The relationship between patient-reported quality of life and clinician-rated outcome scores in patients with autoimmune encephalitis: a study of the Australian Autoimmune Encephalitis Consortium.

IF 2.7 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Christina Kazzi, Nabil Seery, Sarah Griffith, Robb Wesselingh, Tiffany Rushen, Tracie H Tan, Katherine Y Ko, Liora Ter Horst, Genevieve Skinner, Laurie McLaughlin, Hannah Ford, Catherine Meade, Marie O'Shea, Katherine Buzzard, Mirasol Forcadela, Andrew Duncan, Anneke van der Walt, Wendyl D'Souza, Udaya Senvieratne, Richard Macdonell, Sudarshini Ramanathan, Stefan Blum, Stephen W Reddel, Todd A Hardy, Helmut Butzkueven, Terence J O'Brien, Rubina Alpitsis, Charles B Malpas, Mastura Monif
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Abstract

Background: Patients with Autoimmune Encephalitis (AE) commonly report poor quality of life. There is a lack of evidence on whether clinician-rated outcome measures adequately capture patient-reported experiences. This study aimed to characterise long-term quality of life in AE patients and examine its relationship with clinician-rated disability (modified Rankin Score, mRS) and symptom severity (Clinical Assessment Scale in Autoimmune Encephalitis, CASE).

Methods: Patients with AE were recruited through the Australian Autoimmune Encephalitis Consortium Project. Patients with completed NeuroQoL instruments, as well as CASE and/or mRS scores within 6 months of the NeuroQoL were included.

Results: Fifty-four patients with AE (50% female, median age at symptom onset = 49.70 years) completed the NeuroQoL instruments at a median of 50 months (IQR: 18.25-87.50 months) post-disease onset. The median CASE score was 2 (IQR: 0.0-3.0). The median mRS was 1.5 (IQR: 1.0-2.0). In the total AE sample, CASE scores were positively associated with all NeuroQoL domains (r = .42-.53), except Fatigue (r = .28). Total NeuroQoL, Cognitive Function, Satisfaction in Social Roles and Activities, and Stigma T-scores were significantly higher in seropositive AE patients with an mRS > 2 (d = 0.94-1.66). The mRS significantly predicted most NeuroQoL domains in the total AE sample, and the CASE score explained little or no additional variance over and above mRS scores. Similarly, the CASE score was significantly associated with most NeuroQoL domains, with no additional variance explained by mRS scores.

Discussion: The relationships between clinician-rated outcomes and domains of quality of life varied from weak to moderate. This highlights the importance of integrating clinical measures and patient-reported outcomes when assessing outcomes post-AE.

自身免疫性脑炎患者报告的生活质量与临床医生评价的结果评分之间的关系:澳大利亚自身免疫性脑炎联盟的一项研究
背景:自身免疫性脑炎(AE)患者通常报告生活质量差。缺乏证据表明,临床评定的结果措施是否充分反映了患者报告的经历。本研究旨在描述AE患者的长期生活质量,并研究其与临床评定的残疾(改良Rankin评分,mRS)和症状严重程度(自身免疫性脑炎临床评估量表,CASE)的关系。方法:通过澳大利亚自身免疫性脑炎联盟项目招募AE患者。包括完成NeuroQoL仪器的患者,以及在NeuroQoL的6个月内的CASE和/或mRS评分。结果:54例AE患者(50%为女性,出现症状时中位年龄49.70岁)在发病后50个月(IQR: 18.25 ~ 87.50个月)完成NeuroQoL仪器。CASE评分中位数为2分(IQR: 0.0-3.0)。中位mRS为1.5 (IQR: 1.0-2.0)。在AE总样本中,CASE评分与所有NeuroQoL域呈正相关(r = 0.42 - 0.53),除了疲劳(r = 0.28)。血清阳性AE患者的总神经质量、认知功能、社会角色和活动满意度、耻感t评分均显著高于mRS患者(d = 0.94-1.66)。mRS显著预测了AE总样本中的大多数NeuroQoL域,而CASE评分在mRS评分之上解释了很少或没有额外的方差。同样,CASE评分与大多数NeuroQoL域显著相关,mRS评分没有解释额外的方差。讨论:临床评价结果与生活质量领域之间的关系从弱到中等不等。这突出了在评估ae后结果时整合临床测量和患者报告结果的重要性。
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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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