Wolfe Frederick
National Data Bank for Rheumatic Diseases-Arthritis Research Center Foundation and University of Kansas School of Medicine, Wichita, Kansas 67214, USA.
J Rheumatol. 2003 Feb;30(2):369-78.
To develop and validate a pain scale that measures the extent of body pain.
A total of 12,799 patients with rheumatoid arthritis (RA), osteoarthritis (OA), and fibromyalgia (FM) completed a mailed survey regarding the location and intensity of their pain in 38 articular and nonarticular regions. The data were analyzed using item response theory (IRT) by nonparametric Mokken analysis followed by Rasch analysis. The resultant scale was examined for its association with clinical severity variables and its ability to distinguish patients diagnosed with and without FM.
The resultant 19 item regional pain scale (RPS) was composed primarily of nonarticular regions. The scale had strong scalability as measured by the Mokken H statistic (H = 0.52), and satisfied the Mokken monotonicity and double monotonicity criteria. The RPS also fit the Rasch model and had satisfactory reliability and separation statistics. Of all clinical variables assessed by survey, the RPS best identified patients diagnosed with FM. In addition, the scale correlated with measures of clinical severity, regardless of diagnosis, and predicted measures of utilization.
The RPS is a valid scale of pain extent. It can be useful to identify patients with FM or can be used to develop a new definition of FM, even among patients with concomitant illnesses such as RA and OA. In addition, it is a measure of pain extent that is disease independent, and works as well in RA and OA as in FM to identify patients with increased severity and resource utilization.
开发并验证一种用于测量身体疼痛程度的疼痛量表。
共有12799例类风湿性关节炎（RA）、骨关节炎（OA）和纤维肌痛（FM）患者完成了一项邮寄调查，内容涉及他们在38个关节和非关节区域的疼痛位置及强度。数据采用项目反应理论（IRT）进行分析，先通过非参数莫肯分析，再进行拉施分析。对所得量表进行检查，以确定其与临床严重程度变量的相关性以及区分诊断为FM和未诊断为FM患者的能力。
最终得到的19项区域疼痛量表（RPS）主要由非关节区域组成。该量表通过莫肯H统计量（H = 0.52）测量具有很强的可扩展性，并满足莫肯单调性和双重单调性标准。RPS也符合拉施模型，具有令人满意的信度和区分度统计量。在调查评估的所有临床变量中，RPS最能准确识别诊断为FM的患者。此外，该量表与临床严重程度指标相关，与诊断无关，并能预测使用情况指标。
RPS是一种有效的疼痛程度量表。它有助于识别FM患者，或可用于制定FM的新定义，即使在患有RA和OA等伴发疾病的患者中也是如此。此外，它是一种与疾病无关的疼痛程度测量方法，在RA和OA患者中与在FM患者中一样，都能很好地识别病情更严重和资源利用增加的患者。
