Calvo F A, Calvo A, Berrocal A, Pevez C, Romero F, Vega E, Cusi R, Visaga M, De La Cruz R A, Alarcón G S
Department of Medicine, The University of Alabama at Birmingham, 35294, USA.
J Rheumatol. 1999 Mar;26(3):536-9.
To test the reliability and validity of a self-administered 36 joint count developed after the Rapid Assessment of Disease Activity in Rheumatology (RADAR) questionnaire for assessing pain/tenderness.
Two self-administered formats (mannequin and text) were evaluated in 60 patients with rheumatoid arthritis (RA). Reliability between both formats was tested by Spearman rank correlation. Criterion validity/accuracy was tested by Spearman correlation coefficient between each self-report format and a joint count performed by a physician. Construct validity was ascertained by correlation of each format with other variables of disease activity.
Reliability between the 2 formats was high (R = 0.94). Correlations between each format and the physician's joint count were also high (R = 0.77 for mannequin, 0.75 for text). Patients consistently rated their joint pain/tenderness higher than the physician (means 29, 27, and 12 for text, mannequin, and physician, respectively; p < 0.01). Construct validity of the text, mannequin, and physician formats compared with the modified Health Assessment Questionnaire showed R = 0.61, 0.65, 0.63; with Steinbrocker functional class R = 0.41, 0.46, 0.56; with pain R = 0.59, 0.61, 0.62; with global evaluation R = 0.66, 0.71, 0.84; and with morning stiffness R = 0.64, 0.59, 0.60, respectively.
Although both self-administered formats exhibited adequate reliability and construct validity, a systematic difference between patient and physician/trained assistant performed joint counts was observed, with patients consistently rating their pain/tenderness higher. We thus do not believe they can replace standard physician/trained assistant evaluation in obtaining clinical research data in rheumatology.
测试在类风湿病疾病活动快速评估（RADAR）问卷之后开发的用于评估疼痛/压痛的36关节自我计数法的可靠性和有效性。
对60例类风湿关节炎（RA）患者评估了两种自我管理形式（人体模型和文字）。通过Spearman等级相关性检验两种形式之间的可靠性。通过每种自我报告形式与医生进行的关节计数之间的Spearman相关系数来测试标准效度/准确性。通过每种形式与疾病活动的其他变量的相关性来确定结构效度。
两种形式之间的可靠性很高（R = 0.94）。每种形式与医生的关节计数之间的相关性也很高（人体模型R = 0.77，文字R = 0.75）。患者对关节疼痛/压痛的评分始终高于医生（文字、人体模型和医生的平均分分别为29、27和12；p <0.01）。与改良的健康评估问卷相比，文字、人体模型和医生形式的结构效度显示R = 0.61、0.65、0.63；与Steinbrocker功能分级相比R = 0.41、0.46、0.56；与疼痛相比R = 0.59、0.61、0.62；与整体评估相比R = 0.66、0.71、0.84；与晨僵相比R = 0.64、0.59、0.60。
尽管两种自我管理形式都表现出足够的可靠性和结构效度，但观察到患者与医生/受过培训的助手进行的关节计数之间存在系统差异，患者对疼痛/压痛的评分始终更高。因此，我们认为在获取风湿病临床研究数据时，它们无法取代标准的医生/受过培训的助手评估。
