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우리나라 성인에서 일부 질환과 연관된 건강관련 삶의 질 감소
길선령,이상일,윤성철,안형미,조민우,Kil, Seol-Ryoung,Lee, Sang-Il,Yun, Sung-Cheol,An, Hyung-Mi,Jo, Min-Woo 대한예방의학회 2008 예방의학회지 Vol.41 No.6
Objectives: This study was conducted to measure the decline in the health-related quality of life (HRQoL) associated with some diseases in South Korean adults. Methods: The EQ-5D health states in the 2005 National Health and Nutrition Examination Survey (NHNES) and the Korean EQ-5D valuation set were used to obtain the EQ-5D indexes of the study subjects. Each disease group was defined when the subjects reported to the NHNES that they were diagnosed with the corresponding disease during the previous 1 year by physicians. Since the distributions of the EQ-5D indexes in each subgroup were negatively skewed, median regression analysis was used to estimate the effects of specific diseases on the HRQoL. Median regression analysis produced estimates that approximated the median of the EQ-5D indexes and there are more robust for analyzing data with many outliers. Results: A total of 16,692 subjects (6,667 patients and 10,025 people without any disease) were included in the analysis. As a result of the median regression analysis, stroke had the strongest impact on the HRQoL for both males and females, followed by osteoporosis, osteoarthritis, rheumatic arthritis, and herniation of an intervertebral disc. While asthma had a significant impact on the HRQoL only in men, cataract, temporo-mandibular dysfunction, and peptic ulcer significantly affected the HRQoL only in women. Conclusions: Stroke and musculoskeletal diseases were associated with the largest losses of the HRQoL in Korean adults.
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EQ-5D 건강상태에 대한 가치 평가 작업의 타당도와 신뢰도 평가: 컴퓨터 보조프로그램을 이용한 표준도박
조민우,권동섭,김선하,길선령,이상일 대한임상건강증진학회 2010 Korean Journal of Health Promotion Vol.10 No.3
연구배경: 건강상태별 효용 수준을 살펴보기 위해서는 표준도박법을 적용하여 건강상태에 대한 가치 평가 작업을 수행해야 하나 우리나라에서는 아직 표준도박법을 이용하여 가치 평가 작업을 수행한 바 없다. 이 연구는 우리나라 일반 인구집단을 대상으로 EQ-5D 건강상태에 대해 인터넷 보조도구를 활용하여 표준도박법으로 가치 평가하는 작업의 타당도와 신뢰도를 평가하기 위하여 수행하였다. 방법: 먼저 EQ-5D 건강상태에 대해서 표준도박법으로 가치 평가하기 위하여 인터넷 보조프로그램을 개발한 후, 가치 평가 작업을 수행하였다. 가치 평가 작업을 수행할 연구참여자는 경주시 인명전화번호부에서 무작위로 선택하여 20대부터 60대 이상까지 10세 단위로 남녀별로 3명씩 모집하였다. 43개 건강상태에 대해 시각 아날로그 척도법, 시간교환법, 그리고 표준도박법을 이용하여 가치 평가 작업을 수행하였다. 검사-재검사 신뢰도를 살펴보기 위하여 첫 번째 조사 4주 후에 두 번째 조사를 진행하였고, 두 번째 조사에서도 같은 방법으로 연구를 진행하였다. 타당도는 각 가치 평가 방법에 따른 모순값의 수를 살펴보고, 더불어 각 방법으로 구한 가중치 간 상관관계를 살펴보았다. 그리고 신뢰도는 급내상관계수를 이용하여 살펴보았다. 결과: 가치평가작업을 위해 인터넷 보조프로그램을 개발하였다. 그리고 1차 조사에서는 29명의 참가자가 참여를 하였고, 2차 조사에는 이 중 22명의 참가자가 참여하였다. 1차 조사에서 시각 아날로그 척도법, 시간교환법, 그리고 표준도박법에서 4개 이상의 모순값을 보인 참가자는 각각 2명, 9명, 그리고 5명이었다. 더불어 표준도박법과 시각 아날로그 척도법, 표준도박법과 시간교환법 간의 피어슨 상관계수는 0.867과 0.894였고, 유의확률은 모두 0.001 미만으로 통계적으로 유의하였다. 개인수준에서의 급내상관계수는 시각 아날로그 척도법, 시간교환법, 그리고 표준도박법에서 각각 0.919, 0.701, 그리고 0.805로 나타났다. 결론: 인터넷 보조프로그램을 개발하고 이를 이용하여 표준도박법으로 EQ-5D 건강상태에 대한 가치평가작업을 수행한 결과, 모순값과 수렴타당도 측면에서 살펴본 타당도는 받아들일만하다고 판단되었고, 조사-재조사 방법으로 살펴본 신뢰도는 높은 수준으로 나타나 인터넷 보조도구를 활용하여 표준도박법으로 EQ-5D 건강상태에 대해 가치평가작업을 수행하는 것이 타당하고 신뢰도가 있는 방법으로 나타났다. Background: The Standard Gamble (SG) method is the gold standard for valuing health states as a utility. The objective of this study is to examine the validity and reliability of EQ-5D valuation task using a computer-assisted SG method in the general population of South Korea. Methods: An internet-based computer program was developed to allow respondents to conveniently conduct a valuation of EQ-5D health states with SG. For the first survey, 29 persons were recruited randomly from the general population in Gyeongju city. Of