Merkies I S J, Schmitz P I M, van der Meché F G A, Samijn J P A, van Doorn P A
Department of Neurology, University Hospital Rotterdam/Erasmus University, dr Molewaterplein, Rotterdam, Netherlands.
J Neurol Neurosurg Psychiatry. 2002 May;72(5):596-601. doi: 10.1136/jnnp.72.5.596.
To determine the validity, reliability, and responsiveness of a new overall disability sum score in immune mediated polyneuropathies.
Three impairment measures (MRC sum score, sensory sum score, grip strength (Vigorimeter)) and three disability scales (an overall disability sum score (ODSS), Hughes' functional scale (f score), Rankin scale) were assessed in a cross sectional group of 113 clinically stable patients (83 with Guillain-Barré syndrome, 22 with chronic inflammatory demyelinating polyneuropathy (CIDP), eight with a gammopathy related polyneuropathy). The ODSS was also used serially in 20 patients with recently diagnosed Guillain-Barré syndrome (n = 7) or CIDP (n = 13) and changing clinical conditions. Multiple regression studies were performed to compare the impact of impairment disturbances (independent variables) on the various disability scales (dependent variable).
Moderate to good construct validity (stable group: Spearman's rank test (absolute values), r = 0.41-0.79; longitudinal group: multiple correlation coefficient, R = 0.69-0.89; p < 0.006 for all associations) and reliability (intraclass correlation coefficient, R = 0.90-0.95; p < 0.0001) were demonstrated for the ODSS. Its SRM values were high (> 0.8), indicating good responsiveness. Impairment measures accounted for a higher variance proportion of the ODSS compared with the f score and Rankin (R = 0.64 v 0.56 and 0.45, respectively).
All clinimetric requirements were met by the overall (arm and leg) disability sum score in immune mediated polyneuropathies. Its use is therefore suggested in evaluating immune mediated polyneuropathies.
确定免疫介导性多发性神经病新的整体残疾总分的有效性、可靠性和反应性。
对113例临床稳定的患者（83例吉兰 - 巴雷综合征、22例慢性炎症性脱髓鞘性多发性神经病（CIDP）、8例与丙种球蛋白病相关的多发性神经病）的横断面组进行了三项损伤测量（医学研究委员会总分、感觉总分、握力（测力计））和三项残疾量表（整体残疾总分（ODSS）、休斯功能量表（f评分）、兰金量表）评估。ODSS也在20例近期诊断为吉兰 - 巴雷综合征（n = 7）或CIDP（n = 13）且临床状况不断变化的患者中进行了连续使用。进行了多元回归研究，以比较损伤障碍（自变量）对各种残疾量表（因变量）的影响。
ODSS显示出中度至良好的结构效度（稳定组：斯皮尔曼等级检验（绝对值），r = 0.41 - 0.79；纵向组：复相关系数，R = 0.69 - 0.89；所有关联p < 0.006）和可靠性（组内相关系数，R = 0.90 - 0.95；p < 0.0001）。其标准化反应均值（SRM）值较高（> 0.8），表明反应性良好。与f评分和兰金量表相比，损伤测量占ODSS的方差比例更高（分别为R = 0.64对0.56和0.45）。
免疫介导性多发性神经病的整体（手臂和腿部）残疾总分满足所有临床测量要求。因此建议在评估免疫介导性多发性神经病时使用该量表。
