Sanders James O, Polly David W, Cats-Baril William, Jones JoAnn, Lenke Larry G, O'Brien Michael F, Stephens Richards B, Sucato Daniel J
Shriners Hospitals for Children, Erie, Pennsylvania, USA.
Spine (Phila Pa 1976). 2003 Sep 15;28(18):2158-63. doi: 10.1097/01.BRS.0000084629.97042.0B.
This study evaluates the Walter Reed Visual Assessment Scale (WRVAS) compared with clinical parameters and written descriptions of the deformity from idiopathic scoliosis patients and their parents.
The WRVAS demonstrates seven visible aspects of spinal deformity in an analogue scale. Higher scores reflect worsening deformity.
The WRVAS was administered to 182 idiopathic scoliosis patients at four centers in conjunction with open-ended questions about patients' and their parents' perceptions of their spinal deformity. The open-ended responses were categorized as either "deformity noted" or "no deformity noted."
WRVAS scores strongly correlate with curve magnitude (P = 0.01) and clearly differentiates curves of 30 degrees or more from lesser curves. Among treatment groups, patients with surgery recommended had significantly higher scores than that of other patients. The instrument differentiated those noting no deformity from those noting a deformity. The correlation between patients' and parents' scores was high (Spearman's rho = 0.8). When a deformity was noted, parents gave higher scores than did their children for rib prominence, shoulder level, scapular rotation, and the total score, but not for the other dimensions.
Increasing scores of the WRVAS are strongly correlated with curve magnitude lending construct validity to this type of assessment tool. Patients with "surgery recommended" report more visible deformity on the scale than observed, braced, and postoperative patients, supporting the hypothesis that surgery improves the perceived appearance. Parents perceive more deformity of the ribs and shoulders more than did the patients, but other aspects of the deformity are identified equally. WRVAS scores correlate significantly with curve magnitude and treatment. Parents and patients have similar scores, but with parents perceiving more deformity of the ribs and shoulders than patients.
本研究将沃尔特·里德视觉评估量表（WRVAS）与特发性脊柱侧凸患者及其父母对畸形的临床参数和书面描述进行比较。
WRVAS以类似量表的形式展示脊柱畸形的七个可见方面。分数越高表明畸形越严重。
在四个中心对182例特发性脊柱侧凸患者使用WRVAS，并结合关于患者及其父母对脊柱畸形看法的开放式问题。开放式回答被归类为“注意到畸形”或“未注意到畸形”。
WRVAS分数与侧弯程度密切相关（P = 0.01），并能清晰区分30度及以上的侧弯与较小的侧弯。在各治疗组中，建议手术的患者得分显著高于其他患者。该工具能区分未注意到畸形的患者和注意到畸形的患者。患者与父母的分数之间相关性较高（斯皮尔曼等级相关系数rho = 0.8）。当注意到畸形时，在肋骨突出、肩部水平、肩胛骨旋转和总分方面，父母给出的分数高于孩子，但在其他维度上并非如此。
WRVAS分数的增加与侧弯程度密切相关，为这类评估工具提供了结构效度。“建议手术”的患者在该量表上报告的可见畸形比观察、支具治疗和术后患者更多，支持了手术改善外观的假设。父母比患者更能察觉到肋骨和肩部的畸形，但在畸形的其他方面识别程度相同。WRVAS分数与侧弯程度和治疗显著相关。父母和患者的分数相似，但父母比患者更能察觉到肋骨和肩部的畸形。
