Brunner Hermine I, Klein-Gitelman Marisa S, Miller Michael J, Barron Andrea, Baldwin Nicole, Trombley Michael, Johnson Anne L, Kress Angie, Lovell Daniel J, Giannini Edward H
Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
J Rheumatol. 2005 Jan;32(1):150-61.
The Childhood Health Assessment Questionnaire (CHAQ) is a commonly used measure of disability and physical function for children with juvenile rheumatoid arthritis (JRA), whose scores range between 0 (no disability) and 3 (very severe disability), with a smallest potential difference in the CHAQ score of individuals at 0.125. We estimated minimal clinically important differences (MCID) of the CHAQ for worsening and improvement that were actually experienced by children with JRA using patient, parent, and clinical perspectives.
Changes in CHAQ scores were calculated for parent (n = 92) and patient ratings (children age > or = 8 yrs only; n = 67) between subsequent clinic visits. Changes in patient well being and disease activity and the occurrence of flare or important improvement between visits served as external standards for the MCID. MCID were defined as the median changes of the CHAQ scores of individual patients who had a minimal important improvement or worsening between visits.
The median change in CHAQ scores of patients who rated themselves or were rated by others as unchanged was often 0. Depending on the external standard used, the MCID for improvement of the CHAQ was -0.188 at most, while the MCID for worsening was at most +0.125.
The MCID of the CHAQ for both improvement and worsening are often at or close to the level of the smallest potential difference, suggesting that the CHAQ is relatively insensitive to important short term changes in children with JRA. This may warrant a change in the calculation of the global CHAQ score, or the development of more sensitive functional measures.
儿童健康评估问卷（CHAQ）是一种常用于评估幼年类风湿性关节炎（JRA）患儿残疾程度和身体功能的工具，其评分范围为0（无残疾）至3（非常严重的残疾），CHAQ评分中个体的最小潜在差异为0.125。我们从患者、家长和临床角度估计了JRA患儿实际经历的CHAQ恶化和改善的最小临床重要差异（MCID）。
计算了92名家长和67名患者（仅年龄≥8岁的儿童）在后续门诊就诊之间CHAQ评分的变化。患者健康状况和疾病活动的变化以及就诊期间病情复发或显著改善的情况作为MCID的外部标准。MCID被定义为就诊期间有最小重要改善或恶化的个体患者CHAQ评分的中位数变化。
自我评分或被他人评为无变化的患者CHAQ评分的中位数变化通常为0。根据所使用的外部标准，CHAQ改善的MCID最多为-0.188，而恶化的MCID最多为+0.125。
CHAQ改善和恶化的MCID通常处于或接近最小潜在差异水平，这表明CHAQ对JRA患儿的重要短期变化相对不敏感。这可能需要改变CHAQ总分的计算方式，或者开发更敏感的功能测量方法。
