Dionne C E, Von Korff M, Koepsell T D, Deyo R A, Barlow W E, Checkoway H
Department of Epidemiology, University of Washington, Seattle, USA.
Spine (Phila Pa 1976). 1999 Nov 15;24(22):2339-45. doi: 10.1097/00007632-199911150-00009.
We conducted a prospective study with a 2-year follow-up.
To compare pain, functional limitations, and work status indices as measures of outcome among back pain patients.
Work status, pain, and functional limitations indices are often considered as interchangeable outcome measures in back pain research. This perspective has been criticized by several authors, who argue that each of these outcome measures reflects a different construct that may vary independently of the others.
The study was conducted on 720 patients, who sought care for back pain in primary care settings of a large health maintenance organization in 1989-90, and were interviewed one month and two years later. X2 analyses and receiver operating characteristic curves were used to compare the accuracy of a pain rating and a modified 16-item Roland-Morris score in classifying patients on work status and on the change in work status over time.
Moderate agreement between the pain and functional limitations measures and work status was observed. Pain and functional limitations change scores agreed moderately with improvement in work status, but were poorly associated with decline in work status.
Although the pain, functional limitations, and work status indices examined in this study are related, they are not equivalent and should not be regarded as interchangeable. These results argue for a clearer distinction of outcome measures in back pain research.
我们进行了一项为期两年随访的前瞻性研究。
比较疼痛、功能受限及工作状态指标，以此作为背痛患者的预后衡量指标。
在背痛研究中，工作状态、疼痛及功能受限指标常被视为可互换的预后衡量指标。这一观点受到了多位作者的批评，他们认为这些预后衡量指标中的每一个都反映了一种不同的结构，可能独立于其他指标而变化。
该研究针对720名患者开展，这些患者于1989 - 1990年在一家大型健康维护组织的初级保健机构寻求背痛治疗，并在1个月及2年后接受访谈。采用X²分析和受试者工作特征曲线，比较疼痛评分和改良的16项罗兰 - 莫里斯评分在根据工作状态及工作状态随时间变化对患者进行分类时的准确性。
观察到疼痛和功能受限指标与工作状态之间存在中度一致性。疼痛和功能受限变化评分与工作状态改善有中度一致性，但与工作状态下降相关性较差。
尽管本研究中所考察的疼痛、功能受限及工作状态指标相关，但它们并不等同，不应被视为可互换的。这些结果表明在背痛研究中应更明确地区分预后衡量指标。
