EVALUATION OF INDEX AND PROFILE MEASURES OF HEALTH-STATUS IN A RANDOMIZED CONTROLLED TRIAL - COMPARISON OF THE MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM HEALTH SURVEY, EUROQOL, AND DISEASE-SPECIFIC MEASURES

OBJECTIVES. The authors compare two generic measures of health status with disease-specific measures in a randomized controlled trial of tra nsurethral resection of the prostate with laser vaporization prostatec tomy for benign prostatic hypertrophy. METHODS. Patients entered into the trial completed the following questionnaires prior to treatment an d at follow-up at 3 months and 1 year. The Medical Outcomes Study 36-I tem Short Form Health Survey (SF-36) is a generic measure that produce s an eight-dimension profile as well as two summary measures of health status (the physical component score and the mental component score). The EuroQol provides two single index measures of health status; one intended to convey the utility (or lack of) that an individual derives from his or her own health state compared with alternative states and a second simple visual analog scale ''thermometer'' of health status. The American Urological Association symptom score and the Bothersome index are disease-specific indices of health status for use specifical ly with benign prostatic hypertrophy patients. RESULTS. The EuroQol in dicates no statistically significant improvements with time for either arm of the trial. The SF-36 physical and general health perceptions d omains indicates statistically significant improvements for the transu rethral resection of the prostate arm alone at 3 months and 1 year, as do the physical summary score at the 3-month follow-up visit. The eff ect sizes of these improvements, however, are small, using standard cr iteria. In contrast, statistically significant differences are found w ith time for both transurethral resection of the prostate and laser pr ostatectomy on both disease-specific measures; which also indicate sta tistically significant superior outcome for the transurethral resectio n of the prostate arm compared with the laser arm. CONCLUSIONS. The re sults indicate that the disease-specific measures are more sensitive t o change than the generic measures of outcome. Possible explanations f or this are discussed.