| 引用本文：孙菊,郭倩,李浩淼,等.心血管病高危人群健康效用测量工具的选择：EQ-5D-5L与SF-6Dv2的应用验证[J].中国卫生政策研究,2025,18(8):20-28 |
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| 心血管病高危人群健康效用测量工具的选择：EQ-5D-5L与SF-6Dv2的应用验证 |
| 投稿时间：2025-07-07 修订日期：2025-08-06 PDF全文浏览 HTML全文浏览 |
| 孙菊1,2，郭倩1，李浩淼1,2，姚强1,2，祝淑珍3，李俊琳3 |
| 1.武汉大学政治与公共管理学院 湖北武汉 430072;2.武汉大学健康治理研究中心 湖北武汉 430072;3.湖北省疾病预防控制中心 湖北武汉 430079 |
| 摘要:目的 以我国心血管病（Cardiovascular Diseases，CVD）高危人群筛查与干预项目为应用场景，系统评估EQ-5D-5L和SF-6Dv2量表在心血管病高危人群中的适用性。方法 采用Spearman相关系数比较两量表聚合效度；采用组内相关系数（ICC）、Bland-Altman图比较一致性，并采用多元线性回归分析探讨两量表效用差异的影响因素；采用Kruskal-Wallis检验和t检验比较区分度；采用效应量（ES）、相对效率（RE）和ROC曲线下面积（ROC-AUC）比较灵敏度；比较天花板效应与地板效应。结果 5 415个CVD高危人群中，两量表聚合效度较好，但各维度相关性较差，且测量结果一致性水平较低（ICC=0.367）。两量表对健康状况的区分度均较好，但SF-6Dv2的灵敏度更优且天花板效应更轻微。结论 在测量心血管病高危人群健康效用值时，量表选择需审慎，尤其是针对风险级别较高群体，使用SF-6Dv2更合适。 |
| 关键词:CVD EQ-5D-5L SF-6Dv2 健康效用值 |
| 基金项目:湖北省疾病预防控制中心项目（202505004） |
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| Selection of health utility measurement tools for high-risk populations with cardiovascular disease： Application validation of EQ-5D-5L and SF-6Dv2 |
| SUN Ju1,2, GUO Qian1, LI Hao-miao1,2, YAO Qiang1,2, ZHU Shu-zhen3, LI Jun-lin3 |
| 1.School of Political Science and Public Administration， Wuhan University， Wuhan Hubei 430072， China;2.The Research Center for Health Governance， Wuhan University， Wuhan Hubei 430072， China;3.Hubei Province Center for Disease Control and Prevention， Wuhan Hubei 430079， China |
| Abstract:Objective In the context of China's cardiovascular disease （CVD） high-risk population screening and intervention project， this study systematically evaluates the applicability of the EQ-5D-5L and SF-6Dv2 instruments among individuals at high risk of CVD.Methods Convergent validity was assessed using Spearman's correlation coefficient. Measurement agreement was evaluated through intraclass correlation coefficients （ICC） and Bland-Altman plots. Factors influencing utility differences were explored using multiple linear regression analysis. Kruskal-Wallis test and t-test were used to examine discriminant validity. Sensitivity was compared by effect size （ES）， relative efficiency （RE）， and the area under the receiver operating characteristic curve （ROC-AUC）. Floor and ceiling effects were also compared.Results Among 5，415 individuals at high risk of CVD， the two instruments showed moderate overall correlation and acceptable convergent validity， but dimension-specific correlations were weak， and measurement consistency was low （ICC=0.367）. Both instruments effectively distinguished different health states， yet the SF-6Dv2 demonstrated superior sensitivity and a milder ceiling effect.Conclusion When measuring the health utility value of CVD patients， scale selection should be cautious， especially for high-risk groups， and SF-6Dv2 is more appropriate. |
| Key words:Cardiovascular Diseases EQ-5D-5L SF-6Dv2 Health utility value |
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