Bierma-Zeinstra S M, Bohnen A M, Bernsen R M, Ridderikhoff J, Verhaar J A, Prins A
Department of General Practice, Surgery, Erasmus University, The, Rotterdam, Netherlands.
J Clin Epidemiol. 2001 Nov;54(11):1139-45. doi: 10.1016/s0895-4356(01)00398-5.
No validated classification system of hip disorders in primary care is available. This study explores whether it is possible to obtain such a classification with the method of cluster analyses. A total of 224 consecutive patients aged 50 years or older, consulting the general practitioner for pain in the hip region, and referred for X-ray investigation of the hip, underwent a standardized examination. Ward's cluster analysis with variables from history and physical examination of the hip region resulted in a classification with nine different clusters. These clusters were reproduced in 10 random subsamples and with an alternative cluster analysis. Significant relationships of various external variables (radiological and sonographic signs and variables of low-back and knee examination) with the distinctive clusters were found. Twenty of the approached experts recognized the symptoms in seven clusters as identifiable syndromes. However, further validation of the achieved classification system, especially with respect to the clinical importance, is needed before introducing it into clinical practice.
在初级保健中，尚无经过验证的髋关节疾病分类系统。本研究探讨了是否有可能通过聚类分析方法获得这样一种分类系统。共有224名50岁及以上的连续患者因髋部疼痛咨询全科医生，并被转诊进行髋部X线检查，他们均接受了标准化检查。对髋部病史和体格检查的变量进行沃德聚类分析，得出了一个包含九个不同类别的分类。这些类别在10个随机子样本中以及通过另一种聚类分析得到了重现。发现了各种外部变量（放射学和超声体征以及腰椎和膝关节检查变量）与不同类别的显著关系。20位受访专家认为七个类别的症状可识别为综合征。然而，在将所获得的分类系统引入临床实践之前，需要对其进行进一步验证，尤其是在临床重要性方面。
