그척도로 측정한 삶의 질 점수와 EQ-5D 영역들 간의 관계를 평가하고자 함이다. 방법: 시각아날로그척도 점수에 대한 EQ-5D 영역들의영향을 분석하기 위해 국가 대표 표본인 4기 국민건강영양조사 자료를 사용하였다. 시각아날로그척도에 대한 알려진 집단에 따른 구성 타당도는 연령, 수입, 동반질환 같은요소들로 평가하였다. 시각아날로그척도 점수에 대한EQ-5D 영역들의 영향을 인구사회학적 요인과 임상적 요인을 보정하여 다중 선형회귀분석으로 분석하였다. 결과: 시각아날로그척도는 좋은 구성 타당도를 보였다. 시각아날로그 척도 점수는 연령이 증가할수록, 교육과 소득 수준이 감소할수록 유의하게 감소하였다. 시각아날로그 척도 점수는 모든 EQ-5D 영역에서 응답 수준이 높아질수록 감소하였다. EQ-5D 영역들과 수준만을 포함한 모델 1에서 시각아날로그척도의 설명력은 22.9%였고, 모델1에 인구학적 그리고 임상적 요인까지 포함한 모델 2에서는 시각아날로그척도의 설명력이 31.3%로 증가하였다. 결론: EQ-5D 영역들은 시각아날로그척도 점수의 유의한 요인이었지만, 시각아날로그척도 점수의 변이를 충분히 설명하지 못했다. 선호도 기반 삶의 질 측정도구인EQ-5D에 다른 영역을 더하는 것에 대한 추가 연구가 필요할 것이다.
Abstract
Background: The EuroQol-5 Dimension (EQ-5D) is the most frequently used questionnaire in cost-utility studies such as the quality-adjusted life year measure. Nevertheless, little attention has been paid to the relationship between an individual’s visual analogue scale (VAS) score and EQ-5D dimensions. The objective of this study was to assess the relationship between the EQ-5D and VAS quality of life measures after adjusting for socio-demographic factors in the Korean general population. Methods: The Fourth Korea National Health and Nutrition Examination Survey, which is a national representative sample, was used to analyze the impact of the EQ-5D dimensions on the VAS. The known-group construct validity of the VAS was assessed by factors that included age, income and comorbidities. The ordinary linear regression models were applied to test for the effect of the EQ-5D dimensions after adjusting for socio-demographic and clinical factors. Results: We found that the VAS showed good construct validity. The VAS significantly declined as age increased,and as education and income levels decreased. VAS scores decreased for all EQ-5D dimensions as the response level rose. The explanatory power of the VAS increased from 23.0% in the first model, which included only the EQ-5D dimensions and levels, to 25.0% in the full model, which included socio-demographic and clinical factors. Conclusions: While the EQ-5D dimensions were significant factors in determining the VAS, they did not, however,explain a sufficient amount of variance in the VAS. Further research is required on adding more dimensions to the EQ-5D preference-based instrument.
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