these, 22 participated in the second survey. Direct valuation was elicited for 43 health states (42 EQ-5D health states and ‘unconscious’ state) during face-to-face interviews through an internet program with a visual analogue scale (VAS), time trade-off (TTO), and SG method. Validity was assessed using the number of respondents with 4 or more inconsistencies and the relationship between VAS, TTO, and SG values. Intra-class correlation coefficient (ICC) was calculated to evaluate the test-retest reliability. Results: Of the 29 respondents in the first survey, 5 had 4 or more inconsistent responses compared with 2 in VAS and 9 in TTO. Pearson's correlation coefficient of SG-VAS and SG-TTO were 0.867 and 0.894, respectively (P<0.001). The relational formulas were SG=1-(1-VAS)0.962 (R2=0.926) and SG=1-(1-TTO)0.932 (R2=0.868). The medians of individual ICC of VAS, TTO, and SG were 0.919, 0.721, and 0.860, respectively. Conclusions: We found that the internet-assisted SG method can be used as a valid and reliable tool for valuing EQ-5D health states in the general population of South Korea.
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EQ-5D를 이용한 일개 광역시 성인의 건강관련 삶의 질 측정
조민우 ( Min Woo Jo ),이상일 ( Sang Il Lee ),길선령 ( Seol Ryoung Kil ),이지호 ( Ji Ho Lee ),강위창 ( Wee Chang Kang ),손혜숙 ( Hae Sook Sohn ),유철인 ( Cheol In Yoo ) 한국보건행정학회 2008 보건행정학회지 Vol.18 No.3
Measurements of health related quality of life can be used to compare patients with specific conditions to average individuals in the general population in a similar age and gender group. However there are few data available regarding health related quality of life for the general population of Korea. Therefore, this study was conducted to examine the validity of the Korean version of EQ-5D and to measure the health related quality of life of the general adult population in a metropolitan city. The survey was cross-sectional and employed a stratified and multistage sampling design through 100 examination sites in 5 districts of Ulsan. A total of 12,644 individuals from 4,112 households participated in the survey. Of these, we analyzed data from 8,068 adults who were over 19 years old and completed the EQ-5D. To examine the validity of the questionnaire, the differences in 5 dimensions and the EQ-5Dindex were analyzed with regard to demographic and socioeconomic factors such as sex, age, income, and education. In addition, visual analogue scales (VAS) were used to evaluate the overall health related quality of life issues of the respondents. The level of health related quality of life of the general adult population was then compared with the results from the third Korean National Health and Nutrition Examination Survey and other countries. There were a small number of people with problems related tomobility, self-care, and usual activity. In addition, many people complained ofpain/discomfort and anxiety/depression. The complaint rate in each dimension, VAS, and EQ-5Dindex indicated relatively better states for males, the younger group, the higher income group, and the higher education group. In addition, the level of health related quality of life of the general population of Ulsan was relatively higher than that of Koreans nationwide as well as the populations of other countries. EQ-5D provided a valid measure of the health-related quality of life of the general adult population. In addition, the results of a survey of Ulsan revealed that the quality of life of its population is better than that of the overall population of Korea and of the populations of other countries.
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