Snowden M, McCormick W, Russo J, Srebnik D, Comtois K, Bowen J, Teri L, Larson E B
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98104, USA.
J Am Geriatr Soc. 1999 Aug;47(8):1000-4. doi: 10.1111/j.1532-5415.1999.tb01297.x.
To determine the criterion validity and responsiveness to change over time of the Minimum Data Set (MDS).
Cross sectional analysis comparing prospectively collected research data with MDS data reported from nursing homes on identical subjects. Longitudinal follow-up of subjects allowed for calculation of responsiveness to change over time.
Subjects (n = 140) participating in epidemiological research on the natural history of Alzheimer's disease in the University of Washington Group Health Cooperative Alzheimer's Disease Patient Registry (ADPR) who entered nursing homes in Washington State from January 1990 through March 1996.
Spearman's correlation coefficients to compare MDS cognitive performance scale scores with Mini-Mental State Examinations (MMSE), MDS behavior domain scores with ADPR Physician Behavior checklist scores, and MDS activities of daily living (ADL) functioning scores with Dementia Rating Scale scores for ADLs. Partial correlations were used to control for the number of days between MDS and ADPR assessments, age, and function in the other two MDS ratings of ADL, cognition, or behavior. We determined responsiveness by using the mean change in an effect size (ES) calculation for each domain of interest.
MDS measures in all three domains were correlated modestly to the analogous ADPR research instruments, with correlation coefficients 0.45 for cognition, 0.50 for behavior, and 0.59 for ADL functioning. Controlling for age, time between ADPR and MDS assessments, and the MDS ratings of the other two MDS domains did not improve the correlations significantly. In a subgroup of 60 subjects followed for an average of 636 days, the Cognitive performance scale of the MDS had a slightly larger effect size (ES = 0.60) than the Folstein Mini-Mental Status Exam (ES = 0.39) used by the ADPR. However, the Dementia Rating Scale (ES = 0.77) used by the ADPR researchers reflected more change over time than the ADL domain of the MDS (ES = 0.02). The MDS behavior domain (ES = 0.058) was comparable to the research behavior checklist (ES = 0.065).
These data demonstrate reasonable criterion validity of the MDS and the MMSE, ADL, and behavior rating scales and suggest that the MDS data is of adequate validity for research purposes in these areas. The MDS was less able to capture dementia-related change in ADLs in this population of patients with dementia even though the same nursing home staff completing the MDS often supplied the information for completing the research scales. As a result, the MDS may be limited as an outcome assessment instrument.
确定最小数据集（MDS）的标准效度以及随时间变化的反应性。
横断面分析，将前瞻性收集的研究数据与养老院报告的关于相同受试者的MDS数据进行比较。对受试者进行纵向随访，以计算随时间变化的反应性。
1990年1月至1996年3月期间进入华盛顿州养老院的华盛顿大学健康合作组织阿尔茨海默病患者登记处（ADPR）中参与阿尔茨海默病自然史流行病学研究的受试者（n = 140）。
用斯皮尔曼相关系数比较MDS认知表现量表得分与简易精神状态检查表（MMSE）得分、MDS行为领域得分与ADPR医生行为检查表得分，以及MDS日常生活活动（ADL）功能得分与痴呆评定量表中ADL得分。偏相关用于控制MDS和ADPR评估之间的天数、年龄以及ADL、认知或行为的其他两个MDS评定中的功能。我们通过对每个感兴趣领域的效应量（ES）计算的平均变化来确定反应性。
所有三个领域的MDS测量值与类似的ADPR研究工具的相关性中等，认知领域相关系数为0.45，行为领域为0.50，ADL功能领域为0.59。控制年龄、ADPR和MDS评估之间的时间以及其他两个MDS领域的MDS评定，并未显著提高相关性。在平均随访636天的60名受试者亚组中，MDS的认知表现量表的效应量（ES = 0.60）略大于ADPR使用的Folstein简易精神状态检查（ES = 0.39）。然而，ADPR研究人员使用的痴呆评定量表（ES = 0.77）随时间反映的变化比MDS的ADL领域（ES = 0.02）更多。MDS行为领域（ES = 0.058）与研究行为检查表（ES = 0.065）相当。
这些数据证明了MDS以及MMSE、ADL和行为评定量表具有合理的标准效度，并表明MDS数据在这些领域用于研究目的时具有足够的效度。尽管完成MDS的通常是同一养老院工作人员且他们也提供完成研究量表的信息，但在这群痴呆患者中，MDS捕捉与痴呆相关的ADL变化的能力较弱。因此，MDS作为结局评估工具可能存在局限性。